Urinalysis Case Studies
Case # 2: Kidney Transplant Rejection In Diabetes Mellitus Patient
An elderly patient recently underwent a kidney transplant because of
extensive damage done to her kidney's by Diabetes Mellitus. The patient
is placed on anti rejection medication but the doctors are not sure if
it is working. The patient currently has a high fever as well as
lower back pain, nausea, and has gained 2lbs in the last day.
| Urine Volume |
300 ml/24 hrs |
Leukocyte |
Negative |
Glucose |
1000 mg/dl |
| Ketone |
40 mg/dl |
Protein (non stix) |
2.5 g/24 hrs |
Blood |
Large |
Microscopic:
RBC: >50/hpf
WBC: 50-100/hpf
Renal Epithelial cells: 15-20/hpf
Question # 1: Do the patients symptoms fit with kidney transplant
rejection? Answer
Question # 2: Do any of the patients chemical, physical or microscopic
test results point to Kidney rejection? Answer
Question # 3: Is there a discrepancy between the chemical and and
microscopic methods for detection of WBC's and if so why is this
happening? Answer
Question # 4: When the medical technologist preforming the urinalysis
sees the results, she immediately calls the patients doctor. Why did
she do this? Answer
Question # 5: Identify the crystals that can be seen in the following
two pictures. Given that the patients pH was 5.5, which of the sets of
crystals could possibly be seen in the patients urine? Answer
Picture # 1
Picture # 2
