00:01
Welcome to our video series
on interpreting lab values.
00:04
In this section,
we're going to talk
about an important test.
00:08
It's the urine test for protein.
00:10
Now you think about a urine
test, what do we need?
Obviously we need urine,
but you need at least
30 milliliters of urine.
00:18
So that's not really that
much unless you need it.
00:21
Sometimes it's hard for
patients to produce it.
00:24
But 30 mls is the
equivalent of one ounce.
00:27
You can put that in
a clean specimen cup,
it doesn't have
to be be sterile.
00:31
We're not culturing anything and
it we're just looking for urine.
00:34
So we need 30 mls of urine
in a clean specimen cup.
00:39
Now this word is a very
difficult for me to say,
albuminuria, right?
That is one that my tongue
just gets twisted around,
but let me break it down for you
because when you understand
these word parts,
it helps you recognize
terms or other terminology
that you might not have
known the definition for.
00:57
So albuminuria, look at that.
00:59
I want you to underline uria.
01:02
And the second word
proteinuria underline uria,
that means urine.
01:08
So what that's telling me is
whatever is before the letters URIA,
that's what's in my urine.
01:16
And now you might have a little
bit of protein in the urine
but abnormal levels
indicate a problem.
01:21
See protein is supposed to
stay in your bloodstream.
01:25
Remember, it's that big molecules
charged in a way that attracts water
that helps us keep water
in our intravascular space.
01:32
When the blood goes
through the kidney,
we want the protein to
stay in the bloodstream
not to exit out into the urine.
01:40
So you should find protein
in your bloodstream,
but it should not be
present in your urine.
01:46
Stop for a minute and look at
that value greater than 30.
01:50
That's a number I
want you to remember.
01:53
You can have some
protein in your urine,
but if it's bigger
than that number 30,
we've likely got a
problem with your kidney.
02:00
So why is albuminuria a problem?
Well, I bet you can answer
that question now on your own.
02:07
If you want to
feel unlucky today
pause and see if you can answer
that question by yourself.
02:15
Okay,
so let's look at break it down.
02:17
Why albuminuria is a problem.
02:20
On the left,
you have a healthy kidney,
on the right,
you have a damaged kidney.
02:25
Okay work with me I
know it's just a circle
but it's the same thing.
02:29
Look at the kidney is
supposed to filter the blood
and dump what we don't
want into the urine.
02:35
So you see both
have two circles.
02:37
Those are going to
represent your kidney.
02:39
Top half of the circle is blood.
02:41
Bottom half of the
circle is urine.
02:43
Yeah, I you probably could
have figured that out
because one is red and one is yellow
just like body fluids are supposed to be
but work with me here.
02:51
Let's walk through it.
02:53
So you'll notice on
the healthy kidney,
when you have the
protein in the blood,
that's where it stays.
02:59
Look there's none
of it in the urine,
but look at the damage kidney.
03:04
It isn't able to keep the
protein in the bloodstream
and it's ending up
depositing it in the urine.
03:11
The damage kidney has albumin in
inappropriate places in the urine
so this is likely an early
sign of kidney disease.
03:19
Now if you have three positive results
over a period of three months or more
it is a sign, a definitive sign
of some form of kidney disease.
03:29
All right. So as a nurse,
why do I need to know this?
Well, you need to know 1.
03:33
Protein is supposed to stay in
your bloodstream helps me with
fluid pressure keeping everything
in my intravascular space.
03:41
2.
03:41
If I have to high
levels of protein,
I don't get super alarmed
with the first one.
03:47
But if I have a series of three
tests over at least three months
or even a little bit
longer period of time
this is a sign of kidney disease
and this patient needs very
close and consistent follow up.
03:59
Now what kind of people do you
think should be tested, right?
We're looking for people
who are at an increased
risk for kidney disease.
04:05
So this should be a part of their
routine checkup by a healthcare provider
every time they go and see their
primary health care provider.
04:13
They should have this test done.
04:15
They should have a urine sample
and you should look for protein.
04:18
So first up.
04:19
Yeah, most important
people with diabetes.
04:23
Okay, so anyone with type
one, type two,
any type of diabetic client should
have their urine tested every time
that's a minimum standard
because we know that a really
high risk for kidney damage.
04:38
Next number two in the risk category
would be people with high blood pressure.
04:43
Remember the glomeruli
everything is very fragile.
04:46
And if you were just
hammering that kidney with a
really high blood pressure.
04:52
You're damaging that
fragile inner workings.
04:55
So people with high
blood pressure,
even if they don't have diabetes
or risk for kidney damage.
05:01
Now if you are diabetic and
you have high blood pressure,
you're increasing your
risk for kidney damage.
05:08
Now if your family has a
history of kidney failure,
then you should be tested
this runs in my family.
05:14
My dad ended up with chronic
kidney disease and renal failure.
05:17
So this is something that
my family physician follows
every time I go
in for a checkup,
and if you're 65 years
of older as you age,
the organs,
they just start wearing out,
their tired.
05:28
So that's why people who age
was you keep an eye on that
because we know kidneys
are at a high risk.
05:34
Now the last one might seem
kind of strange to you,
but there's certain
ethnic groups
African-Americans, Hispanics,
Asians and American Indians
or Native Americans
whatever your
reference of choice is
we know that these certain ethnic
groups have a tendency to have
a higher risk for renal disease.
05:54
Okay,
so we got five things at there,
I want you to stop for
just a minute and see
how am I going to
keep this in mind?
How is this going
to make sense to me?
Well diabetes and
high blood pressure
probably were at the top
of your list already,
but the rest of it has to
do with me and my family
so think about family history,
certain races and then
sadly as you age
it just comes on.