Sulkovich urine analysis in infants is a test designed to quantify calcium, which is excreted from the children's body by the kidneys. This laboratory study is necessary in order to diagnose a variety of pathologies associated with the metabolic processes of this microelement.
Calcium and its role in the body
Calcium is a trace element that occupies one of the main places in the activity of various systems of the child's body. This is of particular importance for the developing organism, since calcium is the main element in the structure of nails, teeth and bone tissue in a child.
In addition, calcium takes part in the process of blood coagulation, is present in the composition of nerve tissues, participates in neuromuscular transmission, helps to ensure the correct rhythm of contractions of muscle fibers and heart.
This trace element is involved in the synthesis and secretion of certain hormones. Its presence helps to reduce allergic reactions in the body. Due to such an important role of calcium for the child’s body, it is necessary for a specialist to control the level of its content in urine samples.
Deviations from the normal content in any direction may indicate the development of pathological processes in the children's body.
Features of the analysis according to Sulkovich
Laboratory testing of urine samples is mandatory for newborns and infants. The Sulkovich urine sample is a laboratory test for the quantitative and qualitative content of calcium in urine. Deficiency of this element in the child's body can lead to the development of such a pathology as rickets, which negatively affects the formation and development of the child’s bone skeleton.
You can take a urinalysis according to Sulkovich in any medical institution.
In order for the child to grow normally, 400 mg of calcium must be supplied to his body daily, which he receives in the first six months together with breast milk. With the growth of the child, this indicator increases and by the age of one year reaches 600 mg. The child receives the difference along with complementary foods, which should be introduced into his diet from six months of age.
Vitamin D preparations
The use of drugs based on vitamin D for the prevention of rickets is allowed exclusively under the supervision of a pediatrician, since there is a risk of intoxication. An increase in the concentration of calcium in the child's body is fraught with the formation of pathologies. That is why the Sulkovich analysis is necessary for infants and older children.
Rules for collecting urine samples in infants
Find out how to collect the Sulkovich analysis? The collection of urine samples for research in newborns does not present any particular difficulties, however, there are certain nuances and recommendations that parents should follow in order for the collection of biomaterial to be of high quality:
- It is necessary to collect urine for analysis only in the morning, after the child has woken up, on an empty stomach.
- The baby should thoroughly wash the genitals using baby soap and warm water. Then they are well drained with a towel. Girls should be washed in the direction from the labia to the anus to prevent the ingress of microorganisms located in the lower intestine.
- You can collect urine in any way possible.
The collection of biomaterial for Sulkovich analysis in a young child can be done in several ways, using improvised or pharmacy tools. The most affordable ways to collect urine samples are:
- Using a baby urinal. It is a sterile bag made of polyethylene having an anatomical notch for the genitals and a metric scale applied to it, which allows you to determine the amount of urine collected. Each urinal has an adhesive tape that attaches it to the baby’s foot. When used in a boy, his genitals are placed in a recess located on the urinal. When used in girls, the labia should be placed in the notch, leaving the anus outside the vessel. After the urinal is fixed on the body of the child, they put on a diaper to fix it more tightly. After this, the baby is transferred to a vertical position. After the urine sample is collected, an incision is made in the urinal, through which urine is drained into a sterile container.
- Using a bag made of polyethylene. The technique of using a simple bag corresponds to the technique of collecting urine using an urinal. A new bag of cellophane is placed between the children's legs and fixed on the body using previously cut handles.
- Using a container. In this case, urine is collected in a glass container, which is pre-sterilized. Urine collection in boys does not cause difficulties. In girls, urine is collected using a pre-boiled and cooled plate. It is placed under the buttocks. After urine is collected, it is poured into a container.
To make the result more accurate, the use of a sterile urinal is recommended. Bacterial contamination may be present on available urine sample collection equipment.
Unreliable Results
The results of the Sulkovich analysis in a laboratory study of urine largely depend on the diet of the child. If calcium-rich foods are present in the diet, the result of the study may be biased. Excessive consumption of dairy products, cheese, herbs, leafy vegetables can lead to an excess of calcium in the body of a lactating woman.
If a baby receives complementary foods enriched with calcium, as well as mother’s breast milk, the diet of which has errors, the result of Sulkovich’s test may turn out to be unreliable. In such cases, the mother of the child should have her own diet adjusted before taking the Sulkovich test, and the baby should be examined in dynamics.
How is transcript analysis performed according to Sulkovich?
Norm indicators for newborns and older children
An assessment of a laboratory study of urine according to Sulkovich is carried out visually, after which the result is entered in a special form. The sample is based on the introduction of a reagent into the urine sample, which contains the oxalic acid salt. This substance, interacting with calcium, if it is in the urine, gives a cloudy precipitate. Decryption of the sample is carried out on a five-point scale:
- "Minus". In a chemical reaction, urine remains transparent, that is, the result is negative, hypocalcemia is observed.
- Plus and two pluses. As a result of the reaction, slight clouding of the urine is noted, is the norm.
- Three Pluses and Four Pluses. As a result of the reaction, severe turbidity is noted, which indicates the presence of hypercalcemia.
If the analysis reveals deviations from normal values, then this result is not used to make a final diagnosis. In this case, the pediatrician prescribes additional studies. Confirm the normal result of the Sulkovich test with a more informative biochemical study of urine.
To this end, analyze the daily urine of a child using special equipment that determines the rate of calcium concentration:
- In a child from birth to one and a half months, this indicator is 0-1 mmol / day.
- In a child from one and a half months to 4 years old - 2.6 mmol / day.
- In a child 4-14 years old - a maximum of 10 mmol / day.
- In a child of 14-18 years old - 7.5 mmol / day.
What does Sulkovich urinalysis in a child reflect?
Probable pathologies with calcium imbalance
The level of calcium concentration in children's urine, if it deviates from normal values, can have negative consequences regarding its further development. Fluctuations in the calcium content in urine samples in a certain direction may indicate various pathological changes in the child's body.
So, the analysis (test) of Sulkovich can reveal hypocalcemia.
Hypocalcemia
A decrease in calcium concentration in children's urine may indicate a deficiency of vitamin D in the body and the formation of rickets. This pathology is accompanied by the development of the following clinical manifestations:
- Curvature of the lower extremities.
- An increase in the abdomen, ribs that begin to protrude outward.
- An increase in the volume of the head, which begins to take a square shape.
- An increase in the size of the fontanel.
The basis of the clinical symptoms of rickets is deficient calcium in the body, which provokes softening of the cranial bones and leg bones. Such a manifestation of the pathology must be treated by taking vitamin D and adjusting the diet, which should be saturated with foods fortified with calcium.
Hypercalcimia
Therapy of rickets with vitamin D involves monitoring the child in dynamics, as well as conducting control tests of Sulkovich, since an overdose of vitamin D is highly likely. In such cases, the result of the Sulkovich test in a child will indicate a calcium surplus.
An increased concentration of a trace element can provoke the development of a convulsive syndrome in the form of spasmophilia. In addition, a strong calcium surplus leads to its deposition in bone tissue. This pathological process inhibits the development and growth of the baby.
Deciphering the urinalysis according to Sulkovich allows you to determine the dosage of vitamin D required for a particular child. And also control its content and keep it within normal limits.
Recommendations of pediatricians
For the normal growth and development of the child, not only medical recommendations regarding the care of him should be followed, but also his health in a timely manner. This implies, first of all, regular consultations with a pediatrician and the obligatory delivery of clinical blood and urine samples.
Babies are also recommended to spend more time outdoors, take air and sun baths that stimulate the production of vitamin D.
Proper diet
It is also necessary to adhere to a proper diet, which contributes to an adequate intake of calcium. The necessary daily dosage of a trace element to ensure the normal development of the child up to six months is 400 mg. This amount of calcium the baby receives with breast milk. As the child grows, this indicator increases and reaches 600 mg by the age of one year. To ensure the receipt of a dose difference is necessary by introducing complementary foods.
We examined what shows and how to collect a urinalysis according to Sulkovich.