Urinalysis according to Zimnitsky is the most revealing method for checking the excretory function of the kidneys. Urinalysis according to Zimnitsky - how to collect and what the analysis shows

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Often, the results of only a general urine test are not sufficiently informative for the correct diagnosis of any disease. In such cases, the doctor should prescribe specific urine tests or samples.

About analysis

To conduct it correctly, you need to fully adhere to all the recommendations of the attending physician regarding the collection of biomaterial, labeling of containers, storage conditions and the time of sending to the laboratory. It is often quite difficult to interpret the results, so only a specialist can do this. The Zimnitsky test is an affordable way to conduct a laboratory test, the purpose of which is to identify inflammation in the kidneys and organs of the urinary system. Such an analysis can reflect the functioning of the kidneys and show violations of their work.

In this article, we consider the Zimnitsky urine collection algorithm.

How to prepare for the collection of analysis?

The informativeness and accuracy of the readings of the result of the analysis according to Zimnitsky may be affected by some medications used by the patient, as well as food. Therefore, at least a day before the collection of urine, you need to follow a few simple recommendations:

• refusal to use diuretic drugs, both medicinal and herbal;
• compliance with the patient's usual diet and food intake (at the same time, you should limit yourself to eating salty, spicy foods that can provoke thirst, as well as foods that can affect the color of urine, for example, beets, etc.);
• limit excessive drinking.

The algorithm for collecting urine according to Zimnitsky is simple.

It should be remembered that if the patient has several urges to urinate in a certain time interval, it is necessary to collect the liquid in full, nothing can be poured out. If the container for sampling the biomaterial is already full in a given period of time, you need to take an additional container and be sure to indicate the time on it in accordance with the collection algorithm. If the patient does not feel any urge at any of the intervals, then the empty jar must also be sent for laboratory testing so that the volume of fluid can be correctly estimated.

During the day, all urine containers should be kept cold (the best place is a refrigerator), and the next day in the morning the material should be brought to the laboratory, also adding notes on the amount of fluid taken by the patient at the time of collection.

If the Zimnitsky urine collection algorithm is violated, then his technique will be incorrect, which will lead to an increase in the volume of biomaterial. This helps to reduce its density. Because of this, experts can get the wrong result and draw erroneous conclusions.

How to collect biomaterial?

To collect urine for the Zimnitsky test, specialists need to use special equipment. For the study you will need:

The Zimnitsky urine collection algorithm for adults is as follows:

1. You need to empty your bladder at six o'clock in the morning.
2. Throughout the day, every three hours it is necessary to empty into containers, that is, from nine in the morning of the first day to six in the morning of the second.
3. Store gradually filled jars in a closed form in the cold.
4. The next morning, the containers with the collected biomaterial must be delivered to the laboratory along with the notes in the notebook.

The Zimnitsky urine collection algorithm must be strictly observed.

Features of the Zimnitsky test

The method of diagnosis using the study of clearance (or depuration) is more reliable and reliable. Clearance is the clearance ratio, defined as the volume of blood plasma that can be cleared of a particular substance by the kidneys. It is due to such factors as the age of the patient, a certain substance that takes part in the filtration process, the concentration function of the kidneys. The algorithm for collecting urine according to Zimnitsky is of interest to many.

The following types of clearance are distinguished.

• Filtration - the amount of plasma that is completely cleared within one minute by glomerular filtration from a non-reabsorbed substance. The same indicator is observed in creatinine, so it is most often used to measure the amount of filtration.
• Excretion - such a process in which the substance is excreted in full by excretion or filtration. To determine the amount of plasma that has passed through the kidney, diodrast is used - a special substance, the purification coefficient of which corresponds to the goals set.
• Reabsorption - such a process during which the complete reabsorption of filtered substances in the renal tubules occurs, as well as their removal through glomerular filtration. To measure this value, substances with a purification coefficient equal to zero (protein / glucose) are taken, since during the period of their high content in the blood they can help assess the performance of the reabsorption function by the tubules. What else will help determine the Zimnitsky urinalysis collection algorithm?
• Mixed - the ability of a filtered substance to partially reabsorb, for example, urea. In this case, the coefficient will be determined as the difference between the concentration of a given substance in plasma and urine in one minute.

In order to conduct a differential diagnosis of kidney pathologies and evaluate the functioning of the glomeruli and tubules, urea and creatinine are most often used. If, in the presence of renal dysfunction, the concentration of the latter increases, this becomes a symptom of the onset of the development of renal failure. At the same time, creatinine concentration indicators increase much earlier than urea, therefore, in the diagnosis, it is the most indicative. The rules for collecting urine according to Zimnitsky and the algorithm should be told by the doctor.

Analysis results and their interpretation

The fact that the concentration function of the kidneys is normal is evidenced by the following results obtained during the analysis and their interpretation:

• the amount of urine collected during the day should be more than the volume of night urine in a ratio of three to one;
• the volume of urine per day should be included in at least seventy percent of the liquid consumed during the same time;
• the specific gravity coefficient should range from 1010 to 1035 liters in all sample containers;
• the amount of liquid allocated per day should be at least one and a half and not more than two thousand milliliters.

If the results of the analysis of the biomaterial deviate from normal values, there is reason to talk about impaired functioning of the kidneys, determined by some inflammatory process or pathologies of the endocrine system.

Below normal

For example, if the specific gravity coefficient is below a certain norm (hyposthenuria), it is necessary to diagnose a violation of the concentration function, which may be due to an incorrect technique for collecting biomaterial, the use of diuretics (including herbal preparations with the same effect) or the presence of the following pathologies:

• pyelonephritis in the acute stage or inflammation of the pelvis;
• chronic renal failure, which has developed against the background of pyelonephritis and other diseases of the excretory system, if they have not been cured;
• diabetes, or diabetes insipidus;
• heart failure causing blood stasis.

The main thing is that during the analysis the Zimnitsky urine collection technique and the algorithm should be observed.

Above normal

In the event that the specific gravity of urine exceeds the established limits of the norm, this serves as evidence of the content in the laboratory material of substances that have a high density, for example, glucose or protein. As a result of deciphering such a result, the following possible pathologies can be identified:

• dysfunction of the endocrine system (a special case is diabetes mellitus);
• preeclampsia or toxicosis in pregnant women;
• acute inflammatory process.

Using the Zimnitsky test, it is also possible to estimate the amount of fluid released. If this volume is significantly higher than normal (polyuria), then this can signal diseases such as diabetes, diabetes, kidney failure. If the daily diuresis, on the contrary, is reduced (oliguria), then this indicates chronic renal failure in the later stages or heart failure.

In some cases, nocturia can be detected in the transcript, that is, a significant increase in diuresis at night compared to the daily amount of urination. Such a deviation indicates that the development of heart failure occurs or the concentration function of the kidneys is impaired.

Testing for pregnant women

During pregnancy, a woman's kidneys and her excretory system work even more intensively, as they contribute to the excretion of metabolic products of both the body of the pregnant woman and her fetus. In addition, the normal excretion of urine and the constantly growing uterus, which displaces and squeezes the kidneys, further complicates it. Analysis according to Zimnitsky makes it possible to most informatively and accurately assess the activity of the kidneys of a pregnant woman, to monitor their functioning, which makes it possible to prevent the appearance and development of pathology. The collection and delivery of biomaterial at the same time comply with general recommendations, the algorithm is the same.

Algorithm for collecting urine according to Zimnitsky in children

The main feature that distinguishes the Zimnitsky analysis from other urine studies is the emphasis on identifying the volume of urine excreted during the day, as well as determining the density of each portion, indicating the content of dissolved substances in it. Other indicators are not investigated by this sample.

To collect analysis from young children (babies), you can use containers specially designed for them (urinals). Before the child empties, you need to rinse his genitals very thoroughly and attach a container to them. It must be checked periodically and after each urination, drain the liquid into a container designed for this. All jars should then be sent to the laboratory, even if some of them are empty. If, for a certain time period, more urine was collected than can fit in a container, you need to take another container and mark a period of time on it. In addition, it is separately necessary to note the time and amount of liquid drunk by the child.

We reviewed the Zimnitsky urine collection algorithm. The manipulations are simple but effective.

Despite the fact that a general (clinical) urinalysis is the most common method for examining a patient's health status, when assessing the condition of the kidneys, it gives a rather superficial idea, without taking into account the ongoing changes over time and the influence of other factors. That is why scientists have developed and presented other, more extensive methodologies that allow a more detailed assessment of the functional kidney function in cases of suspected various pathological and inflammatory processes.

One of these methods is a urine sample according to Zimnitsky. Although this method is more complicated and inconvenient for the patient, the information obtained from its results is very important and indispensable in the diagnosis of various renal disorders.

What does the analysis of urine according to Zimnitsky show?

The Zimnitsky test makes it possible to evaluate such important renal functions as concentration and dilution, as well as to determine the accumulation of various substances in the urine.

Many people know that the composition of urine, its color, smell and quantity can change during the day. Therefore, for this method, urine collected during the day is used at a certain specified time. Then, the main parameters are examined in the laboratory.

Normally, the Zimnitsky test should record fluctuations in volume (day and night) from 40 to 300 ml, and density changes should be kept in the range of 0.012-0.016 g / ml. In addition, the total daily volume of urine is estimated, it should be approximately 1.500-2.000 ml, while the ratio of fluid consumed and excreted is ~ 60-80%.

Thus, it becomes clear what urine shows according to Zimnitsky: normal or disturbed concentration assignment of the kidneys, their ability to dilute and remove unnecessary substances is determined.

Zimnitsky's analysis is prescribed to patients with assumptions of pathological disorders of functional renal activity, for example, when:

• obvious signs of renal failure;
• suspicion of inflammatory / infectious lesions of the kidneys;
• pyelonephritis (in an acute or chronic stage);
• diagnosing diabetes / diabetes insipidus;
• hypertension.

Urinalysis according to Zimnitsky during pregnancy is recommended for women if the doctor has noticed the appearance of severe edema, which may be a signal of incipient renal failure, or an increased load on the organ.

Only a qualified doctor should decipher the results of the study, a person without education will not be able to understand all the parameters.

No special preparation for the analysis is required from the patient. Before donating, a person should stick to their usual diet and drink. It is recommended to calculate how much liquid was drunk the day before (taking into account soups, any drinks and water). Before the analysis, you should not take diuretics, otherwise the result will be distorted and will not give a full assessment of the work of the kidneys.

How to collect a urine test according to Zimnitsky, the doctor who prescribes the referral must necessarily tell. Feel free to ask questions of interest or take notes on paper for yourself.

For your convenience, we will describe the basic rules and techniques for collecting urine according to Zimnitsky.

The patient must understand that he will collect the material for the whole day. To do this, the day before you need to prepare 8 sterile jars (or special standard containers).

Since urine will need to be collected at a specific time, it will be good if an alarm clock reminds you of this, or there will always be a clock in front of your eyes.

Each collected container must be clearly labeled with your personal details, portion number (1-8) and time period for collection.

As already mentioned, urine collection in Zimnitsky is carried out throughout the day (including the night period), and only after all the samples are collected, within 1-2 hours, the entire jar must be delivered to the honey. institution or laboratory. It is recommended to store previously collected urine in a cool, dark place, in a closed container (preferably in the refrigerator).

Collecting the daily amount of urine in containers is not tricky, and it will not be difficult. It is important not to confuse anything so as not to provide laboratory assistants with deliberately false data and get an incorrect result. Therefore, in this case, the accuracy and veracity of the Zimnitsky analysis depends to some extent on your attentiveness.

For those who are especially forgetful, we will describe in detail the Zimnitsky urine collection algorithm.

At 6-00 the patient will have to wake up and empty his bladder for the first time, but you need to go not into a jar, but simply into the toilet. In the future, every three hours, you need to collect by containers (8 pcs.)

1. from 9 00 to 12 00
2. from 12 00 to 15 00
3. from 15 00 to 18 00
4. from 18 00 to 21 00
5. from 21 00 to 00 00
6. from 00 00 to 03 00
7. from 3 00 to 06 00

Sometimes they conduct another variant of the study of urine according to Zimnitsky, when the patient collects every 4 hours, and therefore he will end up with 6 jars. But this option is rarely used.

It should be noted that in the absence of the urge to urinate at the appointed time, the jar must be left empty. And with increased urine formation (polyuria), if the jar is completely filled before the end of the 3-hour period, then you should get an additional jar and make a note on it that this is the same period of time.

Deviations are detected according to a specially created table of the norm for urinalysis according to Zimnitsky.

So, for example, too low urine density at least in the 1st jar may indicate an exacerbation of pyelonephritis, the development of a certain stage of renal or heart failure.

Increased density, more often indicates the development of diabetes mellitus, acute or chronic glomerulonephritis, or severe toxicosis in pregnant women.

A decrease / increase in the normal daily volume of urine may indicate heart failure or kidney dysfunction.

This study is assigned not only to the adult population, sometimes experts recommend collecting a urine test according to Zimnitsky in children when there is a suspicion of a violation of renal or cardiac activity.

It is not always possible for a doctor to draw specific conclusions from a general urinalysis; sometimes, in order to make an accurate diagnosis, additional detailed studies of human biological fluids are required. The collected urine according to Zimnitsky can provide a more accurate picture of the work of some internal organs, especially the kidneys, and significant deviations will indicate the presence of a particular disease.

Take care of your health responsibly!

Urinalysis according to Zimnitsky is a study of daily urination, thanks to which the work of the kidneys is evaluated. The main indicators that are identified during the analysis are the density and volume of urine, the distribution of their indicators throughout the day. They allow you to diagnose many disorders of the urinary system.

Why do I need a urine sample according to Zimnitsky

The Zimnitsky test is aimed at determining the level of dissolved substances in the urine.

The density of urine changes repeatedly during the day, and its color, smell, volume, frequency of excretion are also subject to changes.

Also, an analysis according to Zimnitsky can show a change in density in urine, which makes it possible to identify the level of concentration of substances.

The normal density of urine is 1012-1035 g/l. If the study shows a result above these values, then this means an increased content of organic substances, if the indicators are lower, then they indicate a decrease in concentration.

Most of the composition of urine includes uric acid and urea, as well as salts and other organic compounds. If protein, glucose, and some other substances appear in the urine that are not excreted by a healthy body, the doctor can judge problems with the kidneys and other organs.

What diseases are prescribed for analysis

The Zimnitsky test is indicated for renal failure, one of the first symptoms of which is problems with excretion of urine. This type of analysis is prescribed by a doctor if the development of such diseases is suspected:

• hypertension;
• diabetes type diabetes;
• pyelonephritis or glomerulonephritis in a chronic form;
• inflammatory process in the kidneys.

Often, a study is prescribed for women during pregnancy if they suffer from very severe toxicosis, preeclampsia, have kidney disease or severe edema. Sometimes a Zimnitsky test is needed to assess the circulatory system, the work of the heart muscle.

Norm indicators for adults and children

Analysis of urine according to Zimnitsky allows us to evaluate several important parameters in the work of the kidneys: the density and fluctuation of the density of urine, the amount of fluid that the body removes per day, as well as the change in the excreted volume depending on the time of day. The normal results of the Zimnitsky test in men and women are:

1. should be 1500-2000 ml.
2. The volume of urine excreted by the kidneys is 65-80% of the total amount of water drunk.
3. The volume of daytime urine should be much larger than nighttime. The norm of daily diuresis is 2/3 of the total daily volume.
4. Each serving has a minimum density of 1012 g/l and no more than 1035 g/l. There are visible changes in the density and amount of urine from different servings. For example, during the day one serving is 0.3 liters, and at night - 0.1 liters. The difference in density is that one portion has an indicator of 1012, and the other has 1025.

The norms of analysis according to Zimnitsky in pregnant women are somewhat different:

1. Each serving has a volume of 40 to 350 ml.
2. The smallest and largest density index differ by 0.012-0.015 g/l.
3. The amount of daily urine is 60% of the daily urination.

The norms for children are lower. All data will depend on the age of the child: the older he is, the more his results are similar to "adults". Doctors must pay attention to this property when interpreting the results. In a healthy child, each jar should contain urine with different density and volume. The specific gravity of urine in children should differ by 10 units, for example, 1017-1027, etc.

This video talks about the analysis of urine according to Zimnitsky, the normal indicators of the study and the reasons for changing the density of urine, as well as the algorithm for conducting the study, the features of preparation and indications for the appointment of a urine test according to Zimnitsky.

Deciphering the analysis according to Zimnitsky from the data obtained

The results of a urine sample, especially if they are far from normal values, make it possible to judge some diseases:

1. Polyuria. when there is an increased release of fluid during the day (more than two liters). This condition may indicate the development of diabetes and diabetes insipidus, renal failure.
2. . It appears if the kidneys cannot cope with the purification of the blood, while the density of urine increases, and its volume decreases significantly. With oliguria, less than a liter of urine is excreted per day. This condition may indicate heart or kidney failure, a decrease in pressure, poisoning of the body.
3. nocturia. Urination occurs mainly at night, that is, it exceeds 1/3 of the total volume. This disease occurs against the background of diabetes mellitus, heart failure, and various disorders of urine concentration.
4. Hypostenuria. The body excretes urine with a density of less than 1012g/l. Hypostenuria may indicate severe problems in the cardiovascular system, pyelonephritis in the acute stage, as well as other chronic kidney complications (diabetes insipidus, leptospirosis, exposure to heavy metals).
5. Hyperstenuria. Represents the opposite state, when the density of urine is more than 1035 g / l. This serves as a signal of the onset of anemia, diabetes mellitus, exacerbation of glomerulonephritis. The appearance of hyperstenuria may be due to toxicosis during pregnancy, blood transfusion, and the rapid breakdown of red blood cells.

On a note! The attending physician should deal with the interpretation of the results of a urine test according to Zimnitsky. Only he will be able to establish the causes of this or that deviation and make the correct diagnosis.

How to collect urine for analysis according to Zimnitsky

There is no special preparation for this study. No pre-diet is required, but be aware that high fluid intake will skew results. Therefore, it is worth observing a number of simple rules: