Diagnosis

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If you are having urinary system symptoms, you may be asked to undergo various tests. Some of the most common are:

Blood tests. Tests for kidney disease include:

• Serum creatinine. Measures blood levels of a substance called creatinine that is generated when the body breaks down and uses protein.
• Creatinine clearance. Measures how effectively your kidneys remove creatinine.
• Blood urea nitrogen (BUN). A nitrogen-containing substance called urea is a normal byproduct resulting when the body breaks down and uses protein. Healthy kidneys remove urea from the blood for excretion in urine. Excess urea in the blood is a sign the kidneys are not functioning well. BUN can also be transiently elevated with dehydration.

Dipstick test for proteinuria. When the kidneys are not functioning well, protein may be present in urine. Foamy urine is a strong sign of protein, but usually there are no visible symptoms. The test for proteinuria uses a dipstick that changes color in the presence of protein.

Renal biopsy. In this procedure a health care professional obtains a sample of kidney tissue to examine under a microscope. A needle is inserted through the skin into the back of the kidney to retrieve a tissue sample.

Renal imaging. If blood and urine testing suggests impaired kidney function, your health care professional may recommend renal imaging, a procedure that captures an image of the kidneys using ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI)

Urinalysis For this test, you will be asked to urinate into a special container and leave the sample with a nurse or lab technician. The urine is then analyzed for blood cells and abnormal substances such as proteins, glucose or white blood cells and bacteria.

Urine culture. A urine culture is a laboratory test that tests for infection in your urine by allowing any bacteria in the urine sample to grow and multiply. The bacteria are then identified and tested to see which antibiotic will work best to kill the bacteria. Your urine is sent for a culture if infection is suspected on urinalysis.

Urine cytology. A urine cytology involves a check of your urine for cancer cells.

Ultrasound. Lubricating jelly is rubbed on your abdomen and pelvis, and a wand passes over your kidneys and bladder to check for abnormalities in your urinary tract or genitals, as well as residual or leftover urine in your bladder.

Intravenous pyelogram (IVP). This test x-rays the urinary tract to identify a malformation, tumor, kidney or bladder stone or other blockage preventing normal urine flow. A dye containing iodine is administered via a needle into a vein; the dye is then incorporated into the urine, making the urinary tract easier to see on x-rays.

Cystoscopic examination. During this test, a health care professional inserts an instrument called a cystoscope through the urethra and into the bladder. The cystoscope is pencil thin and has a light at the tip to allow a look inside the tract. A cystoscope may have an additional instrument attached to perform a treatment procedure, such as scar biopsy. Cystoscopy may be recommended in a variety of circumstances, including frequent urinary tract infections, blood in the urine, incontinence or overactive bladder, presence of unusual cells in the bladder, need for a catheter, chronic pain or interstitial cystitis, urinary tract blockage, kidney stone or an unusual growth. A ureteroscope, which is an even smaller tube, can be inserted into a ureter.

Urodynamic test. This is a series of tests of bladder function. Bladder muscle contraction is measured as the bladder fills, stores and empties urine—in other words, in each phase of bladder activity. For this test, a small tube called a catheter is inserted through the urethra into your bladder. The bladder is then filled with either water or an x-ray dye. Another small tube is inserted into the rectum to measure abdominal pressure when you strain or cough; if a dye is used, an x-ray is taken. Your doctor may suggest this series of tests if your symptoms suggest muscle or nerve problems in the lower urinary system (bladder, urethra and sphincter muscles).