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Hyperuricemia and gout have become common diseases and there is few to be missed or misdiagnosed now. Long term of hyperuricemia can cause renal damage which is called hyperuricemia nephropathy.
Though hyperuricemia nephropathy is relatively easy to be diagnosed, we should know the routine tests that should be done to confirm the diagnosis because hyperurecemia nephropathy needs to be distinguished from other primary glomerular diseases.
Laboratory examinations
1. Urine test. The main urine changes in hyperuricemia nephropathy patients are mild proteinuria, little excretion of red blood cells and stones. In case of renal tubular dysfunctions, there will be diuresis, nocturnal enuresis, low specific gravity urine, decrease of urine osmotic pressure. The protein in urine is mostly small molecular.
2. Blood test. There is obvious increase of blood uric acid and it has been reported that 60% patients have uric acid above 20mg/dl. In the early stage it is the concentrating function is affected and then the filtration functions and there will be increase of creatinine and urea nitrogen. But the increase of uric acid is more significant that that of creatinine and urea nitrogen.
Imaging examinations
1. Renography and CT scan can show irregular renal shape such as expansion or blunting of the calyces in cases of hydrdonephrosis, dilation of the ureter, urinary tract obstruction.
2. B ultrasound can show unven lesion of the two kidneys and it can also help localize kidney stones.
The presence of double refraction uric acid crystallization under polarized light microscopy in renal biopsy can confirm the diagnosis of hyperuricemia nephropathy. However it is not easy to take the pathological tissues because the uric acid mainly deposits in deep renal tissues.
Other related terms that need to be checked include uric acid in urine, urine osmotic pressure, urea, uric acid in blood and protein quantitative.
