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Kidney-
Laboratory

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The kidney laboratory - for the detection of kidney diseases

Differentiated urine diagnostics

Differentiated urine diagnostics, which the renal laboratory has at its disposal, are necessary for the detection of kidney diseases.

The urine is processed in 2 stages. First, the urine is examined for the presence of abnormal components such as blood, inflammatory cells (leukocytes) and protein, as well as the presence of glucose and bile pigment. This is followed by qualitative and morphological analysis.

The quantity of excreted erythrocytes and leukocytes is measured in the counting chamber. The increased protein excretion is recorded quantitatively and it is checked whether abnormal proteins (paraproteins) can be detected in the urine, which indicate the presence of blood cell diseases (multiple myeloma). A phase contrast microscope is used to examine whether the increased blood excretion in the urine is caused by a urological disease (e.g. kidney stone) or an inflammation of the kidneys (glomerular disease - glomerulonephritis). The detection of cylinders (granulated cylinders, erythrocyte cylinders, leukocyte cylinders, wax cylinders), which are important in the diagnosis of kidney disease, is supportive.

Urine cytology also allows the diagnosis of tumours in the kidney and urinary tract
If kidney disease is detected, it must be clarified whether the disease is limited to the kidney (known as primary kidney disease) or whether the kidney is affected secondarily as part of a generalized disease.
One of the main focuses of the Kidney Centre is the diagnosis and treatment of these generalized systemic diseases, known as autoimmune diseases.

These autoimmune diseases include vasculitides (inflammatory diseases of the blood vessels) and collagenoses (inflammatory diseases of the rheumatoid type, which are associated with increased connective tissue formation). Among the vasculitides with kidney involvement, the most common are Wegener's granulomatosis, microscopic polyangiitis, Churg-Strauss syndrome and essential cryoglobulinemic vasculitis (cryoglobulinemia). The most common collagenoses with renal involvement are systemic lupus erythematosus, systemic sclerosis (limited and systemic) (scleroderma) and Sjögren's disease.
The renal laboratory specializes in the detection of these autoimmune diseases. Wegener's granulomatosis, microscopic polyangiitis and Churg-Strauss syndrome can be diagnosed using the ANCA test (antineutrophil cytoplasmic antibodies); the renal laboratory is the reference laboratory for this disease. Cryoglobulinemia is diagnosed by isolating and typing (type I-IIII) the cryoglobulins.
The renal laboratory supports another focus of the renal center, the diagnosis and treatment of systemic lupus erythematosus with renal involvement, by detecting antibodies against core components, nucleosomes, consisting of double-stranded DNA and histones. The detection of antibodies against nucleosomes is relatively specific for SLE. The measurement of antibodies against other nuclear components (SSA-RO/SSB-LA) helps in the diagnosis of a special form of systemic lupus erythematosus (subacute cutaneous SLE) and in the detection of Sjögren's disease.
Autoimmune diseases are treated with immunosuppressants, drugs that combat the derailment of the immune response, but at the same time reduce the body's own defenses, so that the tendency to infection is increased. Diagnosing infections in autoimmune diseases is not easy. Here, the renal laboratory offers a laboratory test to measure procalcitonin, which makes it easier to distinguish between inflammation caused by infection or autoimmune disease.
The focus areas of the renal laboratory are also scientifically documented.

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