The analysis of common test sheets in kidney examination shows that you don't have to bother the doctor in the future!

only high white blood cells and neutrophils are side effects of hormones.)3. Platelets:elevated blood indicates that the blood is sticky and easy to form thrombus;

Have you ever come across this situation: go to the doctor with your own test sheet and want the doctor to analyze it, but many doctors are always too busy to analyze, or send you away with a bad temper. But I feel helpless when I see so many "arrows" on the test sheet and don't know what it means.

Don't worry. Today, I will list and analyze the common laboratory indicators in the department of nephrology. I hope I can help you.

I. Blood routine

1. Hemoglobin: the index of judging whether there is anemia, between 90g L-normal value is mild anemia, between 60-89g/L is moderate anemia, below 60g/L is severe anemia, severe anemia needs blood transfusion.

two。 White blood cells: generally combined with neutrophils and lymphocytes, such as leukocytes and neutrophils rise at the same time, often for bacterial infection; if white blood cells are normal or decreased, the number of lymphocytes increases, generally indicating that there is a viral infection. (to explain here: hormones can lead to the increase of white blood cells and neutrophils. In case of infection, C-reactive protein and procalcitonin can be detected at the same time. If these two items are also high, it means that it is a bacterial infection. If it is not high, only high white blood cells and neutrophils are side effects of hormones.)

3. Platelets: elevated blood indicates that the blood is sticky and easy to form thrombus; when reduced, there is a tendency to bleed.

Second, urine routine

1. Urinary protein: positive generally indicates glomerular filtration membrane damage, the more the + sign, the more serious the injury. The common causes are renal immune inflammation, hypertension, hyperglycemia and so on.

two。 Occult blood: + number has no special significance, simple occult blood positive will not damage renal function. It is usually combined with urine red blood cell analysis.

3. Urinary red blood cells: also known as hematuria, need to do red blood cell deformation rate, such as deformed red blood cells > 60%, it is caused by glomerular injury; if the deformation rate is low, it is caused by extra-glomerular factors, such as stones, tumors and so on.

4. Urine glucose: it shows that there is glucose in the urine. There are two common possibilities in the past: one is that the blood sugar is high, which exceeds the reabsorption capacity of the kidney; the other is that the renal tubules are damaged and the ability to reabsorb glucose decreases. If blood sugar is normal, urine sugar is often caused by renal tubular injury. In addition to the above two cases, the use of glibenclamide drugs can also lead to positive urine sugar, but this is a normal reaction.

5. Urinary leukocytes: renal tubulointerstitial injury and urinary tract infection can be characterized by elevated urinary leukocytes. Urine culture can be identified, if there is bacterial growth in urine culture, it is caused by urinary tract infection; if there is no bacterial growth, and is not accompanied by frequent urination, urgency, pain and other discomfort, it is renal tubulointerstitial injury.

III. Great biochemistry

1. Potassium: elevation can be manifested as numbness at the ends of hands and feet, numbness at the tip of the tongue, slow heart rate, extreme fatigue, etc., and severe high potassium can cause sudden cardiac arrest and death. Generally oliguria, kidney failure in the middle and late stages, caused by uncontrolled diet, while some drugs may also lead to elevated blood potassium, such as spironolactone, sartan or pripril antihypertensive drugs and so on. The decrease can be manifested as limb weakness, abdominal distension, palpitation, and in severe cases, dyspnea, generally caused by polyuria, the use of diuretics, or renal tubular injury.

two。 Calcium: elevation is rare, for nephropathy is common in hyperparathyroidism, such as anorexia, nausea, constipation, fatigue, fatigue and so on. Decrease is more common in patients with renal failure and nephrotic syndrome, more calcium loss, less production, taking hormones can lead to calcium deficiency, such as muscle spasm (cramp), bone pain and so on.

3. Phosphorus: elevated in renal failure patients with phosphorus ion excretion disorders and secondary hyperparathyroidism, hyperphosphatemia characterized by skin pruritus. Therefore, we should eat a low-phosphorus diet and take phosphorus-lowering drugs at the same time, such as calcium, lanthanum carbonate and Sveram carbonate. Children who are in the period of growth and development can be shown to be physiologically elevated, ignore it.

4. Carbon dioxide binding capacity: increased to alkalosis, rare. Acidosis is common in chronic renal failure complicated with metabolic acidosis. Severe acidosis can lead to nausea and vomiting, arrhythmia, dyspnea and life danger, so sodium bicarbonate is used to correct it.

5. Glutamic pyruvic transaminase: elevated indicates damage to liver function.

6. Glutamic oxaloacetic transaminase: elevated indicates liver injury, cardiomyocyte and muscle cell damage.

7. Albumin: is the human body's nutrients, reduced when seen in glomerulonephritis and nephrotic syndrome, a large number of urinary protein leakage, diet control is too strict caused by malnutrition.

8. Globulin: increased in lupus, multiple myeloma, liver cirrhosis, alcoholic liver, etc.; decreased immunity is more common in nephritis, kidney syndrome, a large number of urinary protein leakage.

9. Urea nitrogen: one of the indicators of renal function, is also one of the most common toxins, its toxicity is much greater than creatinine, chronic renal failure or uremia patients common nausea, vomiting, ammonia taste, mental disorders, bleeding, cardiomyopathy and so on, are urea nitrogen "credit". So urea nitrogen should get more attention.

10. Creatinine: needless to say, an important marker of renal function damage, but also a standard for the staging of chronic renal failure. The higher creatinine is, in most cases, the renal damage is more severe, but it is not toxic and is only a marker of renal damage. The decrease of creatinine can be seen in malnutrition, muscle atrophy and disability.

11. Uric acid: the increase can be seen in renal function damage, abnormal self-metabolism and excessive intake of high purine diet. But uric acid is an index that can be independent of renal function, that is to say, people with normal renal function can also have hyperuricemia, and the increase of uric acid has nothing to do with renal function. No matter what causes the long-term increase of uric acid, it may cause gouty arthritis and kidney damage. Slight increase in uric acid can be regulated by a controlled diet, such as significantly elevated, with the help of drugs.

twelve。 Cystatin C: an early indicator of renal function damage, that is, before creatinine increases, cystatin C will be the first to increase, indicating early renal injury, which should be paid attention to for people who think that renal function is still normal. When there is infection, people who take hormone may also lead to the increase of cystatin C, which should be noted.

13. Triglyceride, cholesterol: elevated to hyperlipidemia, nephrotic syndrome can lead to lipid metabolic disorders of hyperlipidemia (mainly elevated cholesterol).

14. Low density lipoprotein cholesterol: high is not good, low is good. High density lipoprotein cholesterol is not good if it is low, but it is good if it is high. So ignore it when you encounter an increase in high-density lipoprotein cholesterol and a decrease in low-density lipoprotein cholesterol.

Quantification of 24-hour urinary protein

The normal range is 0.03-0.15g (each hospital may vary).

It is considered to be 100 points within 0.3g, 90 points within 0.5g, and almost no effect on renal function within 0.5g. 60 points in 1g, just passing.

Within 1g, a small amount of albuminuria, 1-3.5g moderate albuminuria, and more than 3.5g massive albuminuria.

Fifth, urine microalbumin: "trace" means very little, when the excretion of urine protein is very small, it is not enough to make urine protein plus sign in urine routine, which represents early kidney damage. When there is a significant plus sign in urine protein, this test is equivalent to the amount of 24-hour urine protein and has no separate significance.

VI. Antinuclear antibody series

1. Positive antinuclear antibody (ANA): can be seen in systemic lupus erythematosus, rheumatoid arthritis, mixed connective tissue disease, Sjogren's syndrome, scleroderma and other autoimmune diseases.

two。 Anti-SM antibody: systemic lupus erythematosus is a highly specific antibody, but the positive rate is low, so negative can not rule out lupus.

3. Anti-sDNA antibody: it is a specific antibody of systemic lupus erythematosus, with a high positive rate of 60-90%. It is a marker of lupus activity.

4. Anti-SSA and SSB antibodies: positive is associated with Sjogren's syndrome and lupus.

5. Anti-ribosomal P protein antibody: helpful in the diagnosis of neurological lesions caused by lupus.

VII. Immune function

1. Immunoglobulin G: an important antibody for the human body to resist the invasion of "foreign enemies". The decrease indicates low resistance and is common in nephrotic syndrome (massive urinary protein leakage) and immunosuppression (use of hormones and immunosuppressants). Elevation is often seen in pathological conditions: systemic lupus erythematosus, IgG multiple myeloma.

two。 Immunoglobulin A: when IgA nephropathy is highly considered without renal puncture, the increase of immunoglobulin An in the blood indicates that IgA nephropathy is more likely.

3. Immunoglobulin M: elevation is seen in recent infections.

4. Complement C3: reduction is common in three cases, acute glomerulonephritis, membranous proliferative glomerulonephritis, lupus nephritis, the first is easy to cure, the second pathological type is poor, lupus nephritis needs to see the specific classification.

Parathyroid hormone

Parathyroid hormone (PTH): increased in renal failure, high phosphorus and decreased renal excretion capacity is the reason for its increase. Parathyroid hormone itself is a medium molecular toxin that can cause renal osteopathy. Calcitriol treatment is recommended when the index is greater than 300pg/ml, and can be regulated by calcium supplement and phosphorus lowering drugs within 300pg/ml.

IX. Iron metabolism

1. Transferrin saturation: represents available iron

two。 Ferritin: stands for stored iron

When the above two items are reduced or treated with erythropoietin, routine iron supplementation is needed, which can be taken orally or intravenously. The absorption rate of intravenous iron supplementation is high.

Blood clotting function: fibrinogen and D-dimer are elevated, suggesting that the blood is in a state of high coagulation and high viscosity, which is easy to form thrombus, which is common in nephritis and nephrotic syndrome and needs anticoagulation treatment.

11. Glomerular filtration rate: the reference standard for the international staging of chronic kidney disease, and it is also the standard to measure the degree of renal function injury, which is divided into 5 stages. It is necessary to create a contrast agent, which is not suitable for patients with obvious damage to renal function.

12. Endogenous creatinine clearance rate: similar to glomerular filtration rate, there are many ways to calculate it, which is not as accurate as glomerular filtration rate. The advantage is that it does not need to make contrast agent and can be examined through blood and urine, without the risk of kidney injury.

Urine creatinine: creatinine excreted in urine, generally not seen alone, needs to be analyzed together with urine protein, such as urine protein / urine creatinine and 24-hour urine protein quantity have a good correlation, used to evaluate urine protein excretion.

Well, the above is the content of today, if you still do not understand, you can consult in detail!

I'm he Xuehong, a professor of traditional Chinese medicine. You have questions about kidney disease. You are welcome to leave a message in the comments section.