urinalisis budi terbaru

URINALISIS

BUDI I

FKUAJ

2009

GLUKOSA

• GLUKOSURIA :adanya glukosa dalam urin

TUBULAR MAXIMUM REABSORPTIVE CAPACITY( Tm ) GLUKOSA RATA2 350MG/MIN

WANITA: 250 – 360 MG/MIN

LAKI2 : 295 - 455 MG/MIN

• Glukosa darah > 160 – 180 mg/dl

glukosuria

• Sebab glukosuria:• Prerenal- hiperglikemia + glukosuria

• DM• Kelainan hormona

» Hiperthiroid» Acromegaly» Stress,anxiety,cushing disease

• Liver disease• Pancreatic disease• Drugs(e.g thiazide,steroid )

• Renal – gangguan reabsorpsi dari tubulus akan glukosa

• Fanconi syndrome• Keracunan logam berat• Genetik• kehamilan

• PEMERIKSAAN

• DASAR: » Reduksi» oksidasi

• REDUKSI:• COPPER REDUCTION TEST

» BENEDICT» CLINITEST TABLET

• OKSIDASI REAGENT STRIP TEST

glukose oksidase

GLUKOSA + O2 GLUCONIC ACID + H2O2

peroksidase

H2O2 + chromogen oxidized chromogen + H2O

Oksidasi lebih sensitif dan spesifik

Keton

• Ketonuria: adanya keton dalam urin

• Keton bodies:• Asetoasetat 20 %• Beta hidroksibutirat 78 %• Aseton 2 %

• Sebab ketonuria: • Gangguan metabolisme karbohidrat:

DM,kelaparan,latihan yang berat,diet• Mobilisasi trigliserida

• Pemeriksaan:– Rothera– Gerhardt– Reagent strip

Bilirubin

• Bilirubinuria:adanya bilirubin di urin

• Normal:kadar diurin 0,02 mg/dl( tak terdeteksi pada pemeriksaan rutin )

• Cara pemeriksaan: test busa

test Harrison

reagent strip

UROBILINOGEN

• Normal ada diurin 0,5 – 2,5 mg/hari

• Cara pemeriksaan:cara Wallace Diamond

cara Watson-Schwartz

reagent strips

DARAH

• DARAH: HEMATURIA

HEMOGLOBINURIA

MYOGLOBINURIA

• CARA PEMERIKSAAN: REAGENT STRIP

SEDIMEN

• URIN YANG DIPAKAI:SEGAR

PEKAT

• URIN PAGI

• CARA PEMERIKSAAN:

KWALITATIF

KWANTITATIF

• TANPA PEWARNAAN

• DENGAN PEWARNAAN:

• DENGAN PEWARNAAN:

• SUPRAVITAL:STERNHEIMER-

MALBIN

TOLUIDINE BLUE

• ASAM ASETAT

• SUDAN III

• PRUSSIAN BLUE

• NORMAL: • ERITROSIT 0-1/LPB• LEKOSIT 0-5/LPB• SILINDER HYALIN 0-1/LPK GRANULER• EPITHEL SQUAMOUS +,++,+++ TUBULUS RENALIS• KRISTAL OKSALAT +,++,+++ TRIPELFOSFAT

Silinder

• Dibentuk : tubulus distalis dan

collecting tubulus

• Core matrix : uromodulin (glikoprotein,da

hulu Tamm-Horsfall protein)

diproduksi sel tubulus renalis

dari tubulus distalis

hyaline cast and red blood cell

white cell cast and WBC

red cell and RBC

finely granular casts

broad coarsely granular cast

yeast cells

oval fat body and a fiber

fibers

hypotonic urine containing WBC,RBC,2 renal epithelial cell and a transitional epithelial cell

epithelial cell,WBC,RBC and bacteria

white cells,a few red cells,and bacteria

renal epithelial cells

numerous white cells and a few transitional epithelial cells

squamous epithelial cells and calcium oxalates

white cells cast,finely granular cast,and uric acid crystals

finely granular casts and WBC

convoluted waxy cast

epithelial cell cast

mixed cast,yeast cells,and a WBC

finely granular cast and yeast

hyaline cast that is bent back upon itself,and many RBC

hyaline casts

red cells cast

red cell cast 2

white cell cast

many white cell casts and many WBC

finely granular cast

triple phosphate crystals and amorphous phosphates

calcium oxalates, amorphous urates,and a piece of debris