You are on page 1of 3


ur feme

Macleod's Clinical Examination 11E, 2005
Urinary specific gravity
o is an index of the concentration of solute (e.g. sodium, chloride, urea, glucose)
o range of value in health: 1.002 – 1.035
o High values – kidney is actively reabsorbing water
 e.g. fluid depletion
o low values – failure of the renal tubules to concentrate urine (high urine volumes)
Urinary pH
o range of value in health: 4.5 – 8.0
o Use fresh urine for protein testing.
o Reading greater than 'trace' indicates significant proteinuria.
o Causes of transient proteinuria
 Cold exposure
 Vigorous exercise
 Febrile illness
 Orthostatic (postural) proteinuria
 Abdominal surgery
 Congestive cardiac failure
o Orthostatic (postural) proteinuria: occasional finding in healthy young subjects in whom
protein is not detected in the first urine passed after sleeping recumbent overnight, but
will be present during the day
o Proteinuria > 2 g per day suggests glomerular disease.
Urine dipstick test – changes on the reagent area at 60 seconds:
o Intact erythrocytes  green spots
o Free haemoglobin  green colour
 Note: The test does not differentiate between haemoglobin and myoglobin.
Bilirubin and urobilinogen
o Bilirubin: normally absent from urine
o Urobilinogen: may be present - up to 33 μmol/l in health
o Abnormalities of either
 haemolysis or hepato-biliary disease

Page 1 of 3

gpnotebook. RCMP MITC YFN ur feme Haematuria http://www.cfm?ID=-469368825&linkID=38414&cook=yes Aetiology With Respect To Frequency Note: It is important to know what are the clinical and other urinary features associated with this haematuria before you can make a diagnosis of the cause. SLE. infective endocarditis atrial fibrillation .microemboli settling in the kidneys Page 2 of 3 .uk/simplepage. Commonest cause:  urinary tract infection also common:  renal tract stones Less common causes:        renal trauma and infarction benign prostatic hypertrophy benign microscopic haematuria glomerulonephritis malignant hypertension bleeding diathesis (anticoagulant treatment) ulcer at the urethral meatus Uncommon causes:     hydronephrosis polycystic disease transitional cell carcinoma renal adenocarcinoma or Wilm's tumour Rare causes:   polyarteritis nodosa.

and excessive release of Journal of Renal Nutrition Volume 18.UniKL RCMP MITC YFN ur feme http://www. exercise-induced proteinuria is strictly related to exercise intensity rather than to exercise duration. Indeed. Pages 158-164 (January 2008) Renal Alterations During Exercise Guido Bellinghieri. increased production of free radicals. Vincenzo Savica. Certain clinical conditions can. was first observed in soldiers after long marching. and stress. MD. The prevalence of hematuria is higher in the athletic than the general population and the main difference is that sport-related hematuria resolves spontaneously after physical exercise while hematuria found in nonathletic population can be chronic. orthostasis. or following physical activity. Issue 1. MD.jrnjournal. Sport-induced hematuria is influenced by exercise duration and intensity. causes the passage of erythrocytes into the urine. generated during anaerobic conditions. through increased glomerular permeability. hemolysis. Lactic acidosis. A higher incidence of proteinuria has been observed in some sports requiring great exercise intensity and it is certainly related to muscular work intensity and would decrease after prolonged training. exercise. Among the mechanisms underlying the exercise induced hematuria are increased body temperature. fever. Domenico Santoro. result in a functional or temporary proteinuria. Proteinuria is usually due to glomerular or tubular changes or to an excessive production of protein as in myeloma. Page 3 of 3 . however. Prevalence of proteinuria during exercise ranges from 18% up to 100% depending on type of exercise and its intensity. MD Proteinuria and hematuria are common during exercise. especially during pregnancy. Sport-related proteinuria following marching. Exercise aggravates the proteinuria of various nephropathies and that of renal transplant recipients.