Examining the Renal System

All systems need to be examined but pay special attention to the following

Palpation of kidneys

• Place one hand posteriorly on the flank with the other hand anteriorly
• Gently push up from below aiming to 'ballot' the kidney
• Differences between kidney and spleen
• Kidneys are ballotable
• Spleen has a notch
• You cannot get above the spleen
• Spleen is dull to percussion

Kidneys

• Position
• Size
• Shape
• Scars from previous surgery

Urine

• Urinalysis
• Chemical (Stix) testing
• Blood
• Protein
• Glucose
• Bacterial nitrites
• Urinary pH
• Specific gravity and osmolality
• Microscopy
• White cells
• Red cells
• Bacteria
• Casts
• Volume
• Oliguria
• Polyuria