Laboratory research methods in medicine allow you to see the presence of inflammatory processes in the body or indicate specific diseases (for example, pathologies of the blood system, the presence of renal failure, lack of digestive enzymes, diabetes mellitus). Sometimes, through analysis, you can understand the cause of the violation (viral or microbial agent).
There are many methods for assessing the qualitative and quantitative composition of urine. These include the following: general analysis, sample of Sulkovich, Nechiporenko, Zimnitsky, Addis-Kakovsky, Amburge, etc. Each of these methods helps to suspect a certain pathology of the genitourinary system, as well as the presence of other diseases.
Sulkovich test - what is it used for?
Sulkovich urine assessment is designed to determine the content of calcium in it. This method is used for suspected rickets. The disease is associated with abnormal bone formation due to a lack of calcium in the body. This pathology is widespread among infants who do not receive a preventive dose of vitamin D or who lack sunlight. Sulkovich’s test in this case is a relative, and not an absolute indicator, so the diagnosis of rickets only with its help is not correct. More often this analysis is used to control the dose of vitamin D and to avoid its overdose, which is manifested by hypercalcemia.
What is the danger of hypercalcemia?
The condition in which the body is located with an excess of calcium is very dangerous. They are accompanied by many diseases, for example, hypervitaminosis, hormonal disorders, sarcoidosis, tumors, etc. Excess calcium leads to damage to all organs and systems, but bones, central nervous system, intestines and blood vessels are most affected. A pathological condition is expressed by impaired consciousness (up to a coma), muscle weakness or tension, hypertension, decreased heart rate, the appearance of kidney stones, and a deterioration of glomerular filtration. Since calcium is absorbed in the gastrointestinal tract, an increase in its level leads to digestive disorders, including nausea, vomiting, and constipation. Tissue compaction occurs in the skeletal system, which is accompanied by impaired movement and soreness.
Sulkovich test. Deciphering the results
In order to avoid such dangerous conditions as hyper- and hypocalcemia, a Sulkovich test is performed. The mechanism of the procedure is the introduction into the patient's urine of a special substance that contains oxalic acid. If there is calcium in the analysis, Sulkovich’s reagent interacts with it, which is determined in the form of a cloudy precipitate. The sample is evaluated using a five-point system (from 0 to 4). In this case, average values are considered normal. Both with an increased and with a low content of calcium in the body, the result will be shown by a Sulkovich test. Decoding:
1. The complete lack of reaction (urine transparency) allows you to put 0 points. This result indicates hypocalcemia, in this case the Sulkovich test is negative.
2. A slight degree of turbidity indicates 1-2 points. This is a normal result, that is, the amount of calcium in the body is sufficient.
3. With very turbid urine , grade 3 and 4 are set. This indicates hypercalcemia.
Indications for the test
The Sulkovich test is a common diagnostic method that is used to identify many pathologies. Many experts prescribe this analysis, most often it is nephrologists, endocrinologists, oncologists, gastroenterologists, neuropathologists. Such a number of specialists is due to the fact that the symptoms of excess or deficiency of calcium are expressed in the defeat of all systems, so it is necessary to conduct a qualitative differential diagnosis. Indications are as follows: suspected hyper- or hypothyroidism, sarcoidosis, increased intake of vitamins D and A. In oncological practice, this test is used to detect calcium-producing tumors that can be located in any organ, most often in the thyroid gland. The Sulkovich test in children is necessary to control the use of vitamin D, which is widely used in pediatric practice for the prevention of rickets.
Analysis Collection Technique
When assigning this laboratory test, parents have questions about what a Sulkovich test is, how to take an analysis, why it is needed, etc. Dishes for urine should be dry and clean, as this factor can affect the wrong result. Before collecting the analysis, thoroughly wash the genitals with soap. Then release a small stream of morning urine into the toilet, the rest into the dishes. Before taking the test, you must limit yourself to the use of mineral water, dairy products, herbs, alcoholic beverages and coffee. Violation of this rule leads to a false positive test of Sulkovich. The restriction of products containing a large amount of calcium is recommended for 3 days before the study.
Principles of treatment of hyper- and hypocalcemia
With a sharply positive or negative Sulkovich test, proper medication is necessary. With hypercalcemia, it is important to first determine the cause of the disease. If the blame for all is the use of vitamin D, then it should be abolished. With a negative test, fermented milk products, protein foods, ground eggshells are indicated. Calcium preparations must be prescribed under strict control so that the opposite symptoms do not develop.