Sometimes a general study of urine is not enough. Sulkovich urine analysis can be one of a number of additional measures, as it makes it possible to determine the concentration of calcium in human secretions. This test is used for children, but in some cases it is prescribed for adults. A urine test allows you to get more information about the condition of the internal organs.
Below we consider the decoding of urinalysis according to Sulkovich in children and adults.
Why control calcium levels?
Calcium is a vital macronutrient in the body, most of which is located in the teeth and bones. If its metabolism is impaired, the results of a study of urine and blood will show this. Sulkovich urine analysis makes it possible to measure the degree of calciuria. The amount of calcium released from the body allows you to learn about the functioning of the kidneys and metabolism in bone tissue. Thanks to a urinalysis using the Sulkovich method, it is possible to determine whether the patient has hypo- or hypercalcemia, the ratio of vitamin D in which he should be at the prescribed therapeutic course to prevent overdose, since this vitamin is used to absorb calcium.
What pathologies require such an analysis?
Sulkovich urine analysis is required when it is necessary to evaluate the activity of the parathyroid gland, pituitary and thyroid gland, to study osteoporosis, to determine the degree of development of rickets (calcium deficiency) in the treatment of other bone diseases. In other words, such a research method is used both for monitoring the prescribed treatment course and for diagnosis.
Analysis Methodology
The method of collecting urine according to Sulkovich is quite simple. For this purpose, it is not always necessary to collect urine analysis per day (although this type of study is the most accurate), since the morning one is best. The procedure is performed on an empty stomach, otherwise it will be ineffective. It is necessary to fill the prepared container with urine and deliver it to the research department of the medical institution a maximum of two hours after this.
How to take Sulkovich’s urine test, it is important to find out in advance.
A little Sulkovich's solution is added to the sample in the laboratory, the degree of turbidity of the mixture is visually diagnosed. The peculiarity of the chemical reaction lies in the fact that oxalic acid (as one of the components of Sulkovich's solution) interacts with calcium salts contained in urine. The consequence of this is the creation of sedimentary salts that are not soluble in liquids. This sediment is examined directly. It is estimated as the level of turbidity of the sample. The more calcium in the urine, the more dense the sediment will be. The turbidity level is measured in points; it is marked with crosses from one to four. There is also a negative test - zero points.
How is urinalysis according to Sulkovich in infants?
Urine collection in infants
Parents often, before taking the test, first collect baby urine in cotton or diapers for this purpose, and then they only express the liquid into a container. However, this method cannot be correct, since a kind of urine filtration occurs, while the contents of the bladder should be directly transferred to a special container. That is why many parents are interested in how to collect urine from babies.
In infants, the need to collect such an analysis is required in neurology, it is prescribed by pediatricians to determine whether vitamin D is contained in a normal amount in the children's body. This allows you to diagnose hypercalcemia and prevent excessive calcium intake during treatment, which can lead to negative consequences.
When you need to collect urine from a small child, the study is carried out before the first feeding. The diet of children should be limited two to three days before the analysis: you need to exclude kefir, cottage cheese and other foods that contain a lot of calcium.
It is very important that urine emitted during the urination of the baby flow immediately into the prepared container. For collecting in children, special urinals are used, that is, devices that greatly simplify the procedure, since they are easily fixed in the area of the intimate organs of infants with a bandage or Velcro, suitable for collecting urine in both girls and boys. After it is assembled, such devices are removed and the baby is no longer delivered with discomfort.
In what cases do Sulkovich test adults and children?
For children, a urinalysis according to Sulkovich is done in order to be able to control the calcium content in the body. However, adults are also advised to undergo research by specialists of different profiles: neurologists, oncologists, nephrologists, endocrinologists and urologists. Defects in calcium metabolism affect several systems of the human body. There are several indications on the basis of which the analysis of urine is carried out according to the Sulkovich system.
For example, suspicion of the presence of a tumor (certain types of neoplasms produce calcium), excessive consumption of vitamins D and A (the study allows you to determine the normal dosage), suspected sarcoidosis. Experts advise to take not only urine for analysis to determine calcium, but also blood, which will help to more accurately determine the diagnosis. In addition, metabolic disorders can be observed in some cases only in urine, which indicates a violation of renal filtration, and not of the metabolic system in general.
How to prepare for a urinalysis according to Sulkovich to a child and an adult?
Preparing the patient for analysis
It is necessary to take the analysis with preliminary preparation, otherwise the result will be distorted. Firstly, urine can only be examined when the change was made on an empty stomach. You also need to limit your diet and exclude greens, sweets, spirits, colored foods and mineral waters from it. Physically heavy loads also negatively affect the result of the analysis.
Before collecting, wash your genitals with warm, soapy water. The next step is to release some urine, but not all. Thanks to this, it is possible to eliminate bacteria particles from the genitals that can get into the collection. The remaining urine is given in a dry, clean, prepared container, that is, a container cleaned with strong antibacterial agents or special one-time for research. Analysis of urine for calcium is recommended on the basis of morning collection.
Deciphering urinalysis according to Sulkovich
To assess, you need to take morning urine. A very important condition is the delivery of tests on an empty stomach, otherwise a qualitative diagnostic study will not be carried out. The interpretation of the analysis is determined by the level of turbidity of the urine. If the result is negative, it indicates the presence of hypoparathyroidism. Thus, calcium and vitamin D are not enough in the human body. There may also be hypocalcemia, however, such a diagnosis is determined provided that a parallel blood test is performed for reliability.
A negative result may indicate:
- lack of ergocalciferol in the human body;
- dysfunction of the thyroid gland and a decrease in the production of hormones;
- defect in magnesium metabolism;
- tumor metastases of a malignant nature in the prostate gland, which penetrated into the bones;
- chronic and acute renal failure, which is distinguished by the release of diluted urine;
- the use of anti-inflammatory non-steroidal medicines, diuretics containing hydrochlorothiazide;
- the implementation of the blood test determined intolerance to products, including calcium.
One or two points, that is, + or ++, is the established average norm in urine, indicating a low calcium content.
Three and four points (+++ or ++++) indicate excessive excretion of calcium from the body during emptying of the bladder. For example, when a patient has hyperparathyroidism, approximately 200 milligrams of this macronutrient is washed out of his body with urine in 24 hours. Deviations from the norm require additional diagnostics and effective therapy.
Three or four pluses
Decoding of three and four pluses:
- excess production of vitamin D;
- malignant tumors of the lungs or breast;
- benign neoplasm of the thyroid gland;
- granulomatous inflammation of the gastrointestinal tract;
- decreased functional activity of the tubules of the kidneys;
- diabetes;
- cancer of the lymph nodes or blood;
- a malignant tumor from plasma cells;
- nonspecific ulcerative colitis;
- prolonged stay in a stationary state;
- taking diuretics, antibiotics that remove potassium from the body, or drugs that reduce the production of gastric juice.
Decryption of urinalysis according to Sulkovich in infants should be carried out only by a qualified specialist.
The norm of analysis for infants and older children
For infants and for older children, one or two pluses is considered normal. This level shows that the calcium in the child's body is in the right ratio and does not require any adjustment. No further action is needed. The child develops correctly, in accordance with his age.
Risk of abnormalities
A negative result may indicate rickets or malfunctioning of the thyroid gland, kidney disorders, etc. Most often this happens in adults.
In children with a minus, it is still impossible to judge rickets, but about a lack of vitamin D - completely. In the future, the disease will develop if nothing is done. Your doctor may advise you to visit the street more often for ultraviolet radiation, which stimulates the production of vitamin D.
If two or more pluses are obtained, you do not need to panic too much, but the deviations are serious and need additional examination and determining the exact diagnosis.
If the urine was collected incorrectly or the preparation was broken, there may be underestimated or overestimated results, which makes the decryption incorrect. In this case, it is impossible to make a diagnosis.
We examined how to collect a urine test according to Sulkovich and what it shows.