Urine Tests: A Case-Based Guide to Clinical Evaluation and Application PDF
Preview Urine Tests: A Case-Based Guide to Clinical Evaluation and Application
Urine Tests A Case-Based Guide to Clinical Evaluation and Application Victoria J. A. Sharp Lisa M. Antes M. Lee Sanders Gina M. Lockwood Editors 123 Urine Tests Victoria J. A. Sharp • Lisa M. Antes M. Lee Sanders • Gina M. Lockwood Editors Urine Tests A Case-Based Guide to Clinical Evaluation and Application Editors Victoria J. A. Sharp Lisa M. Antes Department of Urology and Department of Internal Department of Family Medicine Medicine University of Iowa Division of Nephrology Iowa City, IA University of Iowa USA Iowa City, IA USA M. Lee Sanders Department of Internal Gina M. Lockwood Medicine Department of Urology Division of Nephrology University of Iowa University of Iowa Iowa City, IA Iowa City, IA USA USA ISBN 978-3-030-29137-2 ISBN 978-3-030-29138-9 (eBook) https://doi.org/10.1007/978-3-030-29138-9 © Springer Nature Switzerland AG 2020 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of transla- tion, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimi- lar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publi- cation. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Preface Consider a medical environment in which urine tests are not readily available for interpretation. Urinalysis for identifica- tion of blood and glucose, urine culture for diagnosis of uri- nary tract infection, and urine pregnancy and drug screening are just a few of the urine tests that have become mainstays in modern medical practice. More recent technological advances in laboratory testing have allowed for expansion of urine-based testing; they are now considered accurate, noninvasive, and cost-effective options for diagnosis of sexually transmitted infections, renal insufficiency, and even cancer screening. Urine Tests: A Case-Based Guide to Clinical Evaluation and Application was conceived in response to the recognition that urine tests are essential in both inpatient and outpatient care settings, yet no clinically based resource exists devoted to understanding their nuances. Appropriate collection, analysis, and interpretation of urine for testing are essential for the diagnosis and management of both common and rare patient concerns. Thus, a handbook describing urine collec- tion technique, methods of analyzing urine, specific tests available, and interpretation for simple and complex diagno- ses is an essential tool. This book is a collaborative effort between specialists, pri- mary care providers, administrators, and researchers who have expert knowledge of urine testing. The authors of this book perform urine testing on patients daily and fully under- stand the advantages and pitfalls of urine-based tests. The v vi Preface focus of this book is to provide practical knowledge and clini- cally relevant scenarios for urine-based tests in order to improve overall patient care. Iowa City, IA, USA V.J.A. Sharp Iowa City, IA, USA L.M. Antes Iowa City, IA, USA M.L. Sanders Iowa City, IA, USA G.M. Lockwood Abbreviations AAP American Academy of Pediatrics ACEi Angiotensin-converting enzyme inhibitor ACR Albumin creatinine ratio ADH Antidiuretic hormone AFB Acid-fast bacillus (bacilli) AG Anion gap AIN Acute interstitial nephritis AKI Acute kidney injury ANA Antinuclear antibody ANC Absolute neutrophil count ANCA Antineutrophil cytoplasmic antibodies Anti-dsDNA Anti-double stranded DNA antibodies APOL1 Apolipoprotein L1 ARB Angiotensin II receptor blocker ARR Aldosterone:renin ratio ASO Anti-streptolysin O ATN Acute tubular necrosis AUA American Urological Association BCG Bacille Calmette-Guérin β-hCG beta-human chorionic gonadotropin BMP Basic metabolic panel BP Blood pressure BPH Benign prostatic hyperplasia BUN Blood urea nitrogen C Celsius C3 Complement C3 C3GN Complement C3 glomerulonephritis vii viii Abbreviations C4 Complement C4 Ca Calcium c-ANCA/PR3 cytoplasmic antineutrophil cytoplasmic anti- bodies/proteinase 3 CBC Complete blood count CBC w/diff Complete blood count with differential CDC Centers for Disease Control and Prevention CDI Clostridium difficile infection CFU Colony-forming unit CK Creatinine kinase CKD Chronic kidney disease Cl Chloride CLIA C linical Laboratory Improvement Amendments CMS Centers for Medicare and Medicaid Services CNS Central nervous system CPT Current Procedural Terminology Cr Creatinine CT Computed tomography CTU Computed tomography urography CVD Cardiovascular disease DDAVP Desmopressin DDD Dense deposit disease DI Diabetes insipidus DKA Diabetic ketoacidosis dL deciliter DM Diabetes mellitus DNA Deoxyribonucleic acid DRE Digital rectal exam EAU European Association of Urology ED Emergency department EGPA E osinophilic granulomatosis with polyangiitis ELISA Enzyme-linked immunosorbent assay ENaC Epithelial sodium channel ESRD End-stage renal disease F Fahrenheit or French size FDA Food and Drug Administration FeNa Fractional excretion of sodium FeUrea Fractional excretion of urea Abbreviations ix FISH Fluorescence in situ hybridization FSGS Focal segmental glomerulosclerosis g gram GBM Glomerular basement membrane GC-MS Gas chromatography-mass spectrometry GFR Glomerular filtration rate GI Gastrointestinal GPA Granulomatosis with polyangiitis GU Genitourinary H Hydrogen (hydronium) HO Water 2 HO Hydrogen peroxide 2 2 HAGMA High anion gap metabolic acidosis Hb, Hgb Hemoglobin HBV Hepatitis B virus HCO Bicarbonate 3 HCPCS Healthcare Common Procedure Coding System HCV Hepatitis C virus HIV Human immunodeficiency virus hpf high power field HPLC/MS High-performance liquid chromatography mass spectrometry HPV Human papilloma virus HTN Hypertension IDSA Infectious Diseases Society of America IgA Immunoglobulin A IgAN Immunoglobulin A nephropathy IgM Immunoglobulin M INR International normalized ratio IV Intravenous K Potassium KDIGO Kidney Disease Improving Global Outcomes kg kilogram KOH Potassium hydroxide KUB Kidney, ureter, and bladder x-ray L Liter LC/MS Liquid chromatography mass spectrometry LE Leukocyte esterase x Abbreviations LMW Low molecular weight LN Lupus nephritis lpf low power field LSD Lysergic acid diethylamide MAR Medication Administration Record Mb Myoglobin MCD Minimal change disease mEq milliequivalent mg milligram Mg Magnesium MGN Membranous nephropathy mL milliliter mm millimeter mmol millimole mOsm milliosmole MPA Microscopic polyangiitis MPGN Membranoproliferative glomerulonephritis MRI Magnetic resonance imaging MRU Magnetic resonance urography Na Sodium NAAT Nucleic acid amplification test NAGMA Non-anion gap metabolic acidosis NH Ammonia 3 NH Smmonium 4 nm nanometer NPV Negative predictive value NSAID Nonsteroidal anti-inflammatory drug PAC Plasma aldosterone concentration p-ANCA/ MPO-ANCA perinuclear antineutrophil cytoplasmic antibodies/myeloperoxidase antineutrophil cystoplasmic antibodies Pap Papanicolaou PCA3 Prostate cancer antigen 3 PCH Paroxysmal cold hemoglobinuria PCN Percutaneous nephrostomy PCNL Percutaneous nephrolithotomy PCP Phencyclidine PCR Protein creatinine ratio OR polymerase chain reaction
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