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What is a Urinalysis?
A urinalysis is a laboratory test of urine commonly referred to by medical professionals as a “UA.” The urine is evaluated for the presence of certain chemicals. A microscopic exam of the urine is also done to look for abnormalities.
A urinalysis is indicated for evaluating pets with urinary abnormalities such as increased urine production, increased urinary frequency, straining to urinate, bloody urine or abnormal color to the urine. This test can also be helpful in cases of unexplained fever, loss of appetite or weight loss. A urinalysis is often done when indicated by the results of an X-ray, results of blood tests indicating a problem with the urinary system or as a follow up to physical examination when abnormalities are detected.
Any evaluation for health or illness should include a urinalysis. Urinalysis results can give an idea of hydration and kidney function; it can also indicate inflammation or infections in the urinary tract.
There is no real contraindication to performing this test. Even normal results help determine health or exclude certain diseases.
Why Is It Done?
Perhaps you might have noticed that even when you go for your routine health checkup, the physician would suggest you to undergo a urine examination. Similarly, when you approach the doctor for a certain specific ailment, then also the physician may suggest you to undergo a urine test. This test is necessary because urine provides considerable data to the physician to ascertain the cause of your ailment. Urine examination is very important as it indicates the state of your general health. A urinalysis is done for several reasons:
- To check your overall health: Your doctor may recommend a urinalysis as part of a routine medical exam, pregnancy checkup, pre-surgery preparation, or on hospital admission to screen for a variety of disorders, such as diabetes, kidney disease and liver disease.
- To diagnose a medical condition: Your doctor may suggest a urinalysis if you're experiencing abdominal pain, back pain, frequent or painful urination, blood in your urine, or other urinary problems. A urinalysis may help diagnose the cause of these symptoms.
- To monitor a medical condition: If you've been diagnosed with a medical condition, such as kidney disease or a urinary tract disease, your doctor may recommend a urinalysis on a regular basis to monitor your condition and treatment.
Other uses of urine examination:
Urine examination or analysis is also called as “urinalysis”. The urine examination reveals early signs of various diseases including ailments like diabetes and kidney diseases. Further, if you are suffering from any infection, the urine analysis will be helpful in determining the type of infection. It also helps in determining pregnancy.
Process of filtration:
As you know, it is the kidneys, which throw out urine. Further, urine contains waste materials removed from the blood by a process of filtration performed by the kidney. In fact, even the health of the kidney can be assessed by a urine examination.
Some of the other salient features of urine analysis are briefly described here:
- In the case of patients suffering from chronic kidney ailment, periodical urine examination will help the physician ascertain the health of the kidney. For example, presence of protein beyond a certain level would be a pointer to evaluate the health of your kidney. Interestingly, in some cases, a few people may release excess protein only occasionally. Therefore, during the course of urine examination, they might not have released excess protein. It is for this reason that the doctor may suggest repeated urine analysis to evaluate the health of the kidney.
- The process of urine analysis is normally grouped into three, namely visual colour examination of the urine, dip stick examination and microscopic examination. The type of examination normally depends on the ailment suspected. Further, depending on the results of urine analysis, the physician may suggest you to undergo various other urine tests.
- Sometimes the accuracy of the results of urine analysis can be affected because of certain medicines that you may be taking or dehydration and for various other reasons. In such cases, the physician may suggest you to repeat the urine examination after a few days.
In some cases, the pathologist may provide certain instructions before collecting your urine for a thorough examination. For example, you may be asked to go empty stomach or a few hours after the meals and so on. Follow these instructions scrupulously; after all, instructions are for the sake of your health and its benefits. If you wish to discuss about any specific problem, you can consult a nephrologist.
Chronic kidney disease, also called chronic kidney failure, describes the gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.
In the early stages of chronic kidney disease, you may have few signs or symptoms. Chronic kidney disease may not become apparent until your kidney function is significantly impaired.
Treatment for chronic kidney disease focuses on slowing the progression of the kidney damage, usually by controlling the underlying cause. Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.
The kidney has multiple functions, and one of it is to act like a filter and remove out waste substances. These filtered out substances are excreted through the urine.
Common kidney diseases including infections, kidney stones, diabetic effects, hypertensive effects, tumours, chronic kidney disease (effects of both hypertension and diabetes) and kidney failure.
Features of kidney diseases:
- Infections usually start with symptoms like burning with urination, change in colour of urine, and low abdominal pain.
- Kidney stones are usually identified by their characteristic pain in the sides of the back
- Smaller stones up to about 4 mm are passed through urine on their own.
- However, for larger stones, external shock waves are used to break them into smaller ones, which are then eliminated by the kidneys.
How Can I Prevent Kidney Disease?
The key to prevention or delay of severe kidney disease is early detection and aggressive intervention -- while there's still time to slow down the progression to kidney failure. Medical care with early intervention can change the course of chronic kidney disease and help prevent the need for dialysis or a kidney transplant.
Diabetes and high blood pressure account for two thirds of all cases of chronic kidney disease. By aggressively managing diabetes and high blood pressure with diet, exercise, and medications, you may be able to prevent kidney failure and help keep as much kidney function as possible.
- To prevent urinary tract infections, proper hygiene is very important.
- Thorough washing of the external urinary tract and use of clean underwear and toilet facilities is very important.
- Intravenous injections of pain relievers to help in pain control immediately on seeing the patient. If pain persists, an additional shot may also be required.
- Patients also have accompanying nausea and vomiting and may require antiemetics to control these.
- At the time of discharge, these medications can be continued at home.
- Hydration is very important, so drink at least 3 litres of water.
- Urine should be strained to ensure the stones have been passed
- Monitoring urine output including quantity and colour for any changes is also important. If urine is turbid, water intake should be increased.
- Avoid oxalate-rich foods. Most kidney stones are composed of calcium oxalate, and therefore foods rich in oxalate should be avoided. Beets, spinach, okra, tea, chocolate, soy, etc., should be minimised
- Reducing intake of salt and animal protein also helps in preventing recurrence. Legumes are a good option for proteins.
- Calcium supplements, if being taken, may need to be reduced or stopped. This can be managed by including enough calcium in the diet.
Chronic kidney disease: This is seen as a side effect of hypertension and diabetes.
- Constant monitoring of both BP and sugar levels is very essential.
- Keep cholesterol levels under check as suggested by your doctor
- Medicines should be taken as prescribed and not altered without medical supervision
- Quit smoking if the habit is still being continued
- Improve physical activity levels, which will also help control BP, sugar, and cholesterol levels
- Weight monitoring is essential to keep check, not just on kidneys but overall health.
- Kidney diseases put a person in a vicious cycle of health problems, so early detection and prevention are advised.
Here are some self-tips to prevent kidney diesease:
- Get Tested Regularly - At your next checkup, and at least within the next year if you haven't had these tests done:
- Ask for a urine test to see if you have excess protein, glucose, or blood in the urine.
- Ask for a blood pressure reading
- Ask for a fasting blood glucose test
- Ask for a creatinine test.
- Control Diabetes - If you have diabetes, work with your health care provider to keep your blood sugar levels under the best possible control. A program of diet, regular exercise, glucose monitoring, and medications to control blood sugars and protect kidney function can help.
- Control High Blood Pressure - If you have high blood pressure, work with your health care provider to get your blood pressure within target ranges. A program of diet, regular exercise, and medications can help.
Chronic kidney disease or CKD is the decreased function of the function of the kidney for a minimum of three months or more. In this the end stage renal disease usually refers to the end of the kidney function where the kidneys work for less than 15% of what they are supposed to. The kidneys play a vital role in the human body and if they do not function properly then a person can die. The functioning of many organs depends on the kidneys. However, the main function of the kidneys is to remove the products and regulate blood and water, control blood pressure, promote healthy and strong bones, and produce hormones.
Here are 5 facts about kidney disease you should know about:
1. Causes of the kidney disease: There are two main common causes of the end-stage kidney disease. These are preventable causes. These are diabetes and high blood pressure, but then kidney disease can be caused by other inherited diseases such as infection, trauma or polycystic kidney disease.
2. Serious stages: The kidney disease has five stages and stage 5 is known as the end stage renal disease; this is the point where patients usually need dialysis or kidney transplant to lead a sane life. The stages of kidney disease are:
Stage 1 – Slight kidney disease
Stage 2 – Mild decrease in kidney function
Stage 3 – Moderate decrease in kidney function
Stage 4 – Severe decrease in kidney function
Stage 5 – End stage renal disease
3. Detection of the disease: Kidney disease is usually difficult to detect because of the presence of very few symptoms. Age, gender along with the blood test is one way to determine information regarding kidney function. The people who are at a risk of getting kidney disease are:
- Over the age of 55 years
- People who suffer from hypertension and diabetes
- Ethnic groups such as Asians, Africans, Americans, Pacific Islanders and Hispanics
4. Signs and symptoms: CKD is usually considered to be a silent disease and many people don’t know that they are suffering from the disease. The signs and symptoms of the disease are:
- Fatigue and weakness
- Nausea, vomiting and loss of appetite
- Numbness and headaches in hand and feet
- Frequent urination
5. Renal replacement treatment: This is the treatment for the end stage of the kidney disease. Dialysis involves the replacement of some part of the lost function of the kidneys and is usually continued throughout life. There are 2 types of dialysis:
- Hemodialysis: This cleans the blood via an artificial kidney which is hooked to the machine
- Peritoneal dialysis: This removes the excess water and waste products and cleans the blood of the body by using the peritoneal cavity as a filter. If you wish to discuss about any specific problem, you can consult an urologist.
The 4 types of Kidney stones and their common symptoms
Defined as hard and small mineral deposits that develop inside your kidney, kidney stones are made up of acid salts and minerals. The causes of this disease are not well-defined, although risk factors include drinking very little amounts of water and having a diet rich in sodium, protein and oxalate (chocolate and green leafy foods for example). However, knowing the type of kidney stone you suffer from can help ascertain the cause.
Here are the common types of Kidney stones.
This type of kidney stone is usually a response to certain kind of infection, such as a urinary tract infection for example. Characterised by rapid growth and a large size, struvite stones can develop without any warning signs.
These are the most common type and are caused by a diet rich in oxalate. Risk factors for calcium stones include a diet consisting of plenty of nuts, chocolates and certain fruits and vegetables; metabolic disorders, high doses of vitamin d and intestinal bypass surgery, all of which can increase the amounts of calcium or oxalate in your urine, indicating the development of kidney stones.
Those individuals with a hereditary disorder that causes their kidneys to produce certain amino acids (cystinuria to be precise) in excess are most likely to get cystine stones.
Uric acid stones
These are common in those whose diets are lacking in water or those who suffer from the excess fluid loss. People with a high protein diet and those who suffer from gout are also at risk. Genetic factors play a major role as well in increasing your risk of getting uric acid stones.
Apart from these, there are other rarer types of kidney stones that can also arise depending on a combination of an individual's lifestyle and genetic make-up.
However, to determine whether you're suffering from any of the aforementioned types of kidney stones, you must first know its common symptoms, which are:
- Excruciating pain in your sides, and back, especially below your ribs
- Feelings of pain in the groin and the lower parts of your abdomen
- Intense and fluctuating pain that comes and goes in waves
- Pain while urinating
- Urine that is red, brown or pink in colour
- Urine that's cloudy or has a foul odour
- Vomiting and nausea
- Constant urge to urinate
- Increased frequency of urination
- Urinating in small amounts
- Chills and fever in case of an infection
If you wish to discuss about any specific problem, you can consult a nephrologist and ask a free question.
Kidneys and Kidney Diseases
The kidneys are organs which aim to filter out huge amounts of blood to produce 1-2 quarts of urine. They also perform the task of filtering out the excessive waste materials from the blood stream.
However, there can be cases when infection enters your bloodstream and affects your kidneys. This can cause serious kidney diseases such as cysts, stones and cancer.
Diabetes: What is it and how does it affect your kidneys?
Diabetes is a condition which is caused when the pancreas does not produce enough insulin (Type 1 Diabetes) or when your body doesn’t react to the insulin in a normal way (Type 2 Diabetes). The sugar in your food cannot be broken down effectively which can result in problems in your kidneys.
The glucose content in your blood causes considerable damage to the filters in your kidneys. When the filters in the kidney are damaged, a particular protein called albumin releases into your blood and your urine. The damage in the kidneys can affect the kidney function and obstruct the filtering out of wastes from the blood.
Thus, diabetes could be attributed as a major cause of kidney disease.
Managing diabetes is crucial to avoid kidney diseases. However, diabetes doesn’t have a proper cure which is why it is even more important to take care of your health in such cases.
Here are a few ways in which diabetic patients can aim to be healthy and prevent kidney diseases:
Quit Smoking: Smoking increases diabetic complications such as nerve damage and heart strokes which can in-turn affect your kidneys’ functions adversely. Hence, it is advisable to quit smoking to keep diabetes under control.
Healthy Meals: Opt for healthy meals which are balanced and packed with nutrients as they help in increasing the insulin function in your body. Foods such as green leafy vegetables, legumes, fruits and lean meat should be included in your meals.
Engage in Physical Exercise: A diabetic person needs to engage in physical exercise in order to maintain a healthy lifestyle. Obesity can increase your chances of complications and can be detrimental to your kidneys as well. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
Kidney stones are often small enough and pass through urine without much bother. Most kidney stones are smaller than 4 mm in diameter. Having said this, even the smallest of kidney stones can be really painful until they pass through urine (learn more what Urine Says About Your Health). It typically takes a couple of days for the body to get rid of it. While medication and self-care are the foremost options, there are a range of other options as well available for treating kidney stones.
Admission to a Hospital-
You must get admitted to a hospital if the stone moves to the ureter, thereby resulting in severe pain. Typically kidney stones which are more than 6 mms in diameter need to be surgically removed through procedures such as ureteroscopy, percutaneous nephrolithotomy (PCNL), open surgery and extracorporeal shock wave lithotripsy (ESWL). A doctor takes a call on any of the above procedure if:
The patient is inching towards a kidney failure.
The pain doesn’t go away even after taking pain killers.
If the patient is pregnant (learn more about for healthy pregnancy)
If the patient is more than 60 years.
Extracorporeal Shock Wave Lithotripsy (ESWL)-
ESWL is one of the simple and most preferred stone removing procedures. It involves the usage of ultrasound shock waves to break the bigger stones into smaller ones. The latter is then passed through urine. A patient is given a few painkillers since this mode of treatment could be a little uncomfortable. A patient might need multiple ESWLs to successfully get rid of all the stones.
If a stone gets stuck in the ureter, a medical procedure known as the ureteroscopy is performed. In this procedure, a thin telescope is passed through the urethra and bladder to the ureter. Either a second instrument is used or the telescope itself has laser energy to break the bigger stone into smaller ones. This procedure is ideal for stones that have a diameter more than 15 mm.
Percutaneous Nephrolithotomy (PCNL)
PCNL is an alternative to ESWL for removing big stones. This procedure involves the usage of nephroscope that is routed into the kidney through a small incision made behind the back of the patient. This procedure requires general anesthesia and is effective for breaking stones that have a diameter of 20 mm or more. It has a success rate of 86%.
This is one of the older methods to eradicate kidney stones. Unless the stone size is abnormally large and other procedures cannot be performed, open surgery is generally avoided. An open surgery involves making an incision and getting access to the ureter and the kidney. The surgeon then removes the stone from the kidney. This procedure requires general anesthesia and the patient needs to be under observation for at least 24 hours, post surgery.