How are the kidneys checked? Research methods to check if the kidneys are healthy

Diseases of the genitourinary system are quite common. Many women know what chronic pyelonephritis is, because this pathology complicates pregnancy. Kidney diseases can lead to dangerous consequences, which require constant purification of the blood from toxic substances (hemodialysis). The ailment has several causes (for example, hereditary predisposition, hypothermia, infection from the genitals, etc.), and often occurs asymptomatically, that is, does not bother the person, so everyone needs to know how to check the kidneys. This will help in time to seek medical help and avoid serious complications.

The structure of the kidneys

Kidneys are paired organs in the lumbar region. Their main function is the formation of urine. Kidneys support oncotic blood pressure and produce erythropoietin. The basic structural unit - nephron - consists of the vascular part (glomeruli) and tubules. The first are responsible for the filtration of blood and the formation of primary urine. The second - are involved in the reabsorption of substances necessary for the body. In the end, there remains a processed product of vital activity - secondary urine. If at some stage an obstruction arises, the kidney function weakens. This is expressed in a change in the qualitative or quantitative composition of urine. To understand how to check the kidneys yourself, you need to know about diuresis disorders, which are practically in all patients. These may include a decrease or increase in the urge to urinate, a change in the color of urine, a more frequent or rare visit to the toilet.

Methods of studying the kidneys

There are many ways that you can identify the pathology of the urinary system. In medical institutions, the kidneys are checked with special samples, for example, by analysis of Zimnitskiy, Nechiporenko, Amburzh. All these methods have been used for a long time, so their effectiveness is proven. Each sample is needed to evaluate a specific function, for example, the analysis of Zimnitskiy allows to reveal a violation of the filtering ability, according to Nechiporenko - the presence of an inflammatory reaction and hematuria. To properly diagnose the use of instrumental examination of the kidneys. Excretory urography and biopsy can be applied to such methods. The gold standard is ultrasound examination of the kidneys. Each of these methods, if necessary, appointed by a doctor and allows you to detect certain pathologies.

How do they check if the kidneys are healthy?

In order to understand whether there is a kidney disease, you need to pay attention to the presence of patient complaints, especially if there are symptoms such as increased frequency and change in urination, an admixture of blood in urine, an increase in nocturnal diuresis. An important sign is soreness in the lumbar region, in the lower abdomen on the right or left. In addition to the main symptoms, there may be a sharp increase in body temperature, a general weakness.

Often, kidney disease is preceded by angina, acute respiratory infections, hypothermia. Signs can be swelling and increased blood pressure. These symptoms appear with glomerulonephritis - an inflammatory process in the glomeruli, which has various forms. In this connection, only a part of the signs or even one of them can predominate. How are the kidneys checked if there are edemas? First of all, it is necessary to find out what is the cause of the appearance of the symptom. If swelling prevails in the morning, and to the touch, they are soft and warm, then you need to go to a consultation with a nephrologist.

Physical methods of examination

After a thorough analysis of complaints and clarification of an anamnesis of the disease, it is necessary to conduct an examination. First you need to assess the general condition of the patient and check all the systems, and then proceed to a direct examination of the diseased organ. How to check the kidneys without special examination methods? It is necessary to assess the condition of the lumbar region (there are no visible changes, puffiness) and to perform palpation. To feel an organ it is possible at various positions of the patient: lying on a stomach, standing and sitting. In doing so, the patient is asked to take a deep breath, during which the doctor brings his hands closer to the palpable kidney. On exhalation the doctor tries to grasp the organ and estimate its size, the presence of pain, structure, consistency and location. In healthy patients, the kidneys are not palpable, that is, they do not lend themselves to palpation.

What are the symptoms that can occur with kidney pathologies?

How to check the kidneys, except for palpation, every doctor should know. If the inflammatory process is suspected, special functional tests are performed to assess its presence or absence. The most widely used method is "a symptom of effleurage". It is conducted by a doctor-therapist who wants to exclude kidney disease. In addition, this method is used in any hospital with a daily doctor's round. The sample is performed when the patient is standing or lying on his stomach. The physician puts one palm on the kidney area, and the other makes light effusive movements along it. After that it is necessary to change the side. The sample allows to assess the presence of soreness in the right or left kidney. Pain indicates an inflammatory process. Most often, a positive reaction to the "symptom of effleurage" is observed in pyelonephritis, a pathological condition in tubules.

Changes in the qualitative composition of urine

If there is a suspicion of kidney disease, many tests are used to detect changes in not only the quantity but also the quality of urine. Such laboratory tests include the sample according to Nechiporenko, Amburzh, Kakovsky-Addis. All these analyzes consist in taking an average portion of urine. The material is then examined for the presence of leukocytes, red blood cells and cylinders. In all cases, the exact calculation of the uniform elements is carried out, after which a conclusion is given.

Samples differ from each other in that in each of them different normal indicators. Nechiporenko analysis is considered good, with leukocyte counts less than 2000, and erythrocytes less than 1000 in the field of vision. Cylinders with normal indices are determined rarely, the norm is up to 500. In the analyzes for Amburge and Kakowski-Addis, the uniform elements are the same. The difference is that in the first rate - 200 and 100 units, and in the second - 2 million and 1 million.

Analysis of urine according to Zimnitsky

The Zimnitsky method is used to determine changes in the quantitative composition of urine. The deviation of the analysis from the norm indicates a violation of the concentration function of the kidneys. The main indicator, which is evaluated when carrying out a sample according to Zimnitsky, is the relative density of urine, which should change during the day. When it decreases, you can think of a large loss of fluid, which is often observed in diabetes mellitus. If the density keeps at the same level all the time, then it should be suspected violations, in which the kidneys lose the ability to concentrate urine, that is, the ability to reabsorb. The test consists in taking the tests throughout the day, every 3 hours (8 servings). In conclusion, daily diuresis, the ratio of day to night urination, and protein loss are calculated.

Urine collection rules for analysis

With changes in the qualitative or quantitative composition of the urine, the physician should develop a further diagnostic plan, that is, think: how to check the kidneys more carefully and what instrumental methods of research to assign? In some cases, poor analyzes depend on the wrong technique of taking the material. In order for the laboratory study to be accurate, it is necessary:

1. Thoroughly rinse the dishes for urine.
2. Carry out the toilet of the external genital organs immediately before the test is given.
3. Immediately after filling the jar with urine, it is necessary to close it, in order to avoid getting bacteria.
4. After collection, take urine to the laboratory within 1-2 hours.

The importance of instrumental research methods

The final diagnosis can be made after carrying out special research methods, which include renal ultrasound, excretory urography, biopsy. These methods allow to detect the wrong arrangement of the body (nephroptosis), the presence of developmental anomalies (polycystosis, doubling), various concrements indicating their size and shape. It is possible to confirm the diagnosis of chronic pyelonephritis even in the absence of its manifestations (extension of CLS to ultrasound). How do they check the kidneys when they suspect a malignant process? Take a biopsy followed by histological and cytological examination of the material.