When is the urine test negative for medical abortion

After you have completed the medical abortion, hcg will naturally become negative. When we usually want to confirm whether we are pregnant, we buy a pregnancy test stick and we will know by testing. This is because the hormones in our body have changed. The progesterone level in pregnant women's bodies is relatively high. After pregnancy, the hormones in women's bodies will begin to change in a series of ways. This is the real reason for morning sickness in the early stages.

Urine test is a medical test method. Including routine urine analysis, urine formed elements detection (

Such as urine red blood cells, white blood cells, etc.), quantitative determination of protein components, urine enzyme determination, etc. Urine examination is of great value in clinical diagnosis, judgment of efficacy and prognosis.

Specimen collection

The requirements and processing of urine specimens vary depending on the urine examination items. All urine specimens should be collected in clean containers; in principle, the first urine after getting up in the morning (morning urine) should be collected for urine sediment microscopy. The midstream urine of random urine can also be collected. Morning urine specimens are also suitable for other urine examinations (24

h (except urine test items); for the determination of renal tubular concentration and dilution function, urine should be voided after fasting for 12 h, and then fasting for 1 h. The urine should be collected after 13 h.

When testing the renal tubular acidification function, liquid paraffin is added to the urine container in advance; before collecting the 24-hour urine specimen, a preservative needs to be added to the container or the container needs to be placed in a 4°C environment [1-2].

When collecting urine specimens, you should pay attention to some special circumstances:

①Female patients should avoid collecting urine specimens during menstruation;

② Urine examination should not be performed on specimens with gross hematuria (except urine sediment);

③ If the medication you are taking affects urine testing, you should collect samples after stopping the medication;

④ If it is chyluria, the patient should be advised to collect the urine after it becomes clear.

Urinalysis

A rapid urine screening test is performed using multiple test strips, also known as a routine urine test. Dipstick methodology is a simple and rapid urine screening method. Currently, routine urine test strip examination items include pH, protein, occult blood, specific gravity, glucose, and ketone bodies. Urobilinogen, nitrate, leukocytes, and some test strips also contain bilirubin and vitamin C [3-5].

Although the urine test strip method is quick and simple, it can only play a qualitative and semi-quantitative role due to methodological limitations. The test results may have false positives and false negatives, and the results are affected by many factors.

pH The kidneys are involved in regulating the body's acid-base balance, and this regulatory ability can be reflected by urine pH. Due to excessive endogenous acid production, urine pH

It is generally acidic, about 5.0 to 6.0. Generally speaking, the "alkaline tide" phenomenon will occur after a meal, and the urine will be alkaline; acidic urine is more common in eating too much meat and certain types of fruits (such as cranberries), metabolic acidosis, respiratory acidosis, and the use of stone-excreting drugs (such as calcium carbonate); alkaline urine is more common in eating vegetarian food and citrus fruits, metabolic alkali poisoning, respiratory alkali poisoning, some kidney diseases (such as renal tubular acidosis), etc.

pH testing requires a fresh urine sample. If urine is left for too long, most bacteria can decompose urea and release ammonia, making the urine alkaline. But sometimes the opposite happens; the carbonate buffer in the urine releases CO2, which escapes into the air, and the urine pH value increases.

[Normal reference value] 5.0 ~ 8.0.

protein

Under normal physiological conditions, a small amount of protein is filtered from the glomerulus and almost completely reabsorbed in the proximal tubule. Therefore, the presence of proteinuria often indicates damage to the glomerular filtration barrier and/or reduced tubular reabsorption capacity. Glomerular proteinuria is often accompanied by loss of large molecular weight protein, generally > 1.5 g/24 h; tubular proteinuria is often a small amount of small molecular weight protein, generally < 2.0 g/24 h. A small amount of protein may appear in the urine during strenuous physical exercise, dehydration or fever, or during pregnancy. Clinically, proteinuria can be caused by a variety of reasons, which should be analyzed in combination with the specific clinical situation.

The test strip method for measuring urine protein is a semi-quantitative method for screening proteinuria. The test strip method has different sensitivities to different proteins in urine and is most sensitive to albumin. A large amount of free light chains may appear in the urine of patients with multiple myeloma, but the test strip method is negative. If there is detergent residue in the container, the urine protein test by the test strip method may be false positive, and the contrast agent may also cause a false positive; when the urine is alkaline, it will destroy the buffer range of the indicator and cause a false negative; when the urine pH is < 3.0, the test strip method will also have a false negative. Positive results require further urine protein quantitative testing.

[Normal reference value] Negative.

Urine sugar

The presence of glucose in the urine is mainly due to prerenal factors - hyperglycemia causing the glucose filtered by the glomerulus to exceed the reabsorption threshold of the tubules or renal factors - decreased reabsorption capacity of the tubules. If the urine sugar is positive, it should be distinguished clinically whether it is physiological or pathological diabetes. Physiological diabetes is more common in overeating, emergency situations and pregnancy; pathological diabetes is more common in diabetes caused by increased blood sugar, renal diabetes caused by impaired renal tubular function, and diabetes caused by some endocrine abnormalities (such as hyperthyroidism, pheochromocytoma, etc.). Taking large doses of vitamin C or some new antibiotics can cause a false-positive result, while high concentrations of ketone bodies in the urine and high specific gravity of the urine can cause a false-negative result.

[Normal reference value] Negative.

Ketone bodies

When the body cannot effectively utilize glucose and fatty acid metabolism is incomplete, a large amount of ketone bodies will be produced, and ketone bodies will appear in the urine. In addition to diabetic ketoacidosis, ketonuria can also be seen in long-term hunger, acute fever, low-carbohydrate diet, vomiting and diarrhea caused by poisoning, etc. Antihypertensive drugs such as methyldopa, captopril and some biguanide hypoglycemic drugs (such as phenformin, trade name Jiangtangling) can cause positive urine ketone body tests. Phenylketonuria, the presence of phthalein dyes, preservatives (8-hydroxyquinoline), and metabolites of levodopa in urine can cause false positive test results; reduced test strip activity and ketone body degradation can cause false negative test results.

[Normal reference value] Negative.

Occult blood

If the urine occult blood test using the test strip is positive, you should highly suspect: ① hematuria. It is more common in some diseases of the kidney and urinary system (such as glomerulonephritis, pyelonephritis, renal cysts, urinary system stones and tumors, etc.), extra-renal diseases, trauma, strenuous exercise and some drugs (such as cyclophosphamide). ②Hemoglobinuria. It is common in intravascular hemolysis (such as transfusion reactions and hemolytic anemia), severe burns, strenuous exercise (march hemoglobinuria) and some infections. In addition, hemoglobin can also be released after the destruction of red blood cells in the urine. ③Myoglobinuria. It is common in muscle injuries (such as severe crush injuries, surgery, ischemia), muscle wasting diseases, dermatomyositis, excessive exercise, etc. If the urine occult blood test is positive, further microscopic examination should be performed to confirm the presence of red blood cells. When the urine contains heat-labile enzymes or bacteriuria, the test result will be a false positive; when there is a large amount of vitamin C in the urine, the test result will also be a false negative.

[Normal reference value] Negative.

Bilirubin

If the blood bilirubin level is elevated, the urine test strip method can detect positive bilirubin. Certain liver diseases, such as viral hepatitis, can cause elevated urine bilirubin. If blood bilirubin is clearly elevated but urine bilirubin is negative or suspected to be positive, specific laboratory verification is recommended. Positive urine bilirubin may also be caused by obstruction of the intrahepatic bile duct, which is common in common bile duct stones, pancreatic head cancer, and intrahepatic inflammation, where increased pressure in the duct causes bile reflux. The metabolites of some drugs (such as pyrimidine) in urine are colored at low pH, which is close to the color of the reaction of the test substance itself, and a false positive may occur; bilirubin is easily decomposed by light, and if the urine is not fresh or has been exposed to light for too long, a false negative may occur in the test result; a large amount of vitamin C or nitrite in the urine will reduce the sensitivity of the test strip method.

[Normal reference value] Negative.

Urobilinogen

After direct bilirubin is secreted into the small intestinal cavity, it undergoes a series of reactions to generate a series of products, with urobilinogen as one of the main products. About 20% of urobilinogen is reabsorbed and enters the enterohepatic circulation, of which a small amount (2% to 5%) enters the bloodstream and is filtered from the glomerulus. The test results combined with the urine bilirubin results analysis can help in the differential diagnosis of jaundice. Some drug metabolites in urine can react with reagents in the test strip, resulting in false positives; porphyrinogen, indole compounds and melanogen in urine also often lead to false positives; if formaldehyde is used as a preservative or the specimen is improperly stored, urobilinogen will be oxidized into urobilin, and the test result may be a false negative.

[Normal reference value] Urobilinogen quantitative 0 ~ 5.9 μmol/24 h (0 ~ 3.5 mg/24 h).

Nitrite

Nitrates are present in the normal diet and are excreted in the urine as nitrates rather than nitrites. In urinary tract infections, most pathogenic bacteria contain nitrate reductase, which can reduce nitrate to nitrite. Factors that affect the formation of nitrite include: pathogens must be able to utilize nitrates; urine is retained in the bladder for 4 hours or more; and the diet contains sufficient nitrates.

The determination of nitrite in urine is often used as a rapid screening test for urinary tract infections. The agreement rate between the test results and urine bacterial culture results was 60%. False positives may result from the oxidation of nitric oxide in the body to nitrite, which is excreted in the urine. Some drug metabolites or improper specimen collection can lead to false positives; large amounts of vitamin C and factors that affect nitrite formation can lead to false negatives.

[Normal reference value] Negative.

Leukocyte esterase

Normal people may have a small amount of white blood cells in their urine, but the urine leukocyte esterase is negative. If the esterase test is positive, it is highly suggestive of a urinary tract infection. Certain kidney diseases such as lupus nephritis, acute interstitial nephritis, and renal transplant rejection may also cause an increase in white blood cells in the urine. Urinary tract Trichomonas and some oxidative substances and drug metabolites in urine can lead to false positives; eosinophils and tissue cells can also cause false positive results. Too much protein, glucose or vitamin C in the urine can cause a false negative. If the urine leukocyte esterase is positive, further microscopic examination must be performed to confirm the presence of leukocytes.

[Normal reference value] Negative.

Vitamin C

The concentration of vitamin C in normal human urine is too low, which is common in vitamin C deficiency (scorbic acid disease); long-term increase in urinary vitamin C may be related to the formation of kidney stones. The concentration of vitamin C in urine mainly reflects the recent vitamin C intake in the diet. Vitamin C in urine affects other items measured by the test strip method (such as urine sugar, urine red blood cells, urine bilirubin, and urine nitrite).

Microscopic examination of sediment

Microscopic examination (abbreviated as microscopic examination) of the urine sediment after centrifugation (abbreviated as "urine sediment") is an important part of urine examination. Urine microscopy can detect casts, cells, crystals, bacteria and other microorganisms, parasites and other visible fixed and non-fixed components in urine.

Cellular components

1. Red blood cells

Under the microscope, red blood cells appear anucleate, smooth, concave on both sides, moderately refractile, dull disc-shaped, and generally 7 μm in diameter. According to the morphology of red blood cells under the microscope, urine red blood cells can be divided into uniform type (similar in shape and size to normal blood red blood cells), polymorphic type (red blood cells have different shapes and sizes), a mixed type of the two accounting for about 50%, and shadow red blood cells (red blood cells have no hemoglobin). The surface of red blood cells is "spike-like", and they are all uniform in size and are also of a uniform type. These red blood cells are called acanthocytes. The main reason for the formation of acanthocytes is the high specific gravity of urine and high urine osmotic volume. In hypotonic urine, cells swell, hemoglobin is released, and red blood cells become ghost cells.

The morphology of red blood cells in urine helps to distinguish the source of hematuria - glomerular (polymorphic) and non-glomerular (homogeneous), which helps in differential diagnosis, but there are exceptions. The Institute of Nephrology at Nanjing General Hospital of Nanjing Military Command found that after renal biopsy, the morphology of urine red blood cells of patients with glomerulonephritis can temporarily change from polymorphic to uniform, and then return to polymorphic after a few days. This finding indicates that even in the case of intraparenchymal bleeding, if the bleeding site is not within the nephron, the red blood cell morphology will not be polymorphic. When renal tubular function is impaired or diuretics are used, water transport is impaired, causing the osmotic volume of the thick ascending limb of the loop of Henle to remain at a high level [> 100 mOsm/ (kg·H2O)]. When red blood cells flow through this area, the deformation process that should occur no longer occurs, that is, there are no more polymorphic red blood cells.

Increased red blood cells in urine can be seen in: ① Kidney disease. Various glomerulonephritis, lupus nephritis, acute interstitial nephritis, renal tuberculosis, renal infarction, renal vein thrombosis, trauma (renal puncture), polycystic kidney, hydronephrosis, kidney stones, renal tumors and traumatic renal damage, etc. ②Lower urinary tract diseases. Such as urinary tract infection, stones, tumors, urinary tract stenosis, hemorrhagic cystitis caused by cyclophosphamide treatment, etc. ③Extrarenal lesions. Such as acute appendicitis, salpingitis, diverticulitis, intestinal and pelvic tumors, fever, etc. ④Toxic reactions of drugs. Such as sulfonamides, salicylates, methenamine, and some anticoagulants. ⑤Intense physical exercise.

2. White blood cells

(1) Neutrophils: Most of the white blood cells in urine are neutrophils. An increase in number is more common in inflammation of the urogenital system, acute post-infectious glomerulonephritis, lupus nephritis, acute interstitial nephritis, etc. After strenuous physical exercise, the number of white blood cells in the urine may also increase.

[Normal reference value] Urine white blood cells 0 to 5/HP.

(2) Eosinophils: The urine sediment is stained with eosin Y. If the cells are positive for eosin Y staining, it indicates the presence of eosinophils in the urine. An increase in eosinophils in the urine is common in allergic interstitial nephritis and is also seen in Churg-Strauss syndrome.

[Normal reference value] Not found/HP.

(3) Lymphocytes: The diameter of urinary lymphocytes is 6 to 9 μm, which can be easily confused with neutrophils. Generally, in cases of urinary tract inflammation, lymphocytes are easily missed because neutrophils make up the majority. In renal transplant patients, lymphocyte counts are elevated. Lymphocytes often outnumber neutrophils, often indicating possible transplant rejection.

[Normal reference value] Not found/HP.

(4) Monocytes and macrophages: Renal interstitial inflammation is often accompanied by infection and immune response, which attracts monocytes and macrophages through chemotaxis.

[Normal reference value] Not found/HP.

3. Epithelial cells

Generally, three types of epithelial cells can be detected in urine sediment, namely tubular epithelial cells, transitional epithelial cells and squamous epithelial cells. Squamous epithelial cells are most common, especially in women. A small amount of epithelial cells in urine is usually a physiological phenomenon of replacement of old cells with new ones. If the number of epithelial cells increases significantly or their morphology becomes abnormal, it often indicates that a lesion or tumor has occurred at the site where the epithelial cells originate. In cases of renal ischemia or renal tubular toxicity (aminoglycosides, heavy metals, immunosuppressants, poisonous mushrooms, etc.), a large number of renal tubular epithelial cells appear in the urine. In severe cases, tubular epithelial cell casts or cell clusters may even appear.

4. Collecting duct epithelial cells

In a variety of renal diseases, such as glomerulonephritis, acute tubular necrosis, renal transplant rejection and salicylate poisoning, the number of collecting duct-derived epithelial cells increases significantly, and fragments of collecting duct epithelial cells can sometimes be seen in the urine. Epithelial cell fragments of collecting duct origin in urine sediment ≥ 3 pieces/HP can be seen in renal tubular injury accompanied by severe destruction of tubular basement membrane integrity, and can also be seen in ischemic tubular necrosis (accompanied by tubular damage and pathological casts).

5. Transitional epithelial cells

It covers the surface of the renal pelvis, ureter, bladder, vas deferens, prostate excretory duct, and urethra, and the cells are large and thin. If a large number of transitional epithelial cells appear in the urine, it indicates a urinary tract infection and may also be seen in cases of indwelling catheters or other urinary tract instrumentation. If there are flakes of exfoliated transitional epithelial cells in the urine without any of the above reasons, one should be alert to transitional cell tumors of the urinary tract below the renal pelvis and an exfoliative cytology examination is required.

6. Squamous epithelial cells

The most common epithelial cells in urine, the detection of squamous epithelial cells in urine sediment has little clinical significance. As research deepens, urinary epithelial cells are gaining more and more attention, including renal intrinsic cells - glomerular podocytes and virus-infected tubular epithelial cells. Glomerular podocytes are one of the important components of the glomerular filtration barrier. When podocyte disease reaches a certain extent, podocytes will detach from the glomerular basement membrane and appear in the urine. Affected by the physical and chemical factors of urine, podocytes are difficult to maintain their original shape in urine and must be identified with the help of special cell chemical staining. Urinary podocyte membrane composition and podocyte count can help assess the severity of renal disease and its response to treatment.

7. Decoy cells Due to the use of large doses of immunosuppressants, the patient's chances of viral infection such as cytomeglovirus (CMV) and BK virus infection increase. When renal tubular epithelial cells are infected with BK virus (Decoy cells), they will undergo degeneration, necrosis, and even fall off. Blood tests are negative in the early stages of infection, but the virus can be detected by immunohistochemical staining of renal tissue. Indirect immunofluorescence was used to detect the presence of Decoy cells in urine. Urine Decoy cell testing can help to change treatment plans in a timely manner.

Crystallization analysis

Solutes in urine precipitate under specific conditions to form crystals or amorphous solids. Crystals do not appear in fresh urine. When urine is left for a long time, especially in the refrigerator, crystals will precipitate. Only a few types of crystals are clinically significant.

As the primary urine flows through the renal tubules, water is reabsorbed and the urine becomes more concentrated. Dehydration (reduced urine volume), diet, and medication lead to supersaturation of solutes, and crystals will form in the urine both inside and outside the body.

1. Acidic urine crystals

Uric acid forms amorphous or non-crystalline salts (sodium, potassium, magnesium or calcium). Under the microscope, urate crystals appear in a variety of shapes, typically flat and tetrahedral, and uric acid produces a series of interference colors under polarized light. Other crystals can also be seen in acidic urine, such as oxalate crystals, bilirubin crystals, cystine crystals, leucine crystals, cholesterol crystals, etc.

2. Common alkaline urine crystals include amorphous phosphate crystals, urine ammonia crystals, calcium carbonate crystals, etc. Amorphous phosphate crystals often interfere with microscopic examination of urine sediment. At this time, the patient should be advised to drink more water and collect urine again, and send it for examination immediately.

Urine protein

The test strip method can quickly screen whether there is protein in the urine, but the sensitivity is low; in the case of tubular proteinuria and overflow proteinuria, the test strip method often gives false negative results and cannot identify the protein component in the urine. With the help of urine protein component analysis, the non-formed components in urine can be detected, providing a more accurate and comprehensive basis for clinical practice. Including urine protein quantification, special protein [such as albumin, α2-macroglobin (α2-MG), urine free light chain, etc.] detection, renal tubular function markers such as NAG, retinol binding protein (RBP), cystatin C (cystatin C), amino acids, electrolytes and glucose, etc.

The normal reference values ​​for urine wet chemical test items vary due to different methodologies. Each laboratory should establish reference values ​​for the corresponding items. In clinical practice, the results of wet chemistry tests are mostly standardized by measuring urine creatinine at the same time.

1. Urine protein quantification

The collection of 24-hour urine is rather cumbersome. In clinical practice, the ratio of random urine protein to creatinine can be measured to replace the quantification of 24-hour urine protein. This method has a good correlation with the 24-hour urine protein quantitative result when the protein qualitative result is below "++", except for patients with renal interstitial tubular lesions. When there is a large amount of proteinuria, it is best to perform 24-hour urine protein quantification. 24-hour urine protein quantification is an important reference indicator for disease progression and efficacy assessment. The analysis of proteinuria can provide valuable information on the location of kidney lesions, pathophysiological characteristics of glomerular diseases, classification, selection of treatment options and efficacy judgment. According to the 24-hour urine protein quantification, > 3.5 g is called heavy proteinuria; < 1.0 g is called light proteinuria; and between the two is called moderate proteinuria.

[Normal reference value] < 0.15 g/24 h urine.

2. Urine albumin quantification

Conventional methods cannot detect urinary microalbumin, and a specific protein analyzer is required to detect the amount of urinary albumin excretion. According to the American Diabetes Association standards, microalbuminuria excretion is 30 to 300 mg/24 h. In addition to diabetes, urinary albumin excretion may also be slightly increased in patients with hypertension, obesity, hyperlipidemia, smoking, oral contraceptives, hormone replacement therapy, women and elderly patients. Microalbuminuria can be used as a marker of early diabetic nephropathy and capillary endothelial cell damage.

[Normal reference value] < 30 mg/24 h urine

3. Urine C3 Assay

C3 cannot be detected in the urine of normal people and patients without glomerular diseases. The increase in urinary C3 is due to the change in the permeability of the glomerular basement membrane. Under normal circumstances, large molecules such as C3 that are difficult to pass through

Filtered from the glomerulus; C3 deposited in the glomerulus is excreted in the form of its antigenic fragments. Clinical urinary C3 can predict the patient's response to glucocorticoid treatment.

[Normal reference value] Urine C3 < 2.76 mg/L

4. Urinary α2-macroglobulin measurement

Under normal circumstances, α2-MG cannot be filtered through the glomerulus. Increased α2-MG in urine indicates that the integrity of the glomerular filtration barrier is damaged.

[Normal reference value] α2-MG < 2.87 mg/L

5. Urinary β2-microglobulin

β2-MG has a small molecular weight and can be directly filtered from the glomerulus, but can be completely reabsorbed in the proximal tubule. Abnormal urinary β2-MG indicates decreased renal tubular reabsorption function. In patients with malignant tumors, the blood β2-MG concentration is significantly increased, and the filtration amount exceeds the reabsorption capacity of the renal tubules, which may also increase the urine β2-MG concentration. β2-MG in urine is extremely unstable and easily degraded in an acidic environment. Therefore, urine should be alkalized when collecting samples to ensure accurate results.

[Normal reference value] Urine β2-MG < 0.3 mg/L

6. Urinary retinol binding protein (RBP)

RBP is freely filtered from the glomerulus and completely reabsorbed in the proximal tubule. Elevated urinary RBP concentration indicates decreased tubular reabsorption function, which is seen in tubulointerstitial lesions. Urinary RBP testing can help detect renal tubular function damage at an early stage and also help determine the prognosis and response to treatment. It is worth noting that the half-life of RBP is approximately 12 h, and its blood level is affected by the synthetic function of the liver. If the liver's synthetic function is reduced or there is malnutrition, the amount of RBP filtered from the glomerulus will decrease, and even if tubular disease occurs, the urine RBP may be within the normal range.

7. Urinary N-acetyl-β-glucosidase (NAG)

NAG is an acid hydrolase present in lysosomes and is abundant in proximal tubular epithelial cells. In most kidney diseases accompanied by tubulointerstitial damage, abnormal urinary NAG activity is a reliable and sensitive indicator of early tubular function damage. Urinary NAG may be elevated in some heavy metal poisoning, early diabetic nephropathy, various glomerulonephritis, and when using certain drugs (such as aminoglycosides).

[Normal reference value] Urine NAG < 16.70 U/(g·Cr)

8. Urinary Cystatin C (Cys C)

Cys C can be freely filtered from the glomerulus, completely reabsorbed by the renal tubular epithelial cells, and degraded within the cells without entering the peritubular circulation; the renal tubular epithelial cells also do not secrete Cys C into the tubular lumen. Urinary Cys C detection is less affected by interference factors and its clinical diagnostic significance is worth studying.

[Normal reference value] Urine Cystatin C < 0.15mg/L

9. Urine Lysozyme Assay

Lysozyme can be freely filtered through the glomerulus, and the proximal tubule has a strong reabsorption capacity for lysozyme. The lysozyme content in normal human urine is extremely low. In general, elevated urinary lysozyme often indicates abnormal renal tubular function. When the lysozyme content in plasma increases significantly (such as acute myeloid leukemia), the amount of lysozyme in the glomerular filtrate far exceeds the tubular reabsorption capacity. In severe urinary tract infection, a large number of white blood cells in the urine release lysozyme, which can also lead to an increase in urinary lysozyme. When using lysozyme tests to diagnose kidney disease clinically, attention should be paid to abnormally high blood concentrations and urinary tract infections.

[Normal reference value] Urine lysozyme < 0.5 mg/L

10. Urine amino acid test

Under normal circumstances, more than 99% of the amino acids in the primary urine are reabsorbed by the renal tubular epithelial cells. Therefore, the amino acid content in the urine of normal people is extremely low and maintained at a relatively constant level. In some pathological conditions, such as renal tubular damage caused by various reasons, amino acid transporter defects caused by genetic diseases, etc., the urinary amino acid content will increase.

[Normal reference value] Urine amino acid 67.6 ~ 367.0 mg/24h

11. Immunoglobulin light chain

Immunoglobulin light chains are divided into two types, κ and λ, which can be freely filtered from the glomerulus but are less reabsorbed by the proximal tubules and have a direct toxic effect on renal tubular epithelial cells. Multiple Myeloma B

The cell clones proliferate and produce large amounts of free light chains, which can be filtered from the glomerulus and exceed the reabsorption capacity of the renal tubules. Routine qualitative urine tests are often negative. In cases of glomerular disease, the immunoglobulins in the urine may also increase, and the urinary free light chains may be slightly elevated. In addition, free light chains may be significantly elevated in the urine of patients with Waldenström macroglobulinemia, lymphoma, and other plasma cell disorders.

[Normal reference value] Urine free light chain κ < 35 mg/L, λ < 50 mg/L