- Examinations of kidneys and urinary tract
- Renal and urinary tract examinations: tests of renal function and bladder function
- Kidney and urinary tract examinations: imaging and bladder mirroring
The entire volume of blood flows through the kidneys three hundred times a day: 1500 liters of fluid, from which initially just under one tenth is filtered off. Of these, only a small fraction passes through the urinary tract along with waste as urine outside - the largest part is taken back into the bloodstream. In addition to blood purification, the kidneys have other important functions in our body.
Symptoms of renal impairment
Disorders of kidney function are often detected only in routine examinations of the blood; In the case of diseases in the draining urinary system, patients often have complaints to the doctor. Typical symptoms of urinary bladder and urinary tract disorders include urinary retention problems such as increased urination, burning and painful urination, delayed urination, bladder weakness, and changes in the odor or discoloration of the urine. You can e.g. indicate an irritable bladder, inflammation of the bladder or urethra, tumors or changes in the prostate gland.
But other diseases can also be manifested by urinary tract disorders, such as the diabetes by increased urination (polyuria) or porphyria by urine discoloration. Kidney pelvic inflammation can be manifested by pulling flank pain and fever, and kidney or urinary stones cause massive colic if they get stuck.
The medical history
In most cases, it is possible to assign the described symptoms to probable diseases by deliberately asking the patient about his medical history (anamnesis). The focus is first on the current symptoms - where, when and how often they occur, whether they have started suddenly or persist for some time and whether there are other complaints. Other past or chronic illnesses, previous surgeries or accidents, medications taken and family diseases are also important.
The basic diagnosis
The physical examination is usually done on standing and lying patients. Outwardly visible signs of disease (inspection) are e.g. Water retention and pale or yellowish skin.
In the palpation, the doctor can examine the kidneys (at least in lean people) and check the filling state and the sensitivity of the bladder, especially when he uses his stethoscope for interception (auscultation); When examining the rectum, the prostate can be palpated. When knocking (percussion) in the area of the flanks reveals a painfulness of the kidney storage - possible indication of an inflammation or a stone.
Urinalysis is among the most important studies of urinary tract disorders. Not only can the amount of urine be determined, but the urine sample can be examined under a microscope for inoculations (e.g., blood or inflammatory cells) and checked for the presence and amount of certain substances. Substances such as uric acid, proteins and sugar are usually absent or present only in small amounts - and give indications of metabolic diseases such as gout and diabetes.
If there is a suspicion of kidney or bladder infection, a "urine culture" can be created, with which germs can be determined. Usually, blood samples are examined at the same time, with which particular statements about the kidney function can be made.