Laboratory parameters of the 1st order – obligatory laboratory tests.
- Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, blood) [glomerular hematuria* : Microhematuria + proteinuria (increased excretion of protein with urine)]
- Albumin in urine [albuminuria > 500 mg/24 h → glomerular hematuria* ]
- Urine sediment – examination of the sediment of urine for blood components (e.g., erythrocyte morphology from fresh urine)[glomerular hematuria* : detection of acanthocytes/dysmorphic erythrocytes]
- Renal parameters – urea, creatinine, possibly cystatin C or creatinine clearance [glomerular hematuria* : increased creatinine/reduced creatinine clearance].
- Urine culture (pathogen detection and resistogram, i.e., testing of appropriate antibiotics for sensitivity/resistance).
* If isolated glomerular microhematuria: 6- to 12-monthly nephrological control examinations (including glomerulonephritis diagnostics).
2nd-order laboratory parameters-depending on the results of the history, physical examination, etc.-for differential diagnostic clarification
- Small blood count
- Differential blood count – to assess the composition of leukocytes (white blood cells).
- Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate).
- Electrolytes – sodium, potassium
- Urine cytology (microscopic examination technique that examines the cellular components of urine and assesses whether cells are malignantly altered based on cellular appearances; spontaneous urine or flush cytology) – for normal baseline diagnosis and persistent (persisting) hematuriaNote:
- Sensitivity (percentage of diseased patients in whom disease is detected by use of the test, i.e., a positive test result occurs) is poor for low-grade NMIBC (nonmuscle-invasive carcinomas of the urinary bladder) and moderate for high-grade tumors (undifferentiated or anaplastic malignant tissue). Therefore, it cannot be recommended in the early detection or screening of carcinoma of the urinary bladder because of the excessively high rate of false-negative findings.
- For the follow-up of high-grade tumors, cytology is particularly suitable due to the high specificity (probability that actually healthy people who do not suffer from the disease in question, are also detected as healthy in the test).
- The procedure is highly examiner-dependent.
- Urinary stone diagnostics
- Urinalysis from 24-hour collected urine: total protein, albumin; quantitative determination of proteinuria (e.g., as albumin–creatinine ratio in spontaneous or collected urine; if necessary, together with determination of creatinine clearance).
- Alpha-2-macroglobulin (elevated in: nephrotic syndrome, glomerulonephritis, diabetes mellitus).
- Glomerulonephritis diagnostics
- Creatinine
- Streptococcal antibody
- Staphylococcal antibody
- ANA/ENA antibodies
- Rheumatoid factor
- Ds-DNA antibody
- ANCA
- Glomerulus basement membrane antibody (GBM-Ak).
- Tubule membrane AK
- IgE C3-
- Nephritis factor
- Creatine kinase (CK) – if myoglobinuria (increased excretion of myoglobin/muscle protein by the kidney) is suspected.
- Hemolysis signs – values such as LDH ↑ (lactate dehydrogenase), HBDH ↑ (hydroxybutyrate dehydrogenase), reticulocytes ↑, haptoglobin ↓ and indirect bilirubin ↑ indicating hemolysis (dissolution of red blood cells).
- Urethral swab (urethral swab) for pathogens – if urethritis (inflammation of the urethra) is suspected.
- PSA (prostate specific antigen) – tumor marker for prostate cancer.
