| At the outset, it may be said that in
| |
| | sample by vaginal secretion/ seme~f the
|
| case there is any predisposing/
| |
| | previous night's intercourse. Hence the
|
| obstructive factor (like urinary stones,
| |
| | importance of proper washing of the whole
|
| benign enlargement of prostate,
| |
| | area, especially in women, before giving
|
| congenital abnormalities of urinary
| |
| | the sample, is again emphasised. And, if
|
| tract, etc.), it must be investigated and
| |
| | still, in spite of all such precautions,
|
| treated according to the lines already
| |
| | traces of albumin in the urine persist,
|
| described. The various tests required for
| |
| | the albumin should be measured in 24-hour
|
| the diagnosis/treatment of UTI are as
| |
| | urine, and normally it should be less
|
| under: 1. Examination of urine It is one
| |
| | than 3.0 g per day. However, presence of
|
| of the most important tests, and it
| |
| | albumin in urine is an important finding
|
| should not be taken casually. It
| |
| | for kidney damage, not only due to
|
| indicates whether the patient is
| |
| | pyelonephritis, but also due to other
|
| suffering from UTI or not especially,
| |
| | diseases of the kidneys. It tells us that
|
| when symptoms of cystitis/pyelonephritis
| |
| | the patient is passing into the chronic
|
| are not marked, or happen to be
| |
| | stage, although he/she may remain
|
| completely absent. The urine specimen for
| |
| | asymptomatic. Hence a periodical
|
| test in laboratory should be very
| |
| | examination of urine is an important
|
| carefully collected, keeping the
| |
| | factor to assess the extent of kidney
|
| following steps strictly in view: (i) The
| |
| | damage. 3. Blood urea and serum
|
| specimen should be from midstream. The
| |
| | creatinine tests Normal levels of blood
|
| patient must pass some urine outside,
| |
| | urea range from 15-35 mg/ dl with an
|
| before passing the urine in a sterilized
| |
| | average' of 25 mg/ dl. Normal serum
|
| container. (ii) Before giving the sample
| |
| | creatinine leve1s range from 0.8 to 1.4
|
| of urine, wash the whole area properly so
| |
| | mg/ dl, the average being 1.00 mg/ dl.
|
| that there is no contamination of E.
| |
| | Both these tests should be carried out in
|
| coli, especially in women. (iii) The
| |
| | order to be on the safe side, although
|
| specimen should be given in laboratory as
| |
| | blood urea is a simple test and serum
|
| urine sample often gets spoiled, on the
| |
| | creatinine a little more difficult to
|
| way to the laboratory. (iv) Second
| |
| | carry out - serum creatinine is more
|
| morning sample is always preferred. In
| |
| | sensitive than blood urea. If the levels
|
| the first morning sample, some changes
| |
| | of serum creatinine are 1.5 mg/ dl,
|
| are likely to occur due to overnight
| |
| | although the kidneys may be fairly
|
| standing of urine, in the urinary
| |
| | damaged, it is still considered early.
|
| bladder. 2. Urine for culture and
| |
| | When levels of serum creatinine are
|
| sensitivity If the examination of urine
| |
| | raised to the extent of 3.5 to 5.5 mg/
|
| shows the presence of pus cells, the
| |
| | dl, the kidneys may still be said to be
|
| urine should be given in the laboratory
| |
| | moderately damaged and one should not
|
| for culture and sensitivity. It may be
| |
| | lose time in initiating the necessary
|
| noted that 0-5 pus cells and 0-1 RBC (a
| |
| | tests arid treatment. But if levels of
|
| little more in females, and markedly if a
| |
| | serum creatinine rise above 8 mg/ dl, it
|
| woman is in mensis) per high power field
| |
| | means that the kidneys are severely
|
| may be normally present in urine,
| |
| | affected, leading to renal failure,
|
| especially when there is no associated/
| |
| | requiring urgent dialysis. 4. 24-hour
|
| contributing factor to UTI. The report of
| |
| | creatinine clearance It is much more
|
| culture and sensitivity is usually
| |
| | reliable than the serum creatinine test.
|
| available after 48-72 hours, and it
| |
| | But it is somewhat cumbersome as in this
|
| guides the physician regarding the
| |
| | test, a 24-hour collection of urine is
|
| administration of antibiotics in a
| |
| | required. It may be carried out to
|
| particular case. The treatment of UTI may
| |
| | diagnose very early cases, wherever
|
| not be possible without this test, and
| |
| | facilities exist. 5. Ultrasonographic
|
| the entire course of treatment depends
| |
| | examination It must be carried out in
|
| upon the report of this test. Therefore,
| |
| | each and every case of UTI. It is a
|
| it should be carried out by an
| |
| | non-invasive test and usually gives
|
| experienced laboratory technician and the
| |
| | valuable information regarding occult
|
| urine must be collected under strict
| |
| | causes of UTI. For example, there may be
|
| aseptic conditions. Besides the
| |
| | an asymptomatic stone lying in the
|
| examination of pus cells, as well as of
| |
| | urinary tract, or there may be some
|
| the culture and sensitivity of the urine,
| |
| | congenital abnormality of the kidneys
|
| a complete detailed routine examination
| |
| | causing obstruction in the urinary tract,
|
| of the urine must be carried out so that
| |
| | or there may be an early enlargement of
|
| any other abnormality, if present, can
| |
| | the prostate, in the case of males. 6.
|
| also be considered while treating the
| |
| | Plain X-ray abdomen, intravenous
|
| case. Many a time one finds in the urine
| |
| | pyelography These may be required
|
| analysis report, traces of albumin,
| |
| | depending upon the case. 7. Renal/kidney
|
| although there is no apparent cause of
| |
| | biopsy It may be indicated to know about
|
| passing albumin in urine in the concerned
| |
| | the exact nature of pathology causing
|
| case. Traces of albumin in urine could be
| |
| | renal damage.
|
| due to the contamination of the urine
| |
| |
|
