A 67-year-old female has a history of kidney and circulatory problems and now has oliguria and marked edema. She visits her physician and he orders a BUN, creatinine, creatinine clearance test, blood lipid and albumin levels, a urinalysis, and a urine culture and sensitivity. Her results are below:
RESULTS:
BLOOD TEST
BUN: Increased
Creatinine: Increased
Serum lipids: Increased
Serum albumin: Decreased
URINALYSIS
Dipstick:
SG: 1.010
Protein: 4+
Blood: 2+
Leukocyte esterase: 1+
Glucose: Trace
Microscopic Examination:
RBCs: 20-25/HPF
WBCs: 0-5/HPF
Oval fat bodies
Cholesterol Crystals
Mixed casts:
Granular casts: 0-5/LPF
Hyaline casts: 0-1/LPF
Waxy casts: 0-1/LPF
Mixed WBC/RTE casts: 0-1/LPF
Fatty casts: 0-5/LPF
Urine Culture: No Growth
QUESTIONS:
1. What do you suspect in her condition?
2. What additional problems does this urinalysis suggest?
3. Are Renal tubular epithelial cells seen in this condition? Why?
4. Why might this patient have glucose in the urinalysis findings?