Research methods kidney

Diagnosis of kidney diseases is based on a survey of the patient, examine its complaint, data on physical, laboratory, x-ray and instrumental examination.
In the survey find out localization and character of pain, their irradiation, violations of urination, the duration of appearance in the urine blood or pus. Thoroughly investigate the history of disease, injury, illness.
On examination, the patient is sometimes possible to determine the bulging front-side abdomen hypochondrium by increasing the kidneys (tumors, hydronephrosis). Probing the kidneys produce when the patient on the back with half-bent legs at the moment deep breath of the patient. Probing produce two hands - during feeling left kidney right hand down under the lumbar region of the patient, while the left is placed on the area hypochondrium and inhaling bring the fingers.
Probing kidneys may also be made when the position of the patient on his side. This technique helps to diagnose the omission of the kidneys. In healthy people kidney't be felt; omitted kidney is defined as a flexible, elastic oval body, shifting up. Kidney cancer is defined as thick, bumpy sedentary education, painful to palpation. Increased smooth painful kidney is determined by palpation with hydronephrosis; increased bumpy kidney - in polycystic.
Great diagnostic importance symptom of Pasternatskogo - tenderness effleurage lumbar region XII below the ribs.
In the diagnosis of kidney diseases applied research method fotovideoporno and concentration of the kidneys. Indicator fotovideoporno function is the number of urine per day (daily diuresis) compared with the amount consumed per day of liquids. The concentration function is determined by measuring the specific gravity of urine in a single three-hour increments. A significant decrease in the amount of urine output - oliguria (see), the lack of urine output - anuria (see) or increase urine output - polyuria (see) serve as an indicator of impairment of renal function.
Reduced share of urine (1008-1014) - hypotenuse, and the share of urine without hesitation - isosthenuria indicate violations of the concentration function of the kidneys, which is usually manifested by a combination of both symptoms, i.e. sociosanitaria. To clarify these functions carry out functional test water samples (test for breeding) and the sample concentration. Water sample is this - patient drinks on an empty stomach 1.5 liters of water, then after 30 minutes start to measure the amount allocated urine within 4 hours. The sample concentration on renal function: the patient during the day consumes only dry food, rich in protein (meat, eggs and other), during this time in the morning he collected urine every 2 hours, measuring the amount and share in each portion.
With normal kidney function of a water sample shows a quick selection of all drinking liquids with low specific weight - 1002-1004; when the sample concentration the amount of urine in each subsequent portions decreases, and the proportion increases to 1030 and more.
More physiological is functional trial of zimnitsky tests; when it is not necessary to load a large amount of liquid or eliminate it. In a patient with normal nutrition collect urine every 3 hours (8 servings); separate day and night serving, measuring the amount of urine and the specific weight of each piece. With normal kidney function of the fluctuations of the share and amount of urine in various portions significant and the most part of urine excreted day. Equally low specific weight in all portions indicates a violation of the kidney.
An important study of kidney function is defined in the serum of the blood of nitrogen products - the so-called residual nitrogen, which in norm contains not more than 40 mg%. When kidney failure , the amount of residual nitrogen may be increased to 100 mg% and above - azotemia (see). Currently in clinical conditions renal function is determined using a more subtle biochemical investigations: clearance test and using radioisotope research - isotope renography and scanning kidneys. The principle method of isotope renografii is that the concentration in the kidneys intravenously introduced radioactive substances registered external dimension using the detector, located in the kidneys from the waist. Radioactive kidney scans allows you to install their shape, size, presence of focal lesions in kidneys with a special device - scanner. The leading value in the diagnosis of urological diseases is x-ray examination of the kidneys, which must start with a survey snapshot of the urinary system. Before any exposure of the patient must be carefully prepared diet and purifying enemas. On the overview image, you can define the contours of the kidneys, their location, the presence of stones in the kidneys or urinary tract. For detection of kidney function produces excretory pielografia (see), in which the front of the chest x-ray is injected into a vein radiopaque substance: 20 ml of 40% solution of sergazina or other substances. Images produced through 10, 30, 45 minutes after injection of a contrast agent. Sometimes for special reasons make the retrograde pyelography in which contrasting kidney substance is injected into the renal pelvis on introduced into the ureter to the catheter. For diagnosis of kidney diseases is often used angiography, in which the contrast agent is injected into the aorta, renal artery.
Of great importance in the diagnosis of urological diseases of the kidney are instrumental studies - cystoscopy (see) and chromatotherapy.

Diagnosis of kidney diseases is based on the analysis of the main symptoms of data on physical, laboratory, x-ray and instrumental studies of the patient.