Preface and Acknowledgments ix
Chapter 1 Functional Renal Physiology and Urine Production 1
Glomerular filtration 1
Tubular reabsorption and secretion 3
Collecting tubules 5
Renal function and measures of renal function 5
Laboratory assessment of renal function 6
Chapter 2 Specimen Procurement 9
Laboratory defi nitions for collection methods 9
Urine specimen containers 12
Specimen handling and preservation 15
Types of urine specimens 16
Chapter 3 Routine Urinalysis: Physical Properties 19
Solute concentration 19
Urine color 25
Chapter 4 Routine Urinalysis: Chemical Analysis 29
pH 29
Protein 32
Glucose 38
Ketone 40
Blood 42
Bilirubin 45
Urobilinogen 48
Nitrite 49
Leukocyte esterase 50
Specific gravity 51
Chapter 5 Routine Urinalysis: Microscopic Elements 55
Urine sediment preparation 55
Examination of urine sediment 57
Microscopic elements of urine sediment 59
Chapter 6 Proteinuria 113
Protein handling by the kidney 113
Signifi cance of proteinuria 116
Laboratory diagnosis of proteinuria 117
Recommendations regarding diagnosis of proteinuria 126
Additional considerations for proteinuria 126
Chapter 7 Advanced Diagnostics 133
Detection of bacteriuria versus diagnosis of urinary tract infection 133
Urinary tract cytology 136
Fractional excretion 147
Urinary biomarkers 149
Chapter 8 Laboratory Quality Assurance 155
Physical requirements of the laboratory 155
Laboratory equipment 157
Reagents and supplies for the urinalysis laboratory 160
Laboratory waste 160
Quality control in the urinalysis laboratory 161
Procedure manuals 163
Index 165