QUANTITATIVE
Glucose
Urea
Creatinine
Total Protein
Albumin
Estimation of Blood Glucose:
Normal values:
• FBS : 70-100 mg/dl
• PPBS: 120-140 mg/dl
• RBS: 200 mg/dl
• Hyperglycemia : > 110 mg/dl
• Diabetes mellitus: > 126 mg/dl
• Hypoglycemia: < 70 mg/dl
• Renal threshold: 180 mg/dl
• True glucose level: 60-80 mg/dl (Blood glucose level estimated by enzymatic
methods is called true glucose)
a) Enzymatic methods:
i) Glucose oxidase method ii) Hexokinase method
b) Reduction methods:
i) King Asatoor method ii) Nelson Somogyi method iii) Folin Wu method
• Non glucose reducing substances:
Glutathione, Glucoronic acid, Fluoride, Salicylates, Ketone bodies, Sulfa
drugs, INH, Cysteine, Creatinine
Hyperglycemia:
• Diabetes mellitus
• Hyperactivity of pituitary, thyroid or adrenal gland,
• Increased intracranial tension like in meningitis, encephalitis, intracranial tumours, sub
arachnoid haemorrhage etc
• Drug induced: Prolonged use of steroids
Hypoglycemia :
• Over dosage of insulin or missing of a meal by a patient of diabetes mellitus
• Hypothyroidism
• Glycogen storage diseases
• Prolonged starvation
• Insulinomas
Why sodium fluoride is used for sample collection?
Ans: Glucose after collection undergoes glycolysis by RBCs so that values decrease by
5-10mg/dl/hour. Fluoride prevents this by inhibiting the glycolytic enzyme enolase
Estimation of Blood Urea
• Normal blood urea level = 28- 40 mg/dl
• Blood urea levels are expressed in terms of its nitrogen content. 60 mgs of urea = 20 mgs of
nitrogen.
BUN = mg % x 0.467
• Methods of urea estimation:
i. Enzymatic:
1. Urease nesselerisation
2. Berthelot’s reaction
ii. Chemical – DAM (Diacetyl monoxime) method
• Urea clearance and its importance:
It is the number of ml of plasma, which contains the urea excreted in a minute by the kidneys.
Urea clearance = U×V P
U = Concentration of urea in urine (mg /100ml)
P = Plasma urea concentration (mg/100ml)
V = Urine flow in one minute. (ml/min)
The clearance of urea has been used in the study of renal function.
• Urea clearance and kidney function:
• 70 % or more - Normal function
• 70-50 %- Mild damage
• 49-20 %- Moderate damage
• Below 19-5 %-Severe damage
• Below 5 %- Uremic coma imminent
• Urea is dependent on protein intake in diet. It is passively reabsorbed
by diffusion at low urinary flow rates. So Urea is not an ideal
substance to measure clearance.
• other substances which can be used for clearance are Creatinine and
inulin which are better than urea.
• Inulin is the ideal substance because it is intact, which is neither
produced nor metabolized in the body. It is not reabsorbed or
secreted by the kidney
Estimation of Serum Creatinine:
Normal value of serum creatinine
Adult males: 0.8-1.5mg/dl
Adult females: 0.6-1.3mg/dl
Children: 0.4-1.2mg/dl
Urinary creatinine: 1-1.5gm/day
Increased creatinine excretion: Muscular dystrophy, Hyperthyroidism
Diabetes mellitus, Starvation, infections
Decreased in Advanced renal disease, Leukemia, Vegetarian diet
• Creatinine clearance:
• It is the most useful clinical estimate of GFR.
• A sensitive indicator of renal function.
• It is defined as the volume of plasma that is cleared of creatinine by the
kidney in one minute.
• Creatinine clearance = UV/P
• U = mg of creatinine /100 ml of urine
• P = mg of creatinine/100 ml of blood
• V = ml of urine excreted per minute
• Normal clearance:
• Males: 95-140 ml/min
• Females: 85-125 ml/min
• Chronic kidney disease = < 60 ml/min
• Kidney failure = < 125 ml/min
Estimation of Total Protein and A:G Ratio
• Methods of estimation:
1. Kjeldahl’s method
2. Biuret method
3. Turbido metric method
4. Lowry method
5. Dye binding method
• Normal value of serum
1. Total proteins = 6-8 gm/dl
2. Serum albumin = 3.5-5.5 gm/dl
3. Serum globulin = 2-3.5 gm/dl
4. Fibrinogen = 200-400 mg/dl
5. A:G ratio – 1.5-2.5
• Total proteins elevated in
1. Chronic infections
2. Dehydration
3. Respiratory distress
4. Hemolysis
5. Alcoholism
6. Leukemia
• Total proteins decreased in :
1. Malnutrition and malabsorption
2. Liver disease
3. Severe burns
4. Loss through urine in severe kidney diseases (Proteinuria)
5. Pregnancy
• A:G ratio may be decreased in:
• Severe protein malnutrition
• Cirrhosis of liver
• Nephrotic syndrome
• A:G ratio increased in:
• Multiple myeloma
• Chronic infections
• Reversed A/G ratio (Increased globulins, hyper proteinemia):
• Hyper gamma globulinemia
• Decreased A/G ratio (Hypo proteinemia):
• No increase in globulin
• Decreased in albumin
• What is Beer Lamberts Law?
• What is OD (Optical Density) ?
• What is colorimetry?
• What is OGTT?
• Diabetes mellitus – Diagnosis , complications, etc
