How are kidneys checked? Research methods that check whether the kidneys are healthy. How can I check the kidneys, what tests need to be done? What kidney tests to take

The excretory system plays an important role in human well-being. The functionality of the kidneys is extremely important. During the day, this paired organ of a small size passes through itself up to 200 liters of blood, purifying and filtering it from excess water and harmful impurities. With kidney disease, people have certain clinical signs, but at first, the manifestations may be absent and appear already with a protracted process that is difficult to treat.

Regular examinations, diagnostic measures and examinations will help to choose treatment tactics in a timely manner and avoid complications. It is very easy to find out about the condition of the kidneys at home. It won't take long, but it will clear things up.

How to check the functionality of an organ at home?

There are several ways to check the kidneys at home. These methods cannot be considered reliable, and the results are reliable. If the results of self-examination indicate the presence of a pathological process, then you should immediately seek medical help. Guesses may not be confirmed at all, and if a pathology is detected, the patient will receive timely assistance.

Diagnosis of kidney function at home involves the study of urine. Only morning biomaterial is suitable for examination, since it can change during the day, which will lead to an erroneous result. On the eve of self-examination, it is worth sticking to a diet: exclude salty and spicy foods, alcohol, diuretics. In the morning after waking up, you need to collect the average portion of urine in a clean white container. After that, it is necessary to visually evaluate the biomaterial according to the following parameters:

• color (normally it should be straw yellow, saturated indicates problems);
• transparency (there should be no impurities, sediment in the liquid);
• volume (morning urine is excreted in the amount of 150-250 ml);
• odor (normally it is neutral, the presence of a pungent odor indicates pathologies).

The daily volume of excreted fluid approaches 2 liters. You can collect urine throughout the day to test your kidneys. The total amount should be close to the amount of liquid drunk. If more or less is secreted, the doctor may diagnose polyuria or oliguria.

You can suspect the disease by some symptoms

Examination of the kidneys at home includes an assessment of the clinical picture. Most common diseases have symptoms. If the kidneys hurt, then this can be manifested by sharp, shooting sensations in the lumbar region. In this case, we are talking about colic, the cause of which can be many pathological conditions.

If the sensations in the back are dull, pressing, then we are talking about a chronic process. In women, these manifestations can be confused with inflammation of the ovaries and uterus. Often, with renal abnormalities, an increase in body temperature occurs. Edema is one of the first signs of pathological conditions.

If a person sees bags under the eyes in the morning, swelling of the eyelids, limbs, a sharp increase in body weight, then you should definitely seek medical help and find out how to check the kidneys, what analysis to take and what to do to fix the problem.

What diagnostic measures does medicine offer?

Before checking the work of the kidneys in a person, the doctor will conduct an oral survey and collect an anamnesis. Therefore, when contacting a medical institution, it is necessary to prepare for a dialogue with a specialist: remember if there were once diseases of the urinary system, pain in the lumbar region, poor test results. A medical examination involves probing and tapping the lumbar zone. This technique will not give exact conclusions, but it will allow you to suspect problems, if any. After the interview, the specialist assigns the patient a list of diagnostic measures, compiled on the basis of the clinical picture and individual characteristics.

The standard urinalysis, which many people do when examining the kidneys, is not enough. The results of this study can show an approximate overall picture, but a more detailed diagnosis requires a set of measures.

Laboratory indicators

The list that determines which tests to take usually begins with a urinalysis. A home appearance assessment is usually not enough to make a diagnosis. Therefore, urine is subjected to laboratory study.

1. The first and main one is a general urine test. The study of the morning portion of urine occurs with an assessment of chemical, physical properties, as well as qualitative and quantitative characteristics. When evaluating the results, general indicators are taken into account in a complex, and not separately. A poor result is indicated by the presence of a large number of leukocytes and protein.
2. Analysis according to Nechiporenko allows you to determine the amount of formed elements in urine, can show the presence of an inflammatory process in the urinary system.
3. helps determine how much the kidneys can concentrate and dilute urine. For the study, the daily volume of released fluid is required.
4. An analysis for Bence-John protein helps to identify tumor diseases in a paired organ, if any.
5. The determination of albumin is carried out in patients with and is an important study of the functionality of the excretory system.

When confirming inflammatory processes, the patient must pass urine for bacteriological examination. The study of the microorganisms present helps to establish their sensitivity to traditional remedies. After receiving the results, the patient is prescribed treatment, if necessary.

Blood analysis

Modern methods for examining the kidneys include in their list not only the diagnosis of urine. To obtain a complete clinical picture, it is necessary to take a blood test: general and biochemical. Some patients are individually assigned to determine the level of sugar.

The study of the kidneys by blood does not allow to determine the localization and stage of the disease. According to the results of the analysis, it can be established that there is an inflammatory process in the patient's body. In renal pathologies, the concentration of urea, uric acid, and creatinine changes.

To check the kidneys as efficiently as possible, you should donate blood for analysis from a vein. If the material is taken from the finger, then there will be fewer parameters for assessing the state of the organism. Preliminary preparation is necessary so that the diagnostic results are as accurate as possible.

Instrumental Research

If the patient has no idea where to start diagnosing the functionality of the urinary system, then an ultrasound can be done. Sonological examination allows to assess the size, position, internal parameters of the components of the kidney. During the scan, calculi, sand, or even a tumor can be detected. Often analyzes do not show this. Ultrasound is a safe diagnostic manipulation, but at the same time quite reliable. If the patient does not want to go to the doctor, but wants to check the function of the paired organ, ultrasound should be preferred. For the purpose of prevention, it can be carried out once every six months.

X-ray examinations of the kidneys help to identify neoplasms in the organ, if any. Such diagnostics are carried out only on the prescription of a doctor if there is evidence. For the purpose of prevention, they are not carried out. How to examine the excretory system and what type of X-ray diagnostics to choose depends solely on individual indicators. For some patients, the procedure begins immediately, while others require preparation and preliminary administration of the solution intravenously.

Magnetic resonance imaging is performed in a specialized institution and is one of the most reliable methods. Kidney ailments reveals a magnet. Manipulation is safe and does not require serious preparation. Despite this, an MRI should be performed as directed by a physician. However, recently there has been a growing number of private institutions offering kidney MRI for money.

Scintigraphy is a study of the excretory system, involving the introduction of a radioisotope substance. Diagnosis allows you to determine the physical characteristics of the kidneys and identify functional disorders. It is performed according to indications with a preliminary conduction of simpler instrumental examinations.

Who Should Get Their Kidneys Checked First?

What tests need to be taken to check the kidneys, it is desirable for all people to know. The paired organ that regulates the functioning of the urinary sphere is vital. If its functionality is violated, the work of the whole organism is distorted, which, under certain conditions, can be life-threatening. Persons with a tendency to kidney pathologies need to know which urine tests to take to check the kidneys. The risk group includes patients with obesity or underweight, hypertension, diabetes, pregnant women, people with bad habits.

A person should immediately think about how to check the kidneys, should be under such conditions:

• high blood pressure, the upper limit of which reaches 140 mm Hg;
• sudden decrease in urine volume;
• nighttime urge to go to the toilet;
• pain, heaviness, shooting in the lower part of the peritoneum and back;
• urine began to smell unpleasant;
• blood appeared in the biological fluid or it acquired a brown saturated hue;
• detection of anemia, not accompanied by bleeding;
• when eating a large number of protein dishes and pickles;
• dehydration of the body due to vomiting, diarrhea or hyperthermia;
• treatment with toxic medicines (some diuretics, antibiotics, aspirin);
• hanging body temperature without additional clinical manifestations of colds;
• systemic and autoimmune diseases;
• a tumor inclusion is palpated in the abdominal cavity.

During pregnancy, a planned examination of the excretory organ is prescribed, which is carried out in the first and third trimesters. If a woman has complaints, then the diagnosis is carried out more times. In addition to the instrumental methods allowed for expectant mothers, a urine test is regularly given. If the indicators indicate a possible pathology, then the patient is assigned additional examinations.

Common diseases

During the examination of the functions of the urinary system, pathological processes can be detected. At initial development, they do not always have symptoms, which greatly complicates the diagnosis. Medical statistics show that the most common deviations are:

1. pyelonephritis - inflammation of the shell of the organ and the pyelocaliceal system;
2. cystitis - inflammation of the membranes of the bladder;
3. urolithiasis - the formation of stones throughout the excretory system;
4. acute insufficiency - a sharp violation of functions and metabolic processes;
5. nephrotic syndrome - the formation of protein in the urine, excessive edema;
6. nephritis is a generalized term that characterizes inflammatory processes.

Statistics show that up to 50% of women suffer from various types of pathologies of the urinary system. In men, the disease is more common. Even with kidney damage affecting 80% of tissues, the organ continues to function and perform its task. However, this condition is very dangerous. Therefore, with a predisposition or in the event of the first clinical signs of the disease, it is necessary to seek medical help and undergo an examination. Timely detection and elimination of pathologists will allow prolonging the health of a vital organ.

Signs of adverse changes in the work of the kidneys are manifested by the appearance of "bags" under the eyes, swelling of the body or pain in the lumbar region. But the presence of symptoms does not mean that the problem concerns the pathology of the excretory system. A nephrologist or urologist will help establish the diagnosis by telling you what tests you need to take to check the kidneys.

The deterioration of kidney function affects the entire body. This is due to a decrease in the quality of blood filtration. Slags, toxins have a toxic effect on other organs.

You can suspect a pathological condition of the kidneys at home by a number of characteristic signs:

1. Change in blood pressure. In people suffering from hypertension, in 25% of cases, an increase in pressure (more than 140/90 mm Hg) is a consequence of a deterioration in kidney function, but it is necessary to differentiate the disease from arterial hypertension. An increase in pressure is observed when the kidney is lowered or twisted (nephroptosis).
2. Changes in urination. There may be an increase in urges at night - nocturia. Its causes are heart or liver failure, a decrease in the ability of the kidneys to form concentrated or diluted urine. The latter dysfunction largely depends on the production of antidiuretic hormone (ADH) and the susceptibility of nephrons to it.
3. Change in diuresis (the volume of urine for a certain time interval). Normally, the daily volume of urine is 75% of the liquid consumed. Increase in urine more than 2250 ml / day. means the development of polyuria, and less than 500 ml / day. - anuria.
4. Increase in body temperature. An acute inflammatory process is characterized by an episodic increase in body temperature up to 39C, and a chronic one is accompanied by temperature fluctuations within the subfebrile level (37.1-38C).
5. The occurrence of sharp stabbing or aching pains in the sacrum, radiating to the lower abdomen. Often, women take renal colic for the development of inflammation of the reproductive organs. Drawing pains are a sign of a sluggish inflammatory process.
6. Change in color and odor of urine. The presence of kidney stones is indicated by a pink tint of urine due to blood impurities.
7. Pain when urinating accompanies urolithiasis. Pathologies of the kidneys manifest themselves as the occurrence of edema and fluctuations in body weight, a feeling of constant thirst, and shortness of breath.

Signs of diseases can appear one by one or in combination. Their occurrence is an indication for examination of the kidneys. It is especially important to carry out diagnostic measures in time for people who are most prone to the occurrence of diseases of the urinary system: patients with diabetes mellitus who systematically take medications; overweight people who use drugs or alcohol.

How to check the kidneys?

There are several ways to check the functionality and structural changes in the kidneys: take tests for laboratory testing, use instrumental diagnostic methods. Before issuing a referral, the doctor collects an anamnesis and examines the patient.

What tests are needed to check the kidneys?

The material for research in the laboratory is urine and blood.

Important! The orange color of morning urine when checking the kidneys at home is a variant of the norm. The reason for the changes is an increased concentration of vasopressin (antidiuretic hormone of the hypothalamus). The pathology of the kidneys is indicated by a changed color of urine in the presence of other symptoms.

Urinalysis

On the eve of the urinalysis for laboratory testing, it is recommended to adhere to the following rules:

1. Refuse to eat salty, spicy foods, as well as fruits and vegetables that can change the color of urine to dark yellow or pink: carrots, beets, persimmons, sea buckthorn, pumpkins, citrus fruits and other foods with a bright color pigment.
2. Stop taking drugs that can change the color and composition of urine (Rifampicin, Warfarin, Uropin, vitamins A, C, B). Before taking the test, you should warn the doctor about taking any medications and clarify the need for cancellation.
3. Exclude the intake of dietary supplements, diuretics.
4. Refuse to visit the bath, sauna, gym.
5. Exclude coffee, alcohol, juices based on bright fruits and berries.
6. Carry out hygiene procedures immediately before collecting urine.
7. To collect, purchase a special sterile container at the pharmacy; for newborns, use special urinals that are easily fixed with an adhesive surface to the skin for the required period of time.
8. It is better for women during menstruation to postpone the test for another day.
9. After cystoscopy, if possible, postpone the examination for 5-7 days.

Depending on what indicators the doctor needs to assess kidney function, different tests may be prescribed.

Morning urine collected on an empty stomach is subject to assessment. To eliminate the distortion of the results, a small part of the liquid must be released, and then continue urination into a special container.

Important! The shelf life of the test material is 1.5-2 hours at a temperature of 5 to 18C.

The main indicators obtained in the general analysis of urine:

Deviations from the norm in the general analysis of urine - a signal that a failure has occurred in the body:

1. With the characteristic smell of ammonia, the development of cystitis is possible, the smell of decay indicates necrosis of the tissues of the urinary system; the smell of acetone indicates ketonuria.
2. Foaming is normally absent, and its appearance or staining indicates the development of jaundice or the presence of protein in the urine.
3. Transparency: urine will be cloudy in the presence of pus, bacteria, salts formed as a result of pyelonephritis, urolithiasis.
4. Increased urine density is observed in diabetes mellitus, infections in the urinary system and toxicosis in pregnant women; low density may indicate the development of renal failure.
5. Elevated protein levels indicate inflammation, allergies, leukemia, kidney damage, and heart failure.
6. Excess sugar levels are the result of impaired functioning of the kidneys and adrenal glands.
7. The presence of blood in the urine may indicate the presence of stones in the kidney, glomerulonephritis, kidney infarction, cancer.
8. Elevated white blood cells - the result of the development of inflammation or the presence of kidney stones; often bacteria are found with them in the urine.
9. The detection of cylindrical formations consisting of erythrocytes, proteins, nephron cells indicates nephrotic syndrome, pyelonephritis, glomerulonephritis, renal failure.

Your doctor may order additional tests to make a diagnosis and check kidney function.

Daily analysis of urine

Its difference from the general one is the need to collect all the urine excreted within 24 hours into a sterile 2-3-liter container. It is necessary to store the collected material in the refrigerator, preventing the liquid from freezing. For laboratory diagnosis of the kidneys, not the entire volume is surrendered, but 100 ml of urine. It must first be shaken, record data on the total volume of liquid.

When conducting a Reberg test, daily diuresis allows you to reliably determine the level of creatinine, a substance formed during protein breakdown.

The rate of creatinine in the urine for women is 7.1-13.2 mmol / l (10-25 mg / kg); for men: 13.2-17.6 mmol / l (18-32 mg / kg). Normal values ​​in different laboratories may vary.

Important! Creatinine will be elevated with excessive consumption of meat products and lowered in vegetarians.

In renal failure, the creatinine level reaches 200 mmol / l. Also, daily diuresis allows you to assess the level of cortisol, metanephrine, oxalate, glucose, uric acid in the test material.

Analysis according to Nechiporenko

Microscopic examination of the urine sediment makes it possible to count the number of cylinders, leukocytes, erythrocytes in 1 ml of material. Deviations from the norm can reveal pyelonephritis, cystitis, glomerulonephritis, urolithiasis, nephrotic syndrome, inflammation of the prostate in men.

Analysis according to Zimnitsky

Features of collecting material for analysis: 6-12 containers are prepared; each of them is filled in 2-4 hours. Next, an assessment is made of the ratio of the volume of fluid released during the day and at night and its density to determine the concentrating ability of the kidneys.

Blood tests

Blood is taken from a finger or a vein on an empty stomach. A general blood test determines whether an inflammatory process develops in the body, and a biochemical one determines whether there are deviations in the levels of creatinine and uric acid.

If kidney dysfunction is suspected, instrumental research methods are additionally resorted to.

Instrumental diagnostics

The most informative methods to find out the condition of the kidneys are:

1. Ultrasound diagnostics (USD). During the examination, the structure of tissues, the size of organs and their location are assessed. The results allow diagnosing: inflammation of the kidneys and bladder, the presence of cysts, tumors, sand or stones, vascular disorders. The procedure is safe for children and pregnant women. On the eve, you must refuse to eat at least 8 hours in advance and take activated charcoal.
2. Computed tomography (CT) is a high-precision research method that involves scanning organs using X-rays. It is prescribed for the difficulty of detecting pathology by ultrasound. CT is not performed: children under 14, pregnant women, people with diabetes in the stage of decompensation.
3. Magnetic resonance imaging is an alternative to CT, which makes it possible to detect pathology based on the measurement of the electromagnetic response of the nuclei of hydrogen atoms in tissues. The procedure is safe for pregnant women of the 2nd and 3rd trimesters, children, but is not suitable for people with any metal objects in the body: a pacemaker, middle ear implants, plates and other elements.
4. Radiography can be performed with contrast (urography), the introduction of radioactive isotopes into the body (scintigraphy) or without additional manipulations to obtain an overview image.

Urography and scintigraphy help to assess the state of the vessels and the blood supply system of the kidneys, the amount of damage to the kidney tissue.

Ultrasound is considered the safest. Other types are prescribed by a doctor, taking into account the condition, health, age, body weight, pregnancy and allergic reactions.

Timely diagnosis will help to avoid the development of pathology to an irreversible stage, when treatment prolongs life, but does not improve the functioning of organs. It is advisable to take a general urine test once a year, and for people with diabetes or high blood pressure - an analysis for microalbuminuria (the presence of protein in the urine). At the initial stage of the development of kidney dysfunction, homeopathic remedies and dietary adjustments can correct the situation, otherwise diseases that can be treated quickly will require long-term therapy.

A general urine test (its norm is known to both laboratory assistants and therapists) is a laboratory test that is mandatory and is carried out for any disease for diagnostic purposes. In this analysis, organoleptic, biochemical, physicochemical, microbiological indicators are checked, and the sediment is also studied.

Why donate?

What does a general urine test show? Why should it be mandatory at all? This study is being carried out in order to understand how the kidneys work, whether there is a pathology in them, and simply to diagnose the general condition of the body. First of all, the task is to determine the function of the urinary system, as well as such diseases as nephritis, oncology, nephrosclerosis, urolithiasis, amyloidosis. In men, this analysis will help determine the functional state of the prostate. Even with a banal preventive examination, this procedure is mandatory and helps to identify many pathologies at an early stage.

The main thing is to correctly assemble

Before collecting urine for analysis, you should refrain from taking medications. Collect the morning portion, which was formed during the night. Before this, hygiene procedures must be carried out, because microorganisms located on the genitals can affect the results of the study. It is generally better for women during menstruation to refuse to take the test. Previously, a urine test (the rate of its indicators is well known to therapists) was all handed over in a glass container. However, its results could be distorted, because it is not so easy to wash it. Today, there are sterile plastic containers for collection, which are hermetically sealed with a lid and are used only once. You should collect the average portion, that is, start urinating into the toilet, and only after a few seconds - into the container.

What needs to be determined?

There are many indicators included in the analysis of urine (their norm depends on various factors). The first is the specific gravity, which in humans ranges from 1015 to 1020, as well as nitrites (they should not be normal either). The reaction of urine is normally acidic, but depending on the diet, it can be alkaline. There are substances that a healthy person should not have in the analysis, these include the following: protein, sugar, ketone bodies, urobilinogen, and bilirubin.

Leukocytes are also included in the analysis of urine, their norm in the field of view of the microscope of a laboratory assistant should be from 3 to 6. Secondary indicators include cylinders (this is the desquamated epithelium of the urinary tubules of the kidneys), hyaline (from one to two), epithelial cells (normal there should be 4 to 5). Bacteria in a normal urine test should not be, and if they are, then we can talk about a urinary tract infection.

Indicators that can help in the diagnosis of many diseases

Specific gravity is an indicator that can increase or, conversely, decrease. An increase indicates that there is sugar, salt, or both indicators in the urine. A decrease in specific gravity down to the density of water (which is 1000) indicates that the kidneys cannot control the process of urine formation, therefore, harmful substances (waste products) are not excreted from the body. In this case, it is worth thinking about kidney failure and checking kidney function in more detail (for this, a urine test is performed according to Zimnitsky). Yes, and a clinical analysis of urine will not be superfluous to pass again, because the consumption of a large amount of liquid can reduce its specific gravity. There is no sugar in the urine of a healthy person, and if it appears, this indicates a very dangerous and formidable disease, such as diabetes mellitus. If ketone bodies are detected by making a urine test (the norm does not provide for them), then this may indicate a complication of the aforementioned disease. A diabetic coma occurs unexpectedly, and in advanced cases, without appropriate assistance, a person may even die.

What should not be normal

The appearance of protein in the urine is called proteinuria. This phenomenon is also abnormal. The reason lies in the fact that the permeability of the glomerular filter is disturbed. As a result, several types of proteinuria are distinguished - depending on where exactly the absorption is impaired. Glomerular proteinuria indicates a deterioration in the permeability of the glomerular filter, with impaired absorption of proteins in the tubules of the kidneys, tubular proteinuria develops.

Important point

The appearance of red blood cells in the urine in excess of the norm is called hematuria. Normally, they are most often not present, up to one cell is allowed in the field of view of the laboratory assistant's microscope. There are micro- and macrohematuria, in the first version there are not very many red blood cells, in the second they occupy the entire field of view. But in both cases it is not normal. Diseases of the kidneys, bladder can provoke an increase in this indicator. Diseases such as glomerulonephritis, oncological processes cause a large number of red blood cells in the analysis, bleeding makes the urine scarlet or red. Red blood cells can be outwardly changed, contain hemoglobin or not.

Norm Options

As mentioned above, it may also contain leukocytes (their norm is a few cells in the field of view), there are also cylinders in a normal analysis. An increase in the first indicator indicates inflammation in the urinary system. There can be up to 20 leukocytes - then this is called leukocyturia. An indicator of 60 or more indicates the presence of pus in the urine, or pyuria, which is reflected in its smell and color. Cylinders, the norm of which in the analysis of urine does not exceed a few units in the field of view, can be hyaline (cells of the tubules), granular (destroyed and degenerated cells of the renal tubules), waxy (a protein that has curled up in the lumen of the tubule), epithelial (desquamated epithelium of the renal tubules ), erythrocytes (erythrocytes layered on hyaline cylinders), leukocytes (leukocytes layered on elongated conglomerates).

I urge you to seriously take tests to check the kidneys. Because severe kidney failure is the worst possible outcome of hypertension and diabetes. Death from kidney disease is the most painful thing that can happen to you.

Learn the symptoms of kidney failure. Dialysis procedures relieve them, but in turn cause such suffering that at least 20% of patients voluntarily refuse dialysis, even knowing that because of this they will die within a few weeks. If you do a kidney transplant, it provides the opportunity to live a long and full life. But the number of patients who require a donor kidney is skyrocketing every year, while the number of available kidneys is not. Conclusion: all attention - to the kidneys! We are examined and treated diligently, so as not to have to get acquainted with the doctors who conduct dialysis.

Signs of kidney failure appear when these organs are 90% destroyed, and it is too late to carry out preventive treatment, i.e. dialysis or kidney transplant becomes vital for the patient. At the same time, blood and urine tests diagnose kidney problems in the early stages, several years before the first symptoms appear. If treatment is started on time, the patient most often manages to live normally without dialysis or a kidney transplant. Check your kidneys at least once a year. If you are being treated for chronic kidney disease, then you need to retake tests every 3 months, or even more often if the doctor says.

The sequence of tests to determine the condition of your kidneys:

Get a blood test for creatinine.
Calculate the glomerular filtration rate using the calculator as described below in the article.
Take urine tests for albumin and creatinine in a single portion, calculate the ratio of albumin and creatinine. Use morning urine. It is not necessary to collect all urine per day or per night.
If the glomerular filtration rate is above 60 ml/min and the albumin/creatinine ratio is normal, repeat the examination once a year.
If it turns out that the glomerular filtration rate is below 60 ml / min and / or the albumin / creatinine ratio shows microalbuminuria - repeat all tests after 3 months.
If the glomerular filtration rate is below 30 ml / min and / or the albumin / creatinine ratio shows macroalbuminuria - consult a nephrologist.

Please note that microalbuminuria and urinary albumin/creatinine ratio are more important than glomerular filtration rate. It often happens that the kidneys are rapidly destroyed, but the glomerular filtration rate is normal or even increased. For example, at the initial stage of diabetes, the glomerular filtration rate does not decrease, but even increases by 1.5-2 times, because the kidneys try to excrete excess glucose in the urine. Assessing how well a person's kidneys work based on test results is not an easy task. To do this, you need to know what creatinine, albumin, and glomerular filtration rate are. It is important to understand what the shortcomings of these indicators are and how to use them together to assess the condition of the kidneys.

Creatinine is a breakdown product that is produced when the body breaks down protein. The kidneys remove creatinine from the body. It is believed that the higher the concentration of creatinine in the blood, the worse the kidneys work. Unfortunately, this is not entirely true. Blood creatinine levels fluctuate greatly for reasons unrelated to the kidneys. The more muscle mass, the more creatinine. Vegetarians have less than meat eaters. After exercise, the concentration of creatinine in the blood jumps. And most importantly, this decay product is removed from the body not only by the kidneys.

For the reasons stated above, the norms for the content of creatinine in the blood are very wide. Let's bring them:

In women, from 53 to 97 µmol / l (micromoles per liter of plasma);
In men - from 55 to 115 µmol / l;
In children under the age of one year - from 18 to 35 µmol / l;
In children aged from one to fourteen years - from 27 to 62 µmol / l.

Glomerular filtration rate is the volume of primary urine formed in the kidneys per unit of time. If the glomerular filtration rate is normal, then the kidneys do their job well, cleansing the blood of waste in time. If it is lowered, it means that the kidneys are damaged. However, the kidneys have a significant margin of safety, not in vain because there are two of them in the body. And only if the glomerular filtration rate is very low, at least 5-6 times compared to the norm, then toxic wastes begin to accumulate in the blood and symptoms of kidney failure appear. In such a situation, if dialysis is not performed or a kidney transplant is not performed, the patient will quickly die from poisoning with decay products.

Glomerular filtration rate is measured in ml/min. In practice, it is not measured directly, but indirectly estimated by blood creatinine, using special formulas. Doctors are well aware of the Cockcroft-Gault formula. But there is also the MDRD formula. It is newer and more reliable. You can calculate your glomerular filtration rate using the MDRD formula from your creatinine blood test using the calculator available on this page.


Fill out the form as shown in the picture, click the Calculate button and wait a bit.

If the picture shown above appears, then your glomerular filtration rate is above 60 ml / min and, most likely, the kidneys are working normally.

If a picture appears with an exact figure below 60 ml / min, you may have kidney disease. If the figure is from 16 to 59 ml / min, you need to be carefully treated to slow down the development of renal failure. A glomerular filtration rate of 15 ml/min or less means that replacement therapy, i.e. dialysis or a kidney transplant, is urgently needed.

When calculating the glomerular filtration rate using the MDRD formula in patients with normal or slightly reduced kidney function, the results are often underestimated. This formula overstates the number of patients with chronic kidney disease. Its accuracy has not been established for children and adolescents under 18 years of age, pregnant women, and older adults 70 years of age or older. Conclusion: if the MDRD formula shows a poor result, then you should not panic, but conduct additional research and consult a nephrologist.

Albumin is a type of protein that is excreted in the urine. Albumin molecules have a smaller diameter than molecules of other proteins. Therefore, if there is kidney damage, then albumin seeps into the urine at its earliest stages, and other proteins later. Microalbuminuria - means that albumin is found in the urine according to the results of the analysis.

Scientists and practitioners have long known that increased levels of albumin excretion in morning or 24-hour urine indicate an increased risk of kidney failure in patients with hypertension and/or diabetes mellitus. Surprisingly, increased albumin secretion also predicts an increased risk of heart attack or stroke. People with microalbuminuria are 1.47 times more likely to develop coronary heart disease than those without it. Macroalbuminuria is when protein is excreted in the urine in an amount of more than 300 mg per day, the next stage after microalbuminuria.

Urine albumin levels fluctuate greatly for reasons unrelated to kidney disease, just like blood creatinine concentrations. After vigorous exercise, the result of a urine test for albumin can be poor for several days, even in healthy people. Also, the concentration of albumin in the urine varies at different times of the day. Previously, patients were advised to collect all the urine for the day, so that the laboratory determined the content of albumin in it. However, this is very inconvenient. It has recently been found that the urinary albumin/creatinine ratio is a reliable indicator of kidney problems. It is convenient to calculate it, because an arbitrary portion of urine is suitable for this.

Albumin indicators in a single portion of urine for men and women:

Less than 20 mg / l is the norm;
20-199 mg / l - microalbuminuria, the initial stage of kidney damage;
more than 200 mg / l - macroalbuminuria, an advanced stage of kidney damage.

Normal creatinine content in a spontaneous portion of urine:

For men - 5.6-14.7 mmol / l;
for women - 4.2-9.7 mmol / l.

Albumin/creatinine ratio, mg/mmol

Men Women
Norm less than 2.5 less than 3.5
Microalbuminuria 2.5-30 3.5-30
Macroalbuminuria more than 30 more than 30

If in the laboratory that makes your tests, creatinine in the urine is calculated not in mmol, but in grams, then the standards for the ratio of albumin and creatinine are as follows.

Albumin/creatinine ratio, mg/g

Men Women
Norm less than 17 less than 25
Microalbuminuria 17-249 25-354
Macroalbuminuria more than 250 more than 355

If the preliminary tests that we have listed show that there are problems with the kidneys, then the nephrologist will first refer you to additional tests and examinations, and then prescribe treatment. Only at this stage it is advisable to do an ultrasound of the kidneys to visually determine if there is damage. If your kidneys are diagnosed and treated in time for diabetes and / or hypertension, then the chance that you can live a normal life without dialysis is greatly increased.

It is necessary to keep all the systems of our body in order, so when and how to check the kidneys, people should know clearly. In medical practice, there are many ways to check the functioning of the kidneys, each of which is used when a certain pathology is suspected. The choice of the research method is carried out by the local therapist, to whom it is necessary to make an appointment at the first symptoms. If the therapist sees a risk of developing a chronic disease, then he can refer the patient to a nephrologist for additional advice.

Indications for a kidney test

Regardless of the type and type of the future survey, it is necessary to carry out serious preparatory work. The kidneys are a powerful filter of the body, taking the brunt of it, so it is necessary to take special care of their health. All studies are painless and do not cause any discomfort to the patient, so they should not be postponed. It is mandatory to carry out such analyzes with the following indications:

1. Elevated blood pressure, which is kept at around 139/89 mm Hg. Do not confuse the problems associated with the work of the cardiovascular system, and pathologies in the development of the kidneys. Only a full-fledged analysis carried out in a medical institution will make it possible to distinguish between these two pathologies.
2. Frequent nighttime urge to go to the toilet, which cannot be fully satisfied.
3. A significant reduction in the amount of urine excreted - you should also be very careful with this indicator. In some cases, we are not talking about serious problems with the kidneys, but about violations in metabolic processes.
4. Discomfort and pain in the lumbar region, which many mistake for gout, salt deposits, etc.
5. Increase in body temperature.
6. Heaviness in the lower abdomen and back, which is attributed solely to problems with the gastrointestinal tract is not entirely correct.
7. Pain when urinating.
8. A change in the color or smell of urine - this indicator should very much alert a person. Here we can talk not only about kidney problems, but also about the risk of developing cancer.
9. Blood clots in the urine.
10. Decreased hemoglobin level.

Each of these reasons must be considered extremely comprehensively, so you should not even try to make a diagnosis yourself at home, while prescribing treatment for yourself. Some kidney pathologies are latent in nature, and their symptoms are misleading. In this regard, the decision of such issues must be entrusted to doctors.

Methods for diagnosing pathologies

Any examination of the kidneys begins with the delivery of urine and blood tests. After reviewing the composition of urine, the doctor will make a conclusion about the state of health based on the following indicators:

• the number of leukocytes, indicating the presence or absence of an inflammatory process in the body;
• epithelium;
• the presence of glucose;
• slime;
• pathogenic bacteria of various etiologies;
• salt;
• additional impurities that can significantly narrow the radius of the search for the cause of malaise;
• erythrocytes;
• average weight;
• the presence of cylinders;
• the presence of protein.

A general urine test for healthy people for prevention purposes must be taken at least once every 6 months. Those who have risk factors need to visit a medical institution even more often in order to pass not only a urine test, but also a Reberg test, which has certain indications. The local therapist and nephrologist will tell you what tests you need to pass.

As a common means of determining various problems with the kidneys, diagnostic methods are divided into several types:

1. Ultrasound examination (ultrasound) of the kidneys is used in the initial diagnosis, as well as to assess the actual state of the renal tissue. The doctor has the opportunity to assess the dynamics and quality of the patient's urinary tract. The frequency of ultrasound appointments is from 12 to 14 months. Children need to spend it 1 time in 8 months.
2. X-ray examination serves to obtain an objective visual representation of the work of the kidneys. For this, an x-ray tube is used in medicine. In some cases, the doctor needs to introduce a special contrast that allows you to highlight the desired area. Conducting such an examination is indicated no more than 1 time per year.
3. Computed tomography of the kidneys is a more informative method that makes it possible to conduct a more precise examination. The use of this tool is possible only if there are appropriate indications.
4. Radionuclide scintigraphy involves the introduction of a small dose of a radioactive substance. It is carried out only if there are necessary indications.
5. Magnetic resonance imaging is based on the use of a special magnet that helps to select the necessary area for the examination.

Comprehensive approach to research

Despite a fairly wide range of diagnostic tools, none of them can be considered completely reliable. A qualified doctor will always resort to several ways to confirm or refute the guess made, for example, the patient may be asked to donate blood to check the kidneys. In some cases, you need to pass a number of other tests, each of which will narrow the circle of causes of malaise.

Do not think that a nephrologist is an unqualified doctor, forcing patients to take the same tests many times.

The many problems associated with the kidneys cannot be accurately identified with just one test.

That is why various methods are used that make it possible to look at the clinical picture of the disease from different angles.

Untimely treatment is no less dangerous than incorrect treatment, therefore, excessive haste is simply unacceptable here and can be fraught with consequences. Speaking about diagnosing problems associated with the kidneys, it is necessary to dwell separately on one important fact. Reasonable prevention is the key to a healthy life. As it may seem to many, various deviations in the work of this organ are immediately noticeable and are associated with severe pain, but this is not entirely true.

In many cases, we can talk about a latent problem that can worsen for a long time. It will seem to a person that here we are talking about a slight malaise, a slight cold or overwork. Subsequently, aching pain will increasingly remind of itself, telling a person about the need to visit a doctor. Official medical statistics show that early diagnosis of urinary system problems allows them to be completely eliminated in 2-4 weeks.

Emphasis will be placed on homeopathic remedies and traditional medicines, selected taking into account the specific cause of the disease, the patient's health status, immune system characteristics, etc. If the patient does not know how to check the kidneys and seeks help at a later stage, then there is a high probability further spread of the malaise. In this case, the entire course of treatment can stretch for several months and even years.