Question

A 39-year-old female suddenly notices her urine is a dark smoke color and she feels general malaise. Her urine output is decreased, and she has edema with puffy eyelids. Her blood pressure has become elevated. She has a history of systemic lupus erythematosus, but her urinary symptoms, edema, and hypertension are new, so she goes to see her physician. The physician orders a BUN, creatinine, creatinine clearance test, and a urinalysis. Her results are below: BUN: increased creatinine: increased creatinine clearance: greatly reduced GFR Dipstick: 4+ protein; 4+ blood; 1+ leukocyte esterase Microscopic: RBC's 25-50/HPF with many dysmorphic RBC's RBC casts: 5-10/LPF Hyline casts: 0-1/LPF What other TESTS or Procedures would you use to confirm the diagnosis?

          A 39-year-old female suddenly notices her urine is a dark smoke color and she feels general malaise. Her urine output is decreased, and she has edema with puffy eyelids. Her blood pressure has become elevated. She has a history of systemic lupus erythematosus, but her urinary symptoms, edema, and hypertension are new, so she goes to see her physician. The physician orders a BUN, creatinine, creatinine clearance test, and a urinalysis. Her results are below:
BUN: increased
creatinine: increased
creatinine clearance: greatly reduced GFR
Dipstick: 4+ protein; 4+ blood; 1+ leukocyte esterase
Microscopic: RBC's 25-50/HPF with many dysmorphic RBC's
RBC casts: 5-10/LPF
Hyline casts: 0-1/LPF

What other TESTS or Procedures would you use to confirm the diagnosis?

Added by Seth J.

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