Diseases of the genitourinary system are quite common. Many women know what chronic pyelonephritis is, since this pathology complicates pregnancy. Kidney diseases can lead to dangerous consequences that require constant purification of the blood from toxic substances (hemodialysis). The ailment has several reasons (for example, a hereditary predisposition, hypothermia, infection of the genital organs, etc.), and often is asymptomatic, that is, it does not bother a person, so everyone needs to know how the kidneys are checked. This will help in time to seek medical help and avoid serious complications.
Kidney structure
The kidneys are paired organs located in the lumbar region. Their main function is the formation of urine. The kidneys maintain oncotic blood pressure and produce erythropoietin. The main structural unit - nephron - consists of the vascular part (glomeruli) and tubules. The former 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, the processed waste product remains - secondary urine. If at some stage an obstruction occurs, then 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 the diuresis disorders that almost all patients have. These may include a decrease or increase in urination, a change in the color of urine, and more or less frequent use of the toilet.
Kidney Research Methods
There are many ways that can identify the pathology of the urinary system. In medical institutions, kidneys are checked using special tests, for example, analyzes according to Zimnitsky, Nechiporenko, Amburge. 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, an analysis according to Zimnitsky allows to reveal a violation of filtering ability, according to Nechiporenko - the presence of an inflammatory reaction and hematuria. For the correct diagnosis, an instrumental study of the kidneys is used. These methods include excretory urography and biopsy. The gold standard is kidney ultrasound. Each of these methods, if necessary, is prescribed by a doctor and allows you to detect certain pathologies.
How are kidneys healthy?
In order to understand whether there is a kidney disease, it is necessary to pay attention to the patient’s complaints, especially if symptoms such as increased frequency and changes in urination, an admixture of blood in urine, and an increase in nighttime urine output are observed. An important sign is pain in the lumbar region, lower abdomen on the right or left. In addition to the main symptoms, a sharp increase in body temperature, general weakness can be observed.
Often kidney disease is preceded by tonsillitis, SARS, hypothermia. Signs may include swelling and high blood pressure. These symptoms appear with glomerulonephritis - an inflammatory process in the glomeruli, which has various forms. In this regard, only part of the signs or even one of them may prevail. How to check the kidneys in the presence of edema? First of all, it is necessary to find out what is the cause of the symptom. If edema predominates in the morning, and to the touch they are soft and warm, then it is necessary to consult a nephrologist.
Physical examination methods
After a thorough analysis of complaints and clarification of the medical history of the disease, it is necessary to conduct an examination. First you need to assess the general condition of the patient and check all 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 (if there are any visible changes, swelling) and palpation. You can feel the organ at various positions of the patient: lying on his stomach, standing and sitting. In this case, 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 grab the organ and evaluate its size, the presence of soreness, structure, texture and location. In healthy patients, the kidneys are not palpable, that is, they can not be palpated.
What symptoms can be observed with renal pathologies?
How to check the kidneys, except for palpation, every doctor should know. If there is a suspicion of an inflammatory process, special functional tests are performed that allow to assess its presence or absence. The most widely used method is the "striking symptom." It is conducted by a general practitioner who wants to rule out kidney disease. In addition, this method is used in any hospital with a daily round of a doctor. The test is carried out with the patient standing or lying on his stomach. The doctor puts one palm on the kidney area, and the other makes light striking movements on it. After that, you need to change the side. The test allows you to assess the presence of pain in the right or left kidney. Pain indicates an inflammatory process. Most often, a positive reaction to the "symptom of striking" is observed with pyelonephritis - a pathological condition in the tubules.
Changes in the quality of urine
If you suspect a kidney disease, many tests are prescribed, with the help of which changes in not only the quantity but also the quality of urine are detected. Such laboratory tests include a sample according to Nechiporenko, Amburge, Kakovsky-Addis. All these tests consist of taking an average portion of urine. Then the material is examined for the presence of white blood cells, red blood cells and cylinders. In all cases, an accurate calculation of the shaped elements is carried out, after which a conclusion is given.
Samples differ from each other in that each of them has different normal values. Nechiporenko's analysis is considered good in the presence of white blood cells less than 2000, and red blood cells less than 1000 in the field of view. Cylinders with normal indicators are rarely determined, the norm is up to 500. In the analyzes according to Amburge and Kakovsky-Addis, the uniform elements are the same. The difference is that in the first norm - 200 and 100 units, and in the second - 2 million and 1 million.
Urinalysis according to Zimnitsky
The test according to the method of Zimnitsky is used to determine changes in the quantitative composition of urine. Deviation of the analysis from the norm indicates a violation of the concentration function of the kidneys. The main indicator, which is assessed during the Zimnitsky test, is the relative
density of urine, which should change during the day. With its decrease, you can think about a large loss of fluid, which is often observed in diabetes mellitus. If the density is kept at the same level all the time, then one should suspect violations in which the kidneys lose their ability to concentrate urine, that is, the ability to reabsorb. The sample consists in taking tests throughout the day, every 3 hours (8 servings). In conclusion, daily diuresis, the ratio of day and night urination are estimated, protein loss is calculated.
Urine collection rules for tests
With changes in the qualitative or quantitative composition of urine, the doctor should develop a further diagnostic plan, that is, think: how to check the kidneys more carefully and what instrumental methods of research should be prescribed? In some cases, poor analyzes are dependent on improper material collection techniques. In order for the laboratory test to be accurate, it is necessary:
- Rinse urine dishes thoroughly.
- Have a toilet of the external genitalia immediately before taking the test.
- Immediately after filling the jar with urine, you must close it to prevent bacteria from entering.
- After collection, take the urine to the laboratory within 1-2 hours.
The value of instrumental research methods
The final diagnosis can be made after conducting special research methods, which include ultrasound of the kidneys, excretory urography, biopsy. These methods allow you to detect the incorrect location of the organ (nephroptosis), the presence of developmental abnormalities (polycystic, doubling), various calculi indicating their size and shape. The diagnosis of chronic pyelonephritis can be confirmed even in the absence of its manifestations (enlargement of CHS on ultrasound). How are kidneys checked for malignancy? A biopsy is taken, followed by histological and cytological examination of the material.