Laboratory parameters of the 1st order – obligatory laboratory tests.
- Small blood count
- Differential blood count
- Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate).
- Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, blood), sediment, urine culture (pathogen detection and resistogram, that is, testing suitable antibiotics for sensitivity / resistance).
- Electrolytes – calcium, potassium, magnesium, phosphate.
- Fasting glucose (fasting blood glucose), if necessary oral glucose tolerance test (oGTT).
- Renal parameters – urea, creatinine, if necessary cystatin C or creatinine clearance.
- Albumin in urine – determination in suspected diabetes mellitus, hypertension [renal, glomerular proteinuria].
- Microalbuminuria: 20-200 mg albumin/l urine or 30-300 mg albumin/24 h.
- Macroalbuminuria: > 300 mg albumin/24 h
- Total protein in blood serum
- Total protein (24h urine)Note: urine: collect day and night separately due toexclusion of differential diagnosis orthostatic proteinuria [daytime: significant proteinuria; nighttime (= first morning urine after getting up): no increased protein output].
- Protein electrophoresis in urine (24-h urine).
- Urinary alpha-1 microglobulin – for screening of tubular proteinuria [tubular proteinuria], eg:
- Fanconi syndrome
- Nephritis, interstitial
- Nephropathies; toxic
- Pyelonephritis, bacterial
- Physical stress
- Alpha-2-macroglobulin in urine – for diagnosis and differentiation of proteinuria or delineation of postrenal proteinuria; the alpha-2-macroglobulin/albumin quotient is particularly sensitive for this purpose.
- <0.02: renal hematuria/proteinuria.
- > 0.02: Postrenal hematuria/proteinuria (e.g., kidney stones).
Laboratory parameters 2nd order – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification.
- Beta-2-microglobulin (β2-microglobulin) in urine – e.g. to check the functionality of kidney transplants.
- Myoglobin in urine – for suspected myoglobinuria (e.g., in rhabdomyolysis) [prerenal proteinuria].
- Immunofixation electrophoresis
- Quantitative immunoglobulin determination (IgA, IgD, IgE, IgG, IgM).
- Quantitative kappa-lambda light chain determination – for suspected plasmacytoma [prerenal proteinuria].
- Bence-Jones proteins in urine
- ANA, ENA, dsDNA, ANCA (depending on age).
- Erythrocyte morphology (shape of the erythrocytes / red blood cells) by phase contrast microscopy from fresh urine – in hematuria (blood in the urine).
