Investigations results

Alan Smith

Age: 69
Sex: Male

Mr Smith is asked to provide a sample of urine but can only manage a dribble. (“Typical,” he says, “Passing urine all the time, then when I have to do it I can’t!”)

You request a number of investigations, and the results are as follows:

Urinalysis:
  • Blood negative
  • Protein negative
  • Nitrites negative
  • Glucose negative
  • Ketones negative
  • pH 5.0
 
Arterial Blood Gas:
  • pH 7.33
  • pO2 11.1
  • pCO2 3.4
  • HCO3 15
  • Base excess -6
  • Lactate 1.0
Bloods:
  • WCC 7.5
  • Neut 6.8
  • Hb 136
  • MCV 90
  • PLT 282
 
Renal function blood tests:
  • Sodium 139 mmol/L
  • Potassium 6.2 mmol/L
  • Urea is 22.9 mmol/L
  • Creatinine 440 µmol/L
Other tests:
  • CRP <2
 
  • Liver function studies – normal
 
  • CXR normal
 
  • ECG normal
Scans:

Renal tract and Bladder USS – Bilateral hydronephrosis, with dilation of both ureters. A distended bladder containing >1L urine.

Ultrasound scan of Mr Smith’s right kidney:

 

Ultrasound scan of a normal kidney for comparison: