Terms Definition and Evaluation of

Mandolang Frankie

 Hematuria
Abnormal presence of blood in the urine More than three red cells per high-power field on at least two occasions.

Initial Hematuria: Bleeding at the start of urination

-Indicates urethral pathology

Terminal Hematuria: Bleeding at the end of urination

- Indicates pathology of the bladder neck, posterior urethra, or prostate.

Total Hematuria: Bleeding throughout urination

- Indicates pathology above the bladder neck

 Proteinuria
Excessive protein excretion in the urine, generally greater than 150-160 mg/24hr in adults.

Transient proteinuria : normal renal function, bland

urine sediment, normal blood pressure, absence of significant edema, quantitative protein excretion of usually less then 1g/day; that is not indicative of significant underlying renal disease, and the proteinuria disappears upon repeat testing

 Orthostatic proteinuria thin adolescents or adults younger than

30 years (may be associated with severe lordosis); renal function is normal and proteinuria usually is less than 1g/day; overnight urine collection shows normal protein excretion ( <50 mg during 8h period)

Persistent proteinuria due to extrarenal disease Renal function is

normal, urine sediment is bland, blood pressure is normal, significant edema is absent, and quantitative albumin excretion usually is less than 500 mg/day; this is not usually indicative of clinically progressive, underlying renal disease

Persistent proteinuria in excess of 500 mg/day is more likely the

result of significant glomerular disease

Edema

Generalized edema is the excessive accumulation of

interstitial fluid throughout the body.

Facial edema refers to either localized swelling for

example, around the eyes or more generalized facial swelling that may extend to the neck

Leg edema results when excess interstitial fluid

accumulates in one or both legs.

Methods of evaluating hematuria

URINALYSIS

Dip strip analysis is critically important in patients with dark

or abnormal appearing urine because several substances may discolor the urine and give the appearance of hematuria.

The urine dipstick test is currently one of the most useful

and sensitive tools in detecting hematuria. This test is based on the peroxidase activity of hemoglobin (rather than the presence of RBCs) and myoglobin.

Confirmation requires a microscopic examination of the

urine for the presence of RBCs and casts.

A freshly voided urine specimen should be used.

Methods of evaluating proteinuria

Evaluation of proteinuria by urinary dipstick primarily
detects albumin and intact globulins, while overlooking positively charged light chains of immunoglobulins. These proteins can be detected by the addition of sulfosalicylic acid to the uric specimen. Precipitation indicates the presence of paraproteins.

The next step is a 24-hr urine collection. A finding of

greater than 150-160 mg/24 hr is abnormal, and greater than 3.5g/24 hr is consistent with nephroticrange proteinuria.