The kidneys in the human body serve as purifiers, as they are engaged in continuous blood filtration. Such filters are called glomeruli, thanks to them, the released toxins penetrate the urine and are excreted with it. Such creatinine can be determined by making a Reberg-Tareev test.
A bit of history
In 1926, a physiologist from Denmark, Paul Reberg (Poul Kristian Brandt Rehberg) (1895-1989), for the first time carried out a method for detecting glomerular filtration rate by the clearance of exogenous creatinine by the kidneys. However, initially there were difficulties with the results of the study. Since there was a need for intravenous administration of creatinine from the outside. True, it was later found that creatinine in blood plasma is practically unchanged and does not undergo significant fluctuations.
Thus, the Soviet physician E. M. Tareev (1895-1986) began to improve the Rehberg method, and began to determine the glomerular filtration rate by the clearance of endogenous (“intrinsic”) creatinine. That is, the substance began to be determined in the blood plasma, and not administered intravenously, as before. Since that time, this study has been called the Reberg-Tareev trial.
Medical indications for sampling
Your doctor may prescribe a Reberg-Tareev test if you suspect a urinary system disease. So, an indication for the study can be such violations:
- The appearance of edema in different parts of the body.
- High blood pressure for no particular reason.
- The daily rate of urine output has been reduced.
- The appearance of seizures in the limbs.
- Muscle weakness and lethargy.
- Cases of loss of consciousness.
- Attacks of nausea and vomiting.
- Tachycardia.
- A change in the color of urine, it may become dark or cloudy, or a change in its consistency.
- Presence of pus, mucus, or blood in the urine.
- Lumbar pain or pain in the lower abdomen.
Such a test is also carried out in order to track the dynamics of the treatment of already known diseases, such as:
- diabetic nephropathy;
- nephrotic syndrome;
- diabetes insipidus;
- heart and vascular disease;
- glomerulonephritis;
- pyelonephritis and others
If the analysis is carried out correctly, this will allow you to choose the right treatment for such common kidney diseases as pyelonephritis, diabetic nephropathy, amyloidosis, renal failure, etc. In addition, it is possible to track the work of the kidneys with endocrine and cardiovascular disorders. Reberg-Tareev analysis is used as a differential diagnosis for cancerous tumors.
What is a Rib test?
Creatinine is a metabolite of creatine phosphate in muscle cells. Its level will directly depend on the weight of the person. Creatinine may change with age. The substance is filtered by glomeruli of the kidneys. After which part of it falls into the urine and is excreted along with it. If pathological obstruction of the renal tubules is observed, then the bulk of creatinine is thrown into the bloodstream. As a result of this, various abnormalities in health are observed in a person, for example, blood pressure rises or glucose exchange is disturbed.
The Reberg test is able to determine the cleansing ability of the glomeruli of the kidneys. Renal clearance is carried out by calculating the speed and quality of removing an element from the body.
Features of the preparation for the analysis of Rehberg
Blood and urine are given for analysis, but this study requires special preparation. So, a day before the urine is taken, it is necessary to adhere to such an algorithm of actions that will reliably determine the creatinine norm in the urine in the Reberg test:
- Do not drink alcohol, coffee, or even strong tea.
- Compliance with dietary nutrition, which involves the exclusion of protein, meat and fish food.
- Refrain from physical activity and sports.
- Do not be nervous, avoid stress.
- Regarding liquids, the usual drinking regime is maintained, that is, up to 1.5 liters of water per day.
- It is forbidden to take any medications, as they will distort the research data.
- If medication cannot be delayed even for a couple of days, then you should inform your doctor who will take this into account when decoding the analysis.
- You can not take medicinal diuretic herbal preparations so that the norms of the Reberg test in the urine do not change.
Rules for preparing for the analysis
In order for the result to be as accurate as possible, and treatment for the disease has paid off, you need to know about the rules for preparing for analysis:
- 48 hours before the study, diuretics are excluded.
- For a day, heavy proteins that are found in meat, legumes, and fish are excluded from the diet. As well as smoked meats, pickles and alcohol.
- On the eve of the analysis, eliminate stress, physical stress.
- Prior to blood sampling, it is necessary to maintain the interval of food intake, it should be 8-12 hours.
- A liquid, in the form of water, is taken 6-8 hours before analysis. Do not drink coffee, tea and carbonated drinks.
- Urine does not collect on critical days.
Normal values of the Reberg-Tareev test: decoding
The results of the test will directly depend on the state of creatinine. The following are the normal values of the Reberg-Tareev test:
- From birth to one year, for both boys and girls, the rate is 70-100 ml / min.
- From 1 year to 30 years, creatinine data are virtually unchanged. For women, they are equal to 85-146 ml / min, for men - 50-150 ml / min.
- From 40 to 50 years, the creatinine norm will be slightly reduced. Normal values of the Reberg test in women are 62-115 ml / min, in men - 65-124 ml / min.
- At 50-60, for women - 57-109 ml / min, for men - 60-120 ml / min.
- The decrease is after 60 years and up to 70 years - for women, these data are reduced to 55-105 ml / min, for men, the figure will be slightly higher - 59-110 ml / min.
- Well, finally, from 70 to 90 years old, the norm of creatinine for women is 48-98 ml / min, and the norm of the Reberg test in men is 51-100 ml / min.
What is needed for change?
In laboratory studies, daily urine is involved. Therefore, it is worth adhering to certain collection rules so that the analysis determines the normal values of the Reberg-Tareev sample. The first morning urine is not taken, the first trip to the toilet is fixed on a piece of paper. After that, throughout the day, urine is collected in a specific clean container. All this time, the liquid is in a cool place.
After receiving the material by the doctor, he measures the volume of urine. Then 60 ml is sent for analysis. Along with measuring urine volume, the doctor measures the patient’s height and weight. On the same day, blood is also donated to detect the level of creatinine in it. The time for a full study according to Reberg-Tareev takes an average of 3 hours.
Features of the survey
When taking blood from a vein, special preparation and compliance with the rules is not required. Blood is taken from an empty stomach vein. Therefore, they hand it over in the morning.
Urine collection is carried out according to two schemes. If you need daily urine, then you need to collect it, following these rules:
- As soon as a person wakes up, you need to drink a glass of clean water.
- First urine is not collected.
- At this time, it is best to donate blood. However, if she will give up after collecting daily urine, then this is also acceptable.
- Having started collecting urine, you need to fix the time, since it will take exactly 24 hours to collect urine. The drain container must be sterile.
- Biomaterial is stored in the refrigerator.
The rest of the sequence has been described above.
Methods for hourly portions of urine
There is a more simplified method of collecting urine to determine the normal values of the Reberg-Tareev test, it is carried out as follows:
- In the morning, water is also drunk, but at a time you need to drink at least 500 ml.
- The first urination is also carried out without collecting urine.
- After half an hour, you can donate blood from a vein.
- After 30 minutes, you need to collect urine in full.
This method is convenient if the person is in the hospital, sometimes the method is also used on an outpatient basis.
Decrease in values
Typically, rates are reduced in chronic or acute renal failure. With a compensated and subcompensated form of the disease, indicators decrease from 30 to 15 ml / min. In the decompensation stage, the creatinine content is reduced to 15 ml / min.
Creatinine clearance will be reduced with the following pathologies:
- congestive heart failure;
- arterial hypertension, which developed against the background of a malignant process;
- glomerulonephritis;
- other diseases associated with kidney damage.
But the norms of the Reberg test during pregnancy in women can be slightly overestimated.
Increase values
If the norm of the Reberg-Tareev sample is overestimated, then most likely this is not associated with a pathological condition, it is possible that a person was actively involved in sports before analysis, or consumed protein food. Creatinine clearance increases during certain periods of pregnancy. Thus, the normal values of the Reberg test in pregnant women can be slightly overestimated.
A pathological increase in the Reberg-Tareev test can be observed with the initial stage of diabetes mellitus, nephrotic syndrome or hypertension. Glomerular filtration rate will show the norm in men and women in different digital data. For men, on average, it is 97-137 ml / min, for women, the indicator is slightly less - 88-128 ml / min.
The analysis will reveal various pathologies at an early stage, which will determine the success of further treatment. After all, the therapy of diseases in advanced stages is difficult due to the appearance of complications.