Urinalysis in the diagnosis of renal disease

UpToDate performs a continuous review of over 270 journals and other resources. Updates are added as important new information is published. The literature review for version 10.2 is current through April 2002; this topic was last changed on June 26, 2000. Patients with renal disease may have a variety of different clinical presentations. Some have symptoms that are directly referable to the kidney (gross hematuria, flank pain) or to extrarenal sites of involvement (edema, hypertensive, signs of uremia). Many patients, however, are asymptomatic and are noted on routine examination to have an elevated plasma creatinine concentration or an abnormal urinalysis. Once renal disease is discovered, the presence or degree of renal dysfunction is assessed and the underlying disorder is diagnosed. Although the history and physical examination can be helpful, the most useful information is initially obtained from estimation of the glomerular filtration rate (GFR) and examination of the urinary sediment. Estimation of the glomerular filtration rate (GFR) is used clinically to assess th