TEST Fs Ginjal & URINALYSIS 2016.pptx

8/16/2019 TEST Fs Ginjal & URINALYSIS 2016.pptx

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Renal Function

Tests & UrinalysisSulistyo M Agustini

Fak. Kedokteran UMM2016


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Referensi

• Shirish M Kawthalkar, 2010. Essentialof Clinical Pathology, JB Meical!"#lishers, !. $%$0

• S"san King S, Mor&orie Sch ' (.,201). *rinalysis an Boy +l"is, inMeical (a#oratory an Bioeical

Science,. Si-th eition•


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*R/(SS

• Peeriksaan "rin, secara "" e#erikan

inforasi The state of the kidney and urinary tract

metabolic or systemic (non renal) disorders

• "&"an "rinalisis1. Me#ant" iagnosis !enyakit

2. Skrining tes

$. Monitoring !er&alanan !enyakit

3. Monitor efekti4tas an ko!likasi -

). 'i5erential 6 Manageent of Ja"nice

7. 'iagnosis !aa Kehailan


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+*/8S 8/J(

• +"ngsi ekskresi 9e#ersihkan sisaeta#s 4ltrasi gloer"l"s 9sei!eria#el:s; t"#"l"s 9 rea#sor!si: !ro"ksi "rin

• Reg"lasi "nt"k hoeostasis elektrolit, air

6 asa%#asa 9!


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*R/(SS

•

*rinalisis

tes terhaa! "rin yg #eg"na iagnosis!enyakit, skrening tes, onitoring !er&lnan !enyakit, 6ke#erhslan;ko!likasi tera!i:

• *"nya "rinalisis inforasi aa inikasi Penyakit gin&al ata" trakt"s "rinari"s 9ga#r akros>

kiiawi 6 seien : !enyakit eta#olik an !enyakit lainnya 9 gl"kose 6 keton

'M, #il &a"nice 6 !enyakit hati, !


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Samling urin

• Botol 9waah: #er"l"t le#ar,#ert"t"!, #ersih, kering, kaca, tak!erl" steril kec"ali "nt"k k"lt"r

• Berla#el 9ientitas:

• Segera i!eriksa 9 1 &a, a- 2 &a:

•


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!enga"et Urine

• ol"ena

#aik "tk gl"kosa, asa aseto%asetat, aseton.

• hyol

• +oralehi 30? "tk seien , !tg ala

enilai k"antitatif ata" "ns"r%"ns"r lseien

• sa s"lfat !ekat "tk eent"kank"antitatif Ca, /itrogen 6 @at inorganik lain

• /atri"kar#onat kh"s"s "tk "ro#ilinogenl enentkn ekskresinya !er 23 &a


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Macam Samel urine

• *rine sewakt" 9 rano sa!ling:

• *rine !agi le#ih !ekat 9A sol"t:

• *rine 2 &a !ost !ranial

• *rine 23 &a 9 "rin ta!"ng :

• *rine clean catch "rin !orsitengah kh"s"s "nt"k k"lt"r 6sensiti4tas test


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Terminologi

• n"ria tk aa !ro"ksi "rin• Dligo"ria !en"r"nan !ro"ksi

"rin

• Poli"ria !e↑ !ro"ksi "rin• /okt"ria srg keih ala hr

• Polakis"ria srg keih g "rin skt

• 'is"ria nyeri isaat keih

• Pi"ria t!t nanah;lekositiala "rin

• 'll ses"ai sel yg aa i "rin


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R#UT$% UR$%A'(S$S !R#T#)#'

Physical !ro!erties 9akrosko!is: color, trans!arency, oor, foa ans!eci4c gra=ity

Cheical screening tests !


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Makroskois

• ol"e F00 G1$00 l; 23 &a9ewasa:

• !< 3,) GF,) 9)%H:>a#noral info

stat"s asa; #asa• Iarna k"ning &ernih,

ker"h ; #erwarna !enyakit, iet

• Ba" tak #er#a" 9tergant"ngakanan:

• BJ 1.001 G1.0$) 9 tgt i"resis;&"lh

!ro "rin:


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"i

• Protein, al#"in /oral 9% ; :, 10 g;lata" 1)0 g;23 &a

• Protein "rine ker"sakan e#r gloer"l"s9al#"in"ria:

• Ptrotein"ria L g kiiawi lain 9eri, le"ko, nitrit6 ikrosko!is:

• *"nya !t ikali4kasikan !rerenal,goler"lar, t"#"lar, lower *, 6 asy!toatic.

• 'era&at !rotein"ria

il 1.0 gr;ay,oerate 1.0 G $ or 3 gr;ay, large A $ or 3gr;ay


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)#M!#%%TS #F T* UR$% +$!ST$)K

TEST VALUES LOW DETECTABLE RANGE COMMENTS

Specific

gravity

1.001-1.035 1.000-1.030 urine alakali, protein

pH 5-9 units 5-8,5 unit Reagen protein/false

rotein 0 15-30 !g/"# al$u!in 1%& 30' (%& 100'

3%& 300'

)%&*(000!g/"#

+lucose 0 5-1(5 !g/"# trace&100' 1& 1000'1& *(000!g/"#

etone 0 5-10 !g/"# acetoacetate race&5' S &15' &)0' #arge&80-10

$iliru$in 0 0,)-0,8 alse2- 4false 2%

loo" 0( 0.015-0.0( alse 2- 4%

6itrite 0 0.0-0.1 alse2- 4%

#eukocyte

2esterase

03 -15 7s/pf :n"ikasi :S


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,lukosuria

• /ilai a#ang 9Renal threshol: th gl"kosakaar gl"kosa arah rea#sor#si gl"kosa it"#"li terhenti 9 noral 170 G 1F0 g;l:

• 8l"kos"ria t&

% 'ia#etes ellit"s

% 8angg"an rea#sor#si gl"kosa i t"#"li sinroa fanconi > !enyakit gin&al !arah

% Ker"sakan otak

% Sinroa C"shing


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*ematuria

•


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*emoglo-inuria

•


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iliri-unuria

Bilir"#in"ria t&


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Uro-ilinuria

• *ro#ilinogen / 9%: ata" 0,1 G1,0Elrlich unit/dL

• Urobilinuria terutama pd

kelainan hemolitik

↑ he!atitis ak"t, sirosis, aneiaheolitik, severe infection

↓ #iliary o#str"ction, inNaatoryisease, renal ins"4ciency, severediarrhea


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Ketonuria

• Bena Keton aseton, as. seto%asetik, as. Beta hiroksi%#"tirat

• Keton"ria t&

% 'ia#etes ellit"s% oiting yang #erle#ihan

% Kela!aran !arah

% Pen"r"nan BB g intakekar#ohirat nihil 9iet ketat K


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%itrit

• *rin noral negatif 9%:• es nitrit 9reagen stri!:

• !enyaring * 9 is cystitis, !ielonefritis:

• E=al"asi tera!i anti#iotik ! *

• Meanta" !asien yg "ah infeksi *

• Penyaring k"lt"r

• Salah sat" inikator tes *, !erl" !- lain

9 le"kosit, !rotein 6 !


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Microscoic• Mikrosko!is !orsi akhir "rinalisis

9seien: l eteksi renal/urinarytract disease

• Scr traisional s#g analisa r"tin9 tk efektif, i!engar"hi faktor AA:shg hsl ikrosko!is ikon4rasikang akrosko!is 6 kiiawi

• Stanarisasi seien =ol "rine 10%1) l sentrif"se ) enit, sisakan ± 1l seien

• Staining inenti4kasi eleen cel"lerg s"!ra=ital stain stemheimer-

malbin stain• Reference =al"es for "rinary

seientRBC Oh!f , IBC, hyalinecasts Ol!f , renal e!ithelial cells,s"ao"s e!ith cells, #acteria, a#/

crystals 9Ohpf= high poer !"# ob$%eld& ''lpf= lo poer "# ob$ %ld)


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Eritrosit


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LEKOSIT

BERGEROMBOL

AIM SEDI

URI-

STAIN


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Urine lama

Bakteri

Yeast

Lekosit


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TEST Fs Ginjal & URINALYSIS 2016.pptx

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