Urinalysis according to Zimnitsky: norm, transcript,how to collect

Update: October 2018

Sample Zimnitsky refers to the additional, extended
laboratory tests of urine and allows us to evaluate kidney function,
identify violations in their work. Analysis developed in 1924
general practitioner Zimnitsky S.S. and still relevant.

Most commonly prescribed for acute or chronic suspected
inflammatory process that leads to a breakdown of the kidneys, and
also renal failure on the background of non-sugar and sugar
diabetes, hypertension.

The method does not require special equipment, therefore
to simple, accessible and informative urine test options.
Most often carried out in a medical institution when
the person is in hospital or on examination.
Patients with chronic kidney disease are prescribed for
control the function of organs.

The study includes the determination of a number of indicators (density
urine, the daily amount of excreted urine, the distribution of total
urine during the day, etc.), the interpretation of which is carried out by the treating
doctor.

The essence of the technique

Sample Zimnitsky allows you to determine the concentration of dissolved
in the urine of substances, i.e. kidney concentration function.

During the day, the kidneys perform the most important work, taking from
blood unnecessary substances (metabolic products) and delaying
necessary components. Osmotic renal capacity
concentrate and then dilute urine directly depends on
neurohumoral regulation, efficient work of nephrons,
hemodynamics and rheological properties of blood, renal blood flow and
other factors. Failure in any link leads to dysfunction
the kidneys.

Urinalysis according to Zimnitsky – how to collect?

Urine collection for this test is done at certain hours.
days. No restrictions on eating and drinking regime
not.

To prepare for the analysis, you need:

  • 8 clean jars with a volume of about 200-500 ml. Each jar
    marked accordingly on a separate three-hour
    period: the surname and initials of the patient, the sample number (from 1 to 8) and
    period;
  • clock with alarm function (not to forget about the time when
    need to urinate);
  • a sheet of paper to record fluid consumption during the day, in
    urine is collected (including the volume of fluid flowing from
    first dish, milk, etc.);

Urine collection

Within 8 three-hour intervals within 24 hours you need
collect urine in separate jars. Those. each jar should
contain urine excreted during a specific three-hour period.

  • Between 6.00 and 7.00 in the morning, you should urinate in
    toilet bowl, i.e. no need to collect night urine.
  • Then at regular intervals of 3 hours should urinate
    in jars (for every urination – a new jar). Begins
    urine collection after night urination, until 9.00 am (the first
    jar), ends until 6.00 am the next day (last,
    eighth jar).
  • It is not necessary to go to the toilet on an alarm clock (exactly at 9, 12 am
    etc.) and endure 3 hours. It is important that all urine excreted in
    three-hour period, was placed in the appropriate jar.
  • It should be carefully written on a piece of paper all consumed
    during these days the liquid and its amount.
  • Each jar сразу после мочеиспускания ставится для хранения
    in the fridge.
  • If at the right time urge to urinate
    missing, the jar is left empty. And with polyuria, when
    jar is filled before the end of the 3-hour
    gap, the patient urinates in an additional jar, but does not pour out
    urine down the toilet.
  • In the morning after the last urination, all the jars (including
    and additional) along with a leaf of records of drunk fluids
    should be taken to a laboratory within 2 hours.
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Deciphering the result of the sample Zimnitsky

Norm:

  • The total daily volume of urine produced 1500-2000 ml.
  • The ratio of body fluid and daily volume
    urine 65-80%.
  • The amount of urine released during the daytime is 2/3, at night – 1/3.
  • Significant increase in urination after drinking
    fluid.
  • Fluctuation of urine density in samples within 1 003-1 035
    g / l.
  • Urine density in several or one jar more than 1020
    g / l.
  • Плотность мочи во всех пробах менее 1035 g / l.

Pathology:

Hypostenuria This is a low urine density. Diagnosed with urine density
во всех баночках менее 1012-1013 g / l. In this state, the reverse
absorption of primary urine is weak.
  • pyelonephritis aggravation
  • severe heart failure
  • end-stage renal failure in the background
    chronic diseases (amyloidosis, hydronephrosis, pyelonephritis,
    glomerulonephritis)
  • diabetes insipidus
  • leptospirosis
  • kidney damage with heavy metals.
Hypertension This is a high urine density. Diagnosed with urine density
в одной из баночек более 1035 g / l. Condition when the opposite
absorption exceeds the filtration rate of urine in the glomeruli
the kidneys.
  • acute or chronic glomerulonephritis
  • accelerated red blood cell breakdown on hemolysis, transfusion
    blood sickle cell anemia
  • diabetes
  • pregnancy toxicosis.
Polyuria This is an increase in the volume of daily urine with a low specific weight.
A condition in which there is an increase in the formation of primary
urine during filtration.

  • Detected when exceeding the daily volume of urine over normal
    indicators in the 1500-2000 ml
  • Or when the daily volume of urine was more than 80% of
    употребленной fluid.
  • сахарный или diabetes insipidus
  • renal failure.
Oliguria This is a decrease in daily urine that has a high
specific gravity. There is a violation of the filtering process.

  • It is diagnosed when the volume of excreted urine is less than 1500 ml.
  • Or when urine volume was less than 65% of consumed
    жидкости в течение days.
  • late stage renal failure
  • heart failure
  • hypotensive state
  • mushroom poisoning
  • mass destruction of red blood cells.
Nocturia This is an increase in the amount of urine released at night (more
1/3 of the daily volume).
  • diabetes (наиболее часто)
  • heart failure
  • impaired concentration of renal function.

Indicators for children and adult patients differ daily
diuresis. The exact volume of daily urine in children under 10 years
calculated as follows: 600 + 100 * (n – 1), where n –
age of the child. Normal diuresis in children from 10 years old approaches
adult rate and approximately 1.5 liters.

In conclusion, the laboratory doctor indicates the results obtained.
Compliance. Оценку же проводит лечащий doctor.

Автор: врач-гигиенист, эпидемиолог

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