Uranalysis help! can't decide what the disease is

[maanggohs]

And there's significant increase in protein, blood, red blood cells, white blood cells, there's a small amount of hyaline cast,

I think it would be Acute Tubular Necrosis because of history of perfusion of blood to kidneys.

But it couldn't it be glomerulonephritis?

I can't decide between the two.

And both acute tubular necrosis and glomerulonphritis can lead to ESRD right?

[ChristineN, BSN, RN]

Why are you trying to pick a diagnosis from a UA sample solely? Oftentimes UA's can be contaminated. With that high a bacteria count it would be interesting to do a Urine Culture (and ensure it is done as sterile as possible) and see if it shows bacteria or anything unusual.

[PsychNurseWannaBe, BSN, RN]

Kinda confused.... the provider diagnosis from diagnostic tests.

[nurseprnRN, BSN, RN]

"history of perfusion"? i sure hope so. unfortunately, it sounds as if there might have been some deficit in that regard along the way.

seriously, all those things (and less than 100,000 bacteria) show that those kidneys are well and truly mad. their little tubules and such are damaged, so they are unable to keep blood cells and blood proteins from slipping out into the urine stream, and they will stop working altogether if this sort of thing doesn't reverse.

here's a cool website with urinalysis info. i really like the drawings.

http://library.med.utah.edu/webpath/tutorial/urine/urine.html