Kidney Function and Biomarkers Quiz

Creatinine

• Creatinine testing is crucial for assessing kidney function.
• Increased serum creatinine indicates potential kidney issues: glomerulonephritis, pyelonephritis, and renal disease.
• Non-renal factors causing elevated creatinine levels: strenuous exercise and certain drugs like salicylates.
• Decreased creatinine levels may signal muscle-wasting diseases.
• Normal creatinine range:
  • Males: 60-130 µmol/L (0.7-1.4 mg%)
  • Females: 40-110 µmol/L (0.4-1.2 mg%)

Urea

• Urea is the primary waste from protein metabolism, synthesized in the liver via the Krebs urea cycle.
• Elevated urea levels can result from damaged kidney function and non-renal factors such as dehydration, diuretic use, and gastrointestinal blood loss.
• Decreased urea levels are associated with pregnancy, malnutrition, AIDS, severe liver disease, and water overload.
• Normal urea range:
  • Adults: 3.3-7.7 mmol/L (20-46 mg%)
  • Infants: 1.3-5.8 mmol/L (8-35 mg%)

Glucose

• Increased glucose levels often indicate diabetes mellitus, pancreatic disease, or endocrine disorders like thyrotoxicosis and Cushing's syndrome.
• Causes of decreased glucose (hypoglycemia) include severe malnutrition, kwashiorkor, severe liver disease, excessive alcohol, insulin-secreting tumors, Addison's disease, and certain medications.
• Normal glucose range:
  • Adults - Fasting: 3.6-6.4 mmol/L, Random: 3.3-7.4 mmol/L
  • Children - Fasting: 2.4-5.3 mmol/L
  • Newborns: 1.1-4.4 mmol/L

Bilirubin

• Bilirubin results from the breakdown of erythrocytes and other heme-containing proteins.
• Increased bilirubin levels may arise from:
  • Hemolytic conditions (haemolytic jaundice)
  • Severe falciparum malaria
  • Sickle cell disease crises
  • Conditions resulting in hemolysis, like G6PD deficiency and hereditary spherocytosis.
• Normal bilirubin range:
  • Adults: 3-21 µmol/L (0.2-1.3 mg%)
  • Newborns: 8-67 µmol/L (0.5-4.0 mg%)

Albumin

• Albumin is synthesized in the liver and accounts for about 60% of total serum protein.
• Increased albumin levels may result from diarrhea or prolonged vomiting.
• Decreased albumin levels can occur due to pregnancy, low protein intake (protein-energy malnutrition), and malabsorption diseases like chronic pancreatitis or celiac disease.
• Normal albumin range: approximately 30-45 g/L.

Urine Analysis

• Physical Examination:

  • Normal urine color is pale yellow; variations are based on urine concentration. Abnormal colors include red (blood presence) and brown (indicating bilirubin).
  • Normal pH is slightly acidic; alkaline urine may indicate urinary tract infection (UTI).
  • Specific gravity measures dissolved particles in urine.
  • Normal urine volume ranges from 50 to 1500 ml per day. Increased volume may signal diabetes mellitus or diabetes insipidus.

• Chemical Examination:

  • Presence of sugar indicates diabetes.
  • Protein presence may suggest renal issues or UTI.
  • Bilirubin indicates liver or hemolytic diseases.
  • Acetone appears in cases of fat metabolism, commonly seen in diabetes.
  • Nitrates may indicate kidney infections or UTI.