Laboratory Test:

1. 升高：serum K+, P, BUN, Creatinine

2. 降低：serum Ca2+, pH (acidosis)

3. CBC檢查：

  • WBC: 以判定病患是否有infection，sepsis
  • eosinophil↑: acute interstitial nephritis
  • hematouria: 常和Proteinuria一起出現àacute intrinsic ARF

4. Proteinuria(尿蛋白): 無特異性；只能說有renal failure的多半有此現象，他只能代表glomerular damage，而無法斷定是否為"acute"；另外tubule damage也有可能出現proteinuria，因無法再吸收"小"分子蛋白。

5. Urinary microscopy: 尿液中若含有crystal, casts, cells可以分辨出病因

Urine sediment

Suggestive of

Cells

Microorganism

RBC

 

WBC

Eosinophill

 

Epithelial cells

 

Pyelonephritis

Glomerulonephritis, Pyelonephritis, renal infarction, renal tumor, kidney stone

Pyelonephritis, interstitial nephritis

Drug-induced allergic interstitial nephritis, renal transplant rejection

Tubular necrosis

Casts

Granular casts

WBC casts

RBC casts

 

Tubular necrosis

Pyelonephritis, interstitial nephritis

Glomerulonephritis, renal infarction,lupus nephritis, vasculitis

Crystals

Urate

Phosphate

 

Postrenal obstruction, nephrolithiasis

Alkaline urine, possible secondary to Proteus sp. Infection, Postrenal obstruction


6. Urine specific gravity↑(尿液比重)à prerenal ARF, 因濃縮尿液能力喪失，需在病患未使用glucosuria和mannitol的情況之下測才準。

 

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