The Rehberg method of urine analysis is one of the types of hemorenal tests, which makes it possible to assess the performance of the kidneys in carrying out their cleansing function. The Rehberg test is based on calculating the rate of filtration and purification of plasma from creatinine.
The Rehberg test is determined by calculating such an indicator as the concentration of creatinine in the blood, as well as its value in the daily collection. In this case, urine is used as a collection. If creatinine in the blood exceeds the established norm, and the indicators in question in the urine are reduced, we are talking about the likelihood of a decrease in the performance of the kidneys when performing their cleansing function.
Purification of the blood from products that are released during metabolism in the body is ensured thanks to the work of the kidneys, their function glomerular filtration, channel secretion and reabsorption. Creatinine in this case is a substance that enters the urine after a filtration process and passes through the glomeruli, without being reabsorbed in the tubules.
After the age of 40, most patients experience a decrease in glomerular capacity. At the same time, the decrease in the efficiency of the cleansing function of the kidneys will be about 1% per year, which contributes to the analysis of taking a Rehberg sample. Such indications include the following:
Before taking a urine test, the patient goes through a fairly simple preparatory process. Determining the sequential preparation steps for taking such a study includes all the main aspects, as with the collection of 24-hour urine. In addition, the patient should avoid strenuous physical activity, drinking alcohol and drinks that contain caffeine, but do not change the amount of liquids consumed daily. It should be noted that the use of any drugs to treat any disease or strengthen the immune system may affect the indicators that will be obtained after this urine test.
At the end of the daily urine collection, a blood test is taken from the patient. This is a necessary step for comparing indicators percentage creatinine in blood and urine.
Glomerular filtration is determined using a standard formula. The “plasma volume” indicator will be equal to the ratio of the urine creatinine concentration multiplied by the plasma creatinine value to the product of the urine creatinine concentration with the value in minutes of collection time.
It should be remembered that the minute volume of filtration depends on the person’s height and weight. At the same time, this fact confirms that the normalized indicator values can differ significantly from the average indicators. Creatinine clearance is calculated in conventional values according to the standard value of body surface, which requires knowledge of a person’s weight and height.
Interpretation of the results of a urine test according to Rehberg is not a diagnosis of any disease or pathological process. A urine test can only confirm or refute guesses. In addition, creatinine clearance may indicate the presence or absence of abnormalities in kidney function and endocrine system. The results obtained as a result of the manipulations necessary to conduct a study such as a urine test are the exclusive basis and criterion for obtaining correct statements from the doctor. A urine test alone is not enough to make a diagnosis. Therefore, the specialist takes into account all the nuances, which include anamnesis, symptoms and other aspects.
In most laboratories, the Rehberg test is measured in ml/min per 1.7 cm2 of body.
Depending on affiliation age category and semi-analysis of the Rehberg test is characterized by the following normal indicators:
An increase in the value during a urine test for the Rehberg test may indicate initial stage development in a patient of diabetes mellitus or diseases that are associated with a serious increase blood pressure, or confirm the presence of nephrotic syndrome.
A decrease in indicators, in turn, indicates a decrease in the level of kidney function of the patient who took a urine test for the Rehberg test. In addition, a decrease in value may be a clear sign renal failure, the description of which is carried out by the attending physician.
Liters of blood pass through the kidneys every day. This organ cleanses them of waste products. They are excreted along with urine. To understand the quality of filtration carried out by the kidneys, the fluid is studied for the content of toxins, for example, creatinine. The Rehberg test allows you to understand the concentration of the component in the blood and urine. This helps the doctor evaluate the functioning of the organ and diagnose their diseases.
This is a diagnosis of glomerular filtration rate. Purpose: assessment of the functioning of the excretory system. An important indicator sample is endogenous creatinine. This component is measured in milliliters per minute.
The founder of the analysis was a Danish scientist named Rehberg in 1926. A decade later, the analysis procedure was corrected and simplified by Tareev. Therefore, in some sources such a study is called the Reberg-Tareev test.
Creatinine is formed from the breakdown of creatine phosphate in muscle tissue. The concentration of this component depends on age group and level of physical fitness. This component is found in the blood and is filtered by the kidneys, excreted in a limited volume by urine. If the kidneys are not working well, the component is excreted less well and its concentration becomes higher. Its increase is typical for high blood pressure, diabetes and other serious pathologies.
To analyze creatinine output, it is necessary to evaluate the composition of the urine that the patient excreted per day and understand the rate of blood purification. This figure for an adult patient is 125 ml of blood per minute. It allows you to understand how blood flows in an organ, how blood is purified, and how reabsorption occurs.
Doctors recommend examining urine and venous blood if you suspect a disease of the excretory system and to identify problems in its functioning. A referral for examination is given by a urologist. The person provides the collected urine to the laboratory and the same morning blood is drawn from a vein.
When is the Rehberg test performed? Doctors recommend taking this test if a person begins to have seizures without visible reasons, pressure rises, eyelids swell. The same must be done when there is urinary retention or its volume decreases, the patient loses consciousness, vomiting begins, and the legs swell. This may be a symptom of nephritis or pregnancy. Similar symptoms may be observed with the development of renal failure, with diabetes mellitus. If the laboratory technician reveals abnormalities during the analysis, the doctor prescribes a repeat test.
With its help, it is possible to promptly diagnose severe kidney pathologies, cardiovascular diseases, toxicosis. The Rehberg test helps diagnose diabetes, kidney failure, heart disease, endocrine diseases etc.
Doctors recommend that patients over 40 years of age undergo this test from time to time in order to early stages diagnose kidney disease. These diseases are often serious and cause serious harm to the body, while being asymptomatic.
How to take the Rehberg test correctly? Before taking the test, you need to prepare for it. With improper preparation, an incomplete reflection of the state of the body may occur. 24 hours before blood and urine collection, the patient should stop eating protein foods and not eat fish or meat. No need to drink tea, coffee, or alcoholic beverages.
The day before the test, a person should not engage in sports or give the body intense physical activity. During this period you should not be nervous. The amount of fluid consumed before the kidney test does not change and should be about 1.5 liters of water. While preparing for the test, doctors prohibit taking cortisol, thyroxine and a number of other drugs. If the drugs cannot be stopped, the doctor must be notified about this in order to accurately assess the results obtained.
Before a urine test is performed, the patient must wash his genitals in the shower. Women are not tested during menstruation.
An increase in clearance occurs after intense physical activity before the study, when using trimethoprim, quinidine and other drugs.
The decrease in clearance begins in people over 40 years of age. Deviations from the norm can also be recorded due to improper preparation for analysis or violation of the collection of biological material for examination.
The level of the component increases in diabetics, hypertensive patients, and with nephritis. This indicator may change when the basis of the patient’s diet is protein food.
The values decrease in case of renal failure or problems with urine excretion. Component level drops when states of shock, with the development of heart pathologies, with dehydration of the body, with impaired renal function, etc. The interpretation of the analysis can only be carried out by a doctor, for example, a nephrologist, therapist, urologist.
First of all, the patient at home must prepare urine for delivery to the laboratory. The first urination is carried out in the toilet, then the genitals are washed. Soap should be free of additives and odor, as neutral as possible.
The rest of the urine is collected in a clean container with a volume of 2-3 liters. It is stored at a temperature range of 4 to 8 degrees so that it does not change physical properties. The last portion is taken a day later, that is, in the morning of the second day.
The collected urine is mixed, 50 milligrams of liquid is poured into another container and closed with a lid. A note with the patient’s data and the date of the test is attached to the container.
The container with biological fluid is sent to the laboratory for testing. Only 50 ml of urine collected per day is examined. Blood is drawn from the patient's vein.
The Rehberg test is carried out based on the analysis of two biological fluids.
What are the normal values of the Rehberg test? The creatinine content in the blood for infants up to one year is from 65 to 100 ml/min. For patients from one to 30 years of age, a value from 88 to 146 units is considered normal.
In people aged 30 to 40 years, the concentration of creatinine in the blood should reach a value of 75 to 140 units. After 40 years, it decreases from 75 to 133 ml/min. At the age of 50 to 60 years in patients, the normal blood creatinine value is considered to be from 64 to 126 ml/min. In people over 70 years of age, it decreases to a limit of 52 to 113 units. Normal value endogenous creatinine is considered to be 125 ml per minute.
If this indicator decreases to the limit of 30 to 50 units, this means that poisoning with toxins and waste products occurs in the patient’s body, and intoxication increases. In the future, this leads to the development of uremia.
If the component decreases to 15 units, then the patient needs urgent help doctor This condition threatens the patient’s life and he requires urgent hemodialysis. When the obtained sample is examined by a laboratory assistant, the result is transmitted to the attending physician. Usually a nephrologist or urologist does the decoding.
The attending physician makes conclusions based on the patient’s age, weight, and other physiological characteristics. Clinical picture is more accurate if the doctor takes into account chronic diseases person. An increase in the indicator is not always a sign of problems with kidney function. It may also be due to cardiovascular or thyroid disease.
Reberg's test is an analysis to assess the condition of nephrons and identify problems with the excretory function of the kidneys. With the correct collection of urine for research, doctors receive accurate data, compare the indicators with the norm, and find out the cause of the deviations.
If you suspect illness urinary tract It is important to know what the Rehberg test is for, how to prepare for the test, and how to give urine. The results help treat diseases of the kidneys and other organs with maximum efficiency.
In 1926, Danish scientist Paul Rebberg conducted a study to measure the rate of fluid filtration by the kidneys. Renal clearance of endogenous creatinine is an indicator on the basis of which doctors analyze the test results.
10 years later, Soviet doctor E.M. Tareev simplified the technique, proving that the level of creatinine remains constant; there is no need to additionally introduce the substance into the body. Many sources offer a double name for the method - the Reberg-Tareev test.
Urine analysis plus sampling venous blood on the same day, it is prescribed when signs indicating problems with the functioning of the kidneys and urinary tract appear. The referral is given by a urologist, the test (urine collection) is carried out at home, and then the patient brings the collected urine to the laboratory. On the same day in the morning you must donate venous blood.
Indications for performing the Rehberg test:
Such signs often indicate the development of renal failure, diabetes, toxicosis of pregnancy, and nephritis. If there are deviations in the indicators, the doctor prescribes a repeat test after a certain time to compare the results.
GFR drops to 30 ml/min? The risk of azothermia also increases.
Taking medications provokes incorrect indicators. Another negative factor, affecting the accuracy of the analysis - increased venous in case of problems with urine excretion. Deviations of 1-5 ml/min are considered acceptable; in all other cases, an in-depth examination with the involvement of other specialists is required.
The Reberg-Tareev test allows you to identify deviations in the functioning of natural filters and promptly recognize a decrease in the number of nephrons. For accurate results it is necessary proper preparation to take the analysis, contact the urologist with the research data for further treatment if there are deviations.
Video - transcript of the analysis for the functional performance of the kidneys:
Rehberg's test is special study, which allows you to determine the condition of the nephrons, as well as identify problems with the functioning of the kidneys due to urinary disorders. If you collect urine correctly for analysis, then specialists will be able to obtain an informative, high-quality, and most importantly accurate result. The resulting indicator is compared with the true norm; if the deviations are strong, then you need to move on to the next stage of diagnosis - determining the cause.
Danish specialist Paul Rebberg conducted a series of experiments in 1926 in which he measured the rate of filtration of biological fluids by the glomeruli of the renal system. The indicator that forms the basis of this test is the clearance of endogenous creatinine. After 10 years E.M. Tareev, a Soviet scientist, significantly simplified this technique; for this, he proved that the level of creatinine always remains at a constant value, so there is no need to introduce additional substances into the body. In many sources since then, the method has been called the Reberg-Tareev test; we will discuss how to collect it further.
First of all, you need to pay attention to those situations when it is advisable to carry out this study to really determine the pathology in the body, and not waste time and effort. Urine analysis along with venous blood sampling on the same day is carried out when symptoms occur that indicate a serious disruption of the functioning of the kidneys and urinary tract. First of all, you need to consult with a urologist; urine collection is carried out at home after completing preparatory measures, after which the patient submits the collected fluid to the laboratory. On this day in the morning you need to mandatory donate venous blood. Indications for the Reberg-Tareev test are as follows:
The Rehberg-Tareev test, or otherwise the clearance of endogenous creatinine, is one of diagnostic techniques making a diagnosis
As a rule, these symptoms indicate the occurrence of renal failure, nephritis, toxicosis of pregnancy, and diabetes. In this case, the norm of the Reberg-Tareev test must be taken into account in order to compare this indicator with what was received. If the deviation is strong, then the specialist will prescribe a repeat examination after some time to compare the results. The test allows timely identification of pathology, among which there are many severe conditions and serious illnesses, these include:
It is important to note that experts advise people after 40 years of age to regularly take a urine test for the purpose of prevention in order to detect deviations from normal indicator. It should be understood that in the first stages of development, renal pathologies do not cause any manifestations, so diseases can be detected only with appropriate diagnostic activities. If as a result of this, deviations are found, then the doctor prescribes additional tests, including a reberg test; we’ll look at how to collect urine later.
The attending physician must tell the patient what actions may affect the result of the study. The patient must know exactly which foods should not be consumed, whether specific foods can be consumed medicines, and also establish your drinking regime. The quality of preparatory measures directly regulates the accuracy of the Rehberg test; we will discuss how to properly carry out this analysis further. In some cases, tests show an incorrect result, then a specialist may prescribe an incorrect diagnosis, and this in turn poses a serious danger when renal pathologies And arterial hypertension. Severe diseases are quite difficult to treat, and there is a high probability of complications occurring, because they accumulate in the body. toxic substances due to problems with urine output.
Before the study, you should not eat spicy, fatty, fried, salty food and smoked meats
Preparatory activities should be carried out in a certain sequence; the algorithm of actions is as follows:
It is advisable to take tests in the morning, preferably between 7-10 am; as a rule, laboratories are open just before this time. Before eating in the morning you need to drink 0.5 liters of water, the first portion of urine should be thrown out. At the next stage, venous blood is collected. After this, throughout the day you need to collect urine in a sterile container, while you need to measure the exact volume and record the time. All liquid is kept cold, that is, in the refrigerator, so that the resources do not deteriorate. The last urine collection should occur no later than 24 hours after the first urination. From the total container, only 50 ml of liquid is taken into a sterile container; it must be taken to the laboratory.
Target:
Indications: Kidney diseases.
Contraindications: No.
Equipment:
1. Dry, clean jar with a capacity of 250 ml.
3. Sterile syringe with needle.
4. Sterile cotton balls.
5. Antiseptic.
6. Rubber gloves, mask.
7. Reset tray.
8. Containers with disinfectant. solutions.
9. Clean test tube
I. Preparation for the procedure:
1. Introduce yourself to the patient, explain the purpose and course of the procedure. Ensure that the patient has informed consent for the upcoming procedure.
2. Provide the patient with a clean, dry jar with directions.
II. Performing the procedure:
3. Invite the patient to have a bowel movement at 6 a.m. bladder toilet.
4. Give the patient 2 glasses (300 ml) of water to drink.
5. At 7 a.m. (1 hour later), take blood from a vein.
6. At 8 a.m. (after 1 hour), collect all the urine in a jar.
7.
III. End of the procedure:
8. Monitor the delivery of urine and blood to the biochemical laboratory.
9. Make an appropriate entry about the procedure in the medical documentation.
Note: EF is normally 80-120 ml/hour.
CONDUCTING A 24-hour URINE ANALYSIS FOR THE REBERG TEST (according to the OKB method)
Target: Determination of glomerular filtration.
Indications: Kidney diseases.
Contraindications: No.
Equipment:
1. Dry, clean jar with a capacity of 3 liters.
4. Dry, clean jar with a capacity of 200 ml
5. Stick for stirring urine.
7. Sterile syringe with needle.
8. Sterile cotton balls.
9. Antiseptic.
10. Rubber gloves, mask.
11. Reset tray.
12. Containers with disinfectant. solutions.
13. Clean test tube/
Algorithm for performing the Rehberg test.
I. Preparation for the procedure:
1. Introduce yourself to the patient, explain the purpose and process of the procedure. Ensure that the patient has informed consent for the upcoming procedure.
2. Provide the patient with clean, dry 3L and 200 ml jars and a referral for a urine test.
3. Inform the patient about the need to drink at least 1.8 liters of water per day, since daily diuresis should be at least 1.5 liters (300 ml will be secreted by other organs).
II. Performing the procedure:
4. Offer to patient from 6 a.m. to 6 a.m. next day collect all the urine in a jar.
5. Wear gloves.
6. Stir the urine with a stick and pour at least ½ of its volume (100 ml) into a jar.
7. Place the jar of urine in a special box in the sanitary room.
8. At 7 o'clock in the morning, take blood from a vein.
III. End of the procedure:
9. Monitor the delivery of urine and blood to the biochemical laboratory.
10. Make an appropriate entry about the procedure in the medical documentation.
The technology is simple medical services
URINE COLLECTION FOR AMYLASE
Target: Determination of the amount of amylase in urine.
Indications: Inflammation of the pancreas.
Contraindications: No.
Equipment:
1. A clean, dry jar with a lid, capacity 200 ml.
Algorithm for collecting urine for amylase.
I. Preparation for the procedure:
II. Performing the procedure:
2. Ask the patient to urinate into a jar at 8:00 in the morning and immediately notify the nurse about the collected urine.
III. End of the procedure:
3. Deliver urine to the laboratory immediately after urination in a freshly isolated form.
Remember:
1. To perform the analysis, 5-10 ml of urine is enough.
2. A nurse collects urine for a seriously ill patient.
Technology for performing a simple medical service
COLLECTION OF FECAL FOR SCATROLOGICAL STUDY
Target: Determine the digestive capacity of the gastrointestinal tract.
Indications: Gastrointestinal diseases.
Contraindications: No.
Equipment:
1. A clean, dry jar with a lid.
3. Vessel (dry).
4. Wooden spatula.
5. Rubber gloves.
6. Soap and towel.
7. Des. means and container with disinfectant. solution.
Algorithm for collecting stool for scatological examination.
I. Preparation for the procedure:
1.Introduce yourself to the patient, explain the process and purpose of the procedure. Ensure that the patient has informed consent for the upcoming procedure.
2. Wash your hands.
3. Wear rubber gloves.
4. Give the patient a clean, dry bedpan.
II. Performing the procedure:
5. After defecation, collect feces with a spatula for scatological examination in the amount of 5-10 grams from several places in a jar.
6. Attach a direction.
III. End of the procedure:
7. Pour the contents of the vessel into the toilet and process the vessel according to the instructions.
8. Throw the gloves into a container with disinfectant. solution and wash your hands.
9. Arrange for delivery of stool to the laboratory.
Technology for performing a simple medical service
COLLECTION OF FECES FOR EGGS OF HELMINTHES AND PROTOZOOS.
Target: Detection of helminth and protozoan eggs.
Indications: Gastrointestinal diseases.
Contraindications: No.
Equipment:
1. The vessel is dry.
2. Clean, dry glass jar with lid.
3. Wooden spatula.
5. Gloves.
6. Soap and towel.
7. Des. products and a container with disinfectant solutions.
