Renal failure urinalysis

Nephrolithiasis/ urolithiasis/ crystalluria IDV Onset Any time after initiation of therapy, especially if 4- fluid intake Symptoms Flank pain and/or abdominal pain, dysuria, frequency pyuria, hematuria, crystallauria rarely, Tserum creatinine and acute renal failure 1. History of nephrolithiasis 2. Fhtients unable to maintain adequate fluid intake 3. High peak IDV concentration 4. tDuration of exposure Drink at least 1.5-2 L of non-caffeinated fluid per day Tfluid intake at first sign of darkened urine monitor urinalysis and serum creatinine every 3-6 months Increased hydration pain control may consider switching to alternative agent stent placement may be required... 

Foxall PJD, Bending MR, Gartland KI, et al. 1989. Acute renal failure following accidental cutaneous absorption of phenol Application of NMR urinalysis to monitor the disease process. Human Toxicol 9 491-496. 

Renal Effects. In one individual, acute renal failure was noted from inhalation and/or dermal exposure to diesel fuel which was used as a shampoo. Biopsy detected tubular dilation, mitosis, and vacuolization in renal cells, and some cellular proliferation in the glomerulus in this individual (Barrientos et al. 1977). Another individual experienced renal failure following inhalation of diesel fuel vapor for 10 days (Reidenberg et al. 1964). Renal necrosis developed in one man after washing his hands with diesel fuel over several weeks (Crisp et al. 1979). Urinalysis was normal following inhalation of JP-5 by two individuals or ingestion of kerosene by numerous individuals (Dudin et al. 1991 Mahdi 1988 Nouri and Al-Rahim 1970 Porter 1990). 

Baseline electrolytes, renal function tests, and urinalysis baseline and at least BUN, creatinine, potassium within 2 weeks after initiation of therapy (increased levels may indicate acute renal failure)... 

Nishimura M, Takahara K (1985) A case of abnormal urinalysis found by a school health check-up with exercise-induced acute renal failure (Japanese abstract). Nippon Jinzo Gakkai Shi (Jpn J Nephrol) 27 1730... 

A 43-year-old woman with rheumatoid arthritis developed dizziness having taken celecoxib 200 mg/day for 2 weeks. At the start of treatment she had normal renal function (104). Her serum creatinine was 670 pmol/l (7.4 mg/dl) and blood urea nitrogen 30 mmol/1 (90 mg/dl). Creatinine clearance was 16 ml/minute. Urinalysis was normal and casts were not present. Urinary chemical analysis showed a sodium concentration of 18 mmol/1, a fractional excretion of sodium of 0.3, and a renal failure index of 0.493, consistent with prerenal acute renal insufficiency. Celecoxib was withdrawn. Although her renal function then improved, her serum creatinine was still abnormal (4.7 mg/dl) 1 month later. 

Clinical manifestation of arsine intoxication appears within 24 h of exposure (usually within a few hours). Renal failure due to tubular destruction is an important consequence of arsine exposure. The urine is frequently discolored (brown, red, or black), and hemoglobin in the urine is thought to be the major cause. Urinalysis... 

The answer is D. The patient s symptoms are consistent with a kidney stone, which is confirmed by the radiographic finding. The etiology of the stone is indicated by the urinalysis data, which suggest cystinuria. The cells of this patient s renal proximal tubules would be deficient in a transporter responsible for the reabsorptive uptake of cystine and the basic amino acids, arginine, lysine, and ornithine. Failure of the tubules to reabsorb these amino acids from the ultrafiltrate causes them to be excreted at high concentration in the urine. 

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