well as the likely information (s), which can be obtained from a particular test, should be clearly understood. Very often, in the early stages of some renal diseases. it is not apparent from the signs and symptoms, that the kidneys have started to fail. Some test of kidney (e.g. blood analysis) may or may not reveal the incipient failure. However, more sophisticated tests (e.g. clearance tests) may reveal the incipient failure at this stage and the pnysician and the patient, both now being alive to the incoming danger, can take appropriate action. The tests of the kidney functions are Urine examination. Chemical examination of blood. Clearance tests. Concentrating power of the kidney, Radioiogicai and imaging investigations. Udrine examination Features of normal urine have already been deserbed (chap 2, sec VIII) The outstanding features which may be obtaned in a case of kidney dysfunction are mentioned below 1. Volume : Normally the volume, of urire per. day is f. 500 ml (range 800 lo 2,500 ml/day) if he volume is less than 500 ml/day (severe ollguria) waste product cannot be satisfactcrity excreted and they atcurnlate In blood. Conversety, in polyuria, so much water and Na may be lost that symploms may be produced Oliguna may be produced try severe lacK of drinking water, acute giornerlonephritis. cardavastilar shocK cardiac insufficiency and other conditions Diabetes mellitus, diabetes insipidus and chrome pyelonephritis are some of the well known causes of polyura}. 2 Specific gravity (Sp. gr) Very low and fixed sp.gr. (i.e where the kidineys have lost-the power to concentrate the urine) may be obtained r chrome nephrite Very high sp grof urine is found incases ofgtycosuna Proiemuna causes onfy a margnainge of ( HYPERLINKhttp//sp.gr) of urine. 3. Urinary reaction in some types of renal disorders. the ability secrete H* is reduced and as a result surfficiently acd urine cannot be formed, causing renal acidosis This may be esiabtehed by adminstratlon of NH4 Ci
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