So, how should we judge whether there is something wrong with our kidneys?
The simplest method is undoubtedly a physical examination once a year, mainly to see urine routine and blood creatinine.
What about health? What inspection indicators do I need to check? How should I look at it? "img _ height =" 463 "img _ width =" 750 "data-src ="//imgq7.q578.com/ef/0322/ad 7109de7bf15dbd.jpg "src ="/a. Since many people ask what urine routine should look at, here are some other indicators:
1. Color of urine
Normal people's urine color is light yellow, but with the change of water consumption, exercise and diet, urine color will be slightly different. Urine color is too light and too deep. Pay attention to brown, dark brown, red and milky white urine. However, it should be reminded that some foods or drugs can also cause urine discoloration. For example, ingestion of beet, rhubarb or senna leaves may lead to red urine, rifampicin may lead to orange urine, and cimetidine may lead to green or blue-green urine.
2. Urine turbidity
Most fresh urine of normal people is clear and transparent. In addition to urine contaminated by female secretions and left for too long, urine turbidity is more common in urate crystals, chyluria, pyuria and hematuria.
What about health? What inspection indicators do I need to check? How should I look at it? "img _ height ="1024 "img _ width =" 685 "data-src ="//imgq7.q578.com/ef/0322/f0f984fdbb67e48e.jpg "src ="/a2020/img/.
Urine pH value can reflect the ability of kidney to regulate acid-base balance of body fluids. Under normal diet, the urine pH value is generally 4.5~8.0 (the inspection index range of some hospitals is 5.4~8.4). The decrease of PH value to acidic urine is mainly seen in acidosis, high fever, dehydration, gout and so on. If you take acidic drugs such as vitamin C, the urine pH will also decrease; The increase of pH value is alkaline urine, which is mainly seen in alkalosis, urinary retention, urinary system infection and the use of alkaline drugs such as sodium bicarbonate.
4. Urine specific gravity
The specific gravity of urine mainly depends on the concentration and dilution function of kidney. The urine proportion of normal people will fluctuate greatly due to different conditions such as diet, sweating and urination. The specific gravity of random urine sample is 1.003 1.030. The increase of urine specific gravity can be seen in patients with oliguria, acute nephritis, high fever, cardiac insufficiency and dehydration. The increase of urine specific gravity is accompanied by the increase of urine volume, which is common in diabetes. The decrease of urine specific gravity is common in diseases that affect urine concentration function, such as drinking a lot of water, chronic glomerulonephritis, diabetes insipidus, renal insufficiency and so on.
5. Urinary granulocyte esterase
If the index is positive, there may be urinary tract bacterial infection, and it is necessary to evaluate whether there is urinary tract infection by combining urine white blood cells, bacterial culture and clinical symptoms.
6. Nitrite in urine
Under normal circumstances, there is no or only a small amount of nitrite in urine, and positive is common in urinary tract bacterial infections. Gram-negative bacilli can reduce nitrate in urine to nitrite and determine whether there is nitrite in urine. Combined with urine granulocyte esterase and bacterial examination, we can know whether there is bacterial infection in urinary system.
7. Urinating sugar
Under normal circumstances, there should be no glucose in urine, and the test result is negative for urine sugar. If "+"appears, diabetes should be diagnosed first. The more "+",the higher the urine glucose content. In addition, there are diabetes, chronic nephritis, nephrotic syndrome and hyperthyroidism. There may be urine sugar positive, such as normal blood sugar and abnormal urine sugar. Pay attention to whether it is caused by ingesting a lot of sugar, and the specific reasons need further examination and diagnosis. In addition, SGLT-2 inhibitors such as Dapagliflozin and Engleggin can also cause multiple "+"in urine sugar.
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Under normal circumstances, urine protein should not appear in urine. When there is "+"in urine protein, it suggests that there may be kidney disease, and the more "+",the more serious the condition is. It should be noted that strenuous exercise, high fever and high protein diet may also cause proteinuria, but the proteinuria caused by these reasons generally does not exceed a "+". When evaluating renal diseases, we will further do a 24-hour urine protein quantitative examination, and the 24-hour urine protein quantitative >: 150mg can be diagnosed as proteinuria, >; 3.5g is massive proteinuria.
9. Urine ketone body
The urine ketone body qualitative test of normal people is negative. When there is hunger, glucose metabolism disorder and diabetic ketoacidosis caused by various reasons, ketonemia may occur because the speed of ketone body production is greater than the speed of tissue utilization, and then ketonuria may occur. Positive urine ketone bodies are often associated with diabetes, pregnancy, malnutrition and chronic diseases, such as diabetic ketoacidosis, and may also be caused by severe diarrhea, vomiting, hunger, phosphorus poisoning and taking metformin.
10. Urine bilirubin
Under normal circumstances, urinary bilirubin is negative. "+"is usually closely related to jaundice, and the increase of urinary bilirubin is usually manifested as deepening urine color and dark brown color. Urinary bilirubin positive is common in liver parenchyma or obstructive jaundice. It is suggested to go to the outpatient department of nephrology and gastroenterology to further improve the relevant examinations and clarify the cause.
1 1. uridine
Uridine is converted from bilirubin, so when the bilirubin value in the blood rises, jaundice will appear, and if excretion is not blocked, the value of uridine will also rise. The results of urine urobilinogen should be analyzed together with the results of urine bilirubin examination.
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Under normal circumstances, centrifugal urine is generally no more than 3 per HP red blood cell, which is negative for urine occult blood. If there are more than three red blood cells in each high-powered field, it is called microscopic hematuria. If there are more red blood cells, besides nephritis and nephropathy, urinary inflammation or calculus, urinary tract mucosa injury, tuberculosis and tumor can all cause occult blood to be positive, and myoglobinuria and hemoglobinuria can also cause occult blood to be positive. For those who have no clinical symptoms and have positive urine occult blood, they should be reviewed regularly. Some drugs may also cause occult blood in urine, such as warfarin, aspirin and other antithrombotic drugs. Generally, the source of red blood cells in urine is identified by combining urine phase contrast microscope examination and evaluation. If there is a red blood cell cast in urine, it is helpful to determine glomerular hematuria.
13. Urine leukocytes
There may be a small amount of white blood cells in normal urine. Generally, the number of white blood cells per HP is 1~2, which is within the normal range. If there are more than 5 white blood cells in each high-power field, it is called pyuria under the microscope. When the number of white blood cells increases obviously, it generally indicates urinary system infection, such as pyelonephritis, cystitis and urethritis. However, it should be noted that there are many factors affecting urinary leukocytes: when inflammation occurs in the reproductive system of adult women, vaginal secretions are easily mixed with urine, resulting in false positive; But leaving urine for too long will lead to leukopenia, resulting in false negative.
What about health? What inspection indicators do I need to check? How should I look at it? "img _ height =" 521"img _ width =" 736 "data-src ="//imgq7.q578.com/ef/0322/da882e5adc850113.jpg. In muscle, creatine is metabolized to form creatinine, which is released into the blood and excreted with urine. Creatinine is a small molecular substance, which can be filtered by glomerulus and rarely absorbed by renal tubules. Creatinine produced in the body is excreted with urine almost every day, and is generally not affected by urine volume.
Serum creatinine concentration is a commonly used method to evaluate glomerular filtration function, but its sensitivity is low, which can not reflect early renal damage, and often starts to increase when glomerular filtration function is damaged by 50%. In addition, serum creatinine concentration may be affected by sex, age, muscle mass, protein intake and some drugs (such as cimetidine).
What about health? What inspection indicators do I need to check? How should I look at it? " img _ height = " 8 16 " img _ width = " 1280 " data-src = "//imgq 7 . q 578 . com/ef/0322/b 7306204 ade 7 1 D4 c.jpg "src ="/a2020/img/data-img.jpg "> Different hospitals may have different standards to measure the normal range of serum creatinine. Clinically, the creatinine value, gender, age and weight of patients are generally substituted into relevant formulas to calculate creatinine clearance rate or glomerular filtration rate and evaluate the severity of renal insufficiency. When creatinine clearance rate