Decoding Your Lab Report (Continued)
Name That Test
- Microalbumin—Often ordered as a microalbumin/creatinine ratio, this is a test that measures very small amounts of protein in the urine (microalbuminuria). It is a symptom of the very early stages of kidney disease. Microalbumin is usually measured annually.
- Creatinine Clearance—helps detect and evaluate kidney dysfunction or decreased blood flow to the kidneys.
- eGFR –Estimated Glomerular Filtration Rate assesses kidney function.
- CMP—Comprehensive Metabolic Panel is a frequently ordered panel of tests that gives your doctor important information about the current status of your kidneys, liver, and electrolyte and acid/base balance as well as of your blood sugar and blood proteins.
- BUN—evaluates kidney function or monitors the effectiveness of dialysis and other treatments related to kidney disease or damage.
- Creatinine—determines if your kidneys are functioning normally and monitors treatment for kidney disease.
- Cystatin C—helps detect and monitor acute and chronic kidney dysfunction.
Related tests: BUN/creatinine ratio; BMP
Random urine samples are tested for glucose, protein, and ketones during a physical. However, this is not a good test for blood sugars slightly above normal because glucose is only found in the urine when the kidney is not able to filter the excess sugar. Also, urine can stay in the bladder for hours so it is not a good indicator of current blood plasma glucose levels.
- Ketones—not normally found in the urine, the presence of ketones can indicate insufficient insulin.
- Urinalysis—screens for metabolic and kidney disorders and for urinary tract infections.
- Urine Specific Gravity – measure of how concentrated the urine is to help the physician evaluate if the sample is the best one to detect a particular sample. Urine is usually most concentrated in the morning.
- Urine glucose – Glucose is normally not present in urine. When glucose is present, the condition is called glucosuria and it results from high blood glucose levels, such as may be seen in people with diabetes.
- Ketones – Ketones are not normally found in urine. Ketones in urine can give an early indication of insufficient insulin.
- Blood – This test is used to detect hemoglobin in the urine, which indicates blood in the urine. Increased levels of blood in the urine can be due to numerous diseases of the kidney and urinary tract.
- Protein – Measures the amount of albumin in the urine. Albumin is an early indicator of kidney dysfunction. If blood sugar levels are high, it taxes the kidneys, and the increased pressure results in protein spilling into the urine.
- Bilirubin – Bilirubin is not present in the urine of normal, healthy individuals. Presence of bilirubin in urine is an early indicator of liver disease.
- Urobilinogen – Urobilinogen is normally present in urine in low concentrations. This test helps detect liver diseases as well as biliary obstructions.
- Nitrite – Normally the urinary tract and urine are free of bacteria. When bacteria are present, they can convert nitrate to nitrite in your urine. A positive nitrite test can indicate a urinary tract infection.
- Microscopic Examination – After urine has been centrifuged, the concentrated urine sediment is examined to count and identify substances:
- RBC microscopic – Normally, a few RBC's are present in urine sediment. Inflammation, injury, or disease in the kidneys can cause increased levels of RBC's.
- WBC microscopic – The number of WBC's in urine is normally low. When the number is high, it indicates infection or inflammation in the urinary tract.
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In junior high school, I'd gotten my hands on one of my father's old English books and read a story by Nathaniel Hawthorne, "The Great Stone Face". The story is based on the natural mountain/rock formation in New Hampshire of the same name (you can see an image of it on New Hampshire state quarters). In the story, there was a legend that the person whose face looked like The Great Stone Face would be "the...