How to pass a urine test according to Zimnitsky. Preparation for the test according to Zimnitsky

Urinalysis according to Zimnitsky is a laboratory diagnostic method that allows you to examine the functional state of the kidneys. Using the analysis of urine according to Zimnitsky, the ability of the kidneys to concentrate and excrete urine is assessed.

Urine is formed in the kidneys by filtering the blood. During the day, the kidneys pass 1800 liters of blood, while normally 1.5-2 liters of urine should be excreted. The waste products of the body are excreted in the urine. Water balance is also regulated by urine excretion. If the body receives little fluid, little urine is produced, but it becomes more concentrated. If there is a lot of liquid received (for example, with heavy drinking), the concentration of urine drops. If the kidney function is impaired, this mechanism stops working, as a result, the water balance is disturbed, the composition of the blood changes and this affects the general condition of the body.

Urinalysis according to Zimnitsky allows you to determine how much urine is excreted per day and what is the concentration of urine.

When is a urinalysis according to Zimnitsky prescribed?

Indications for the Zimnitsky test are:

• clinical signs of renal failure;
• suspicion of an inflammatory process in the kidneys;
• diagnosis of diabetes insipidus;
• hypertonic disease.

Collection of urine for analysis according to Zimnitsky

Urine collection for analysis according to Zimnitsky is carried out during the day. This will require 8 sterile containers (jars).

Urine collection begins in the morning. The first portion of urine after waking up is not collected, but goes down the toilet. Next, urine is collected in jars, for which a separate jar is used every three hours:

• from 9:00 to 12:00 in the morning;
• from 12-00 to 15-00;
• from 15:00 to 18:00;
• from 18-00 to 21-00;
• from 21-00 to 24-00;
• from 0-00 to 3-00;
• from 3:00 a.m. to 6:00 a.m.;
• from 6:00 am to 9:00 am.

Collected portions of urine should be stored in the refrigerator. After collecting the last portion of urine, all material should be delivered to the laboratory.

Preparation for analysis according to Zimnitsky

No special preparation for analysis is required. On the eve and on the day of urine collection, diuretics should not be taken. On the day of urine collection, it is necessary to maintain the usual diet and drink as much as usual (no more than 1.5-2 liters per day). It is recommended to calculate the amount of liquid you drink (taking into account liquid dishes - soups, jelly, etc.).

Urinalysis indicators according to Zimnitsky

The following values ​​are determined in the laboratory:

• the amount of urine in each jar (3-hour portion);
• the relative density of urine in each portion;
• the total volume of urine (in comparison with the volume of liquid drunk);
• the total volume of daily urine (daily diuresis) - from 6-00 to 18-00;
• the total volume of night urine (night diuresis) - from 18-00 to 6-00.

Norms and decoding of urine analysis according to Zimnitsky

The total volume of urine (daily diuresis) should normally be from 1500 to 2000 ml.

If the volume of urine allocated per day exceeds 2000 ml, it is diagnosed polyuria. Polyuria can be a sign and also indicate kidney failure.

The ratio of the volume of urine excreted per day to the volume of fluid drunk during the same time is normally 65-80%.

If the ratio is below normal, this indicates that water is retained in the body. Edema increases, the disease progresses. Exceeding the norm means that the edema subsides, the patient's condition improves.

The amount of daytime urine should normally exceed the amount of urine excreted at night (daytime urine is 2/3 of the daily volume, nighttime urine is 1/3). An increased or predominant proportion of nocturnal diuresis may be a sign of dysfunction of the heart (heart failure). Equal shares of night and daytime diuresis (50% each) indicate a violation of the concentration function of the kidneys (the kidneys do not respond to the activity of the body).

The density of urine should normally be in the range from 1.012 to 1.025 g/ml. Data on density in different portions should be different, since during the day the kidneys react to changes in the water balance and body activity.

Low urine density (in all jars below 1.012 g / ml) indicates a violation of the concentration function. Such a state is called hypostenuria. Hypostenuria can be detected in chronic renal failure, inflammatory processes in the kidneys (), diabetes insipidus, heart failure.

It only gives an idea of ​​the state of the kidneys at a particular point in time and does not reflect changes in their work under the influence of various factors. In an effort to compensate for this shortcoming, scientists have developed other methods for examining urine, which give a broader idea of ​​\u200b\u200bthe work of this organ. One of these methods is the analysis of urine according to Zimnitsky.

This analysis allows you to thoroughly study the excretory and concentration function of the kidneys throughout the day - with the help of a traditional general study, the study of these indicators of the functioning of the excretory organs is almost impossible. Although this analysis is more difficult to perform and brings some inconvenience to the person, the information obtained with its help makes an invaluable contribution to the diagnosis of various kidney disorders.

Urine analysis according to the Zimnitsky method requires quite careful preparation.

• The day before the study, eight containers are prepared. Usually, each of them is written with the last name and first name of the person, the date of the analysis and the time of urination - 9:00, 12:00, 15:00, 18:00, 21:00, 00:00, 03:00, 6:00.
• A diary is being prepared, which will indicate the amount of fluid consumed.
• At least a day before, any pharmaceutical preparations that directly or indirectly affect the functioning of the kidneys are canceled. For this purpose, the person must inform the attending physician about all the medicines that he takes. The decision on the need to cancel them in this case is made by a specialist.
• Directly on the day of the study, the subject must empty the bladder at six in the morning. After all these manipulations and preparations, you can begin to collect material for analysis.

The essence of this diagnostic method is that a person, starting at nine o'clock, collects all urine in prepared containers. The first portion is collected in a jar with the indication "9:00". The next urination must be done at twelve o'clock in the next container, and so on throughout the day. It is forbidden to relieve a small need not in a container or at another time - only every three hours. In the event that it was not possible to collect urine at the appointed time due to its absence, the jar remains empty, and the next urination must be carried out in another three hours in the next container.

At the same time, a person or assigned medical worker must keep a record of the fluid taken. It is important to take into account the high water content in first courses, some fruits and vegetables. The resulting figures are recorded in a prepared diary. After the last urine collection was made (at six in the morning of the next day), all eight containers are delivered to the laboratory for research.

Deciphering the results of the analysis

The interpretation of the urine test according to Zimnitsky differs in that, as the results of this study, not specific numbers are especially important, but their relationship to each other. They reflect the concentration and excretory functions of the kidneys. In a healthy person, the work of these organs undergoes certain fluctuations throughout the day, which affects the properties of urine. With various disturbances, these fluctuations can change or smooth out, which is clearly seen in the framework of this analysis.

Brief description of analysis indicators according to Zimnitsky

Daily diuresis is the amount of urine excreted per day. For the purposes of this study, it is determined by simply adding up the liquid volumes of all eight servings. The volume of diuresis depends on the amount of fluid taken, the functioning of the kidneys, the state of the body, and the hormonal background. The normal indicator of diuresis for an adult are figures from 1200 to 1700 ml. Decreases up or down can indicate various kinds of disorders and damage to the kidneys or the body as a whole.

The ratio of diuresis to the amount of fluid taken- this criterion is found out by comparing the daily volume of urine with data from the diary, which indicated how much liquid a person drank per day during the study. Normally, the volume of diuresis is somewhat less than the amount of water that has entered the body - it is 75-80%. The rest of the fluid leaves the body through sweating, respiration, and other mechanisms.

The ratio of night and day diuresis- it is for the clarification of indicators like this that it is important to mark the time of urination on the containers for collecting material. Normally, during the day, the kidneys work much more actively than at night, therefore, in a healthy person, the volume of daytime diuresis is about three times greater than at night. In the case of an impaired functional state of the kidneys, this ratio may not be fulfilled.

Volume of one urination is normally about 60-250 ml. Other values ​​​​of this indicator indicate the unstable work of the excretory organs.

Maximum difference between urination volumes- during the day, the amount of urine excreted at a time should change. Moreover, the difference between the largest and smallest volume values ​​during the day should be at least 100 ml.

Density (specific gravity) of urine- one of the most important indicators of analysis according to Zimnitsky, which characterizes the ability of the kidneys to accumulate various salts and metabolic products in the urine - this is the essence of the concentration function of the excretory organs. The normal values ​​for this criterion are the figures 1.010 - 1.025 g / ml.

Maximum density difference in different portions- as well as the volume of urine, its specific gravity should change. The minimum value of this difference is 0.010 g/ml. As a rule, in a healthy person, urine excreted at night (between 21:00 and 3:00) is more concentrated.

Despite the apparent complexity of urinalysis according to Zimnitsky, it is the most accurate and at the same time minimally invasive method for studying the functional state of the kidneys. That is why it has not lost its relevance for decades and continues to be in service with specialists in many countries.

Any medical examination begins with laboratory tests, and urinalysis is one of the first. Indicators of the biological fluid allow you to assess the general condition of the patient. The first thing that deviations from the norm will tell about is a violation of the kidneys. If it is, a number of additional studies are carried out, in particular, a Zimnitsky test. Why and in what cases is it prescribed and how to collect urine for analysis?

What will the functional test according to Zimnitsky show

The main function of the kidneys is to remove unnecessary toxins from the body - metabolic waste, poisons, foreign elements. By filtering the blood, secondary urine is formed, where, together with water, protein breakdown products, nitrogenous compounds, enter. And useful substances - minerals, protein and glucose - come back into the blood. The concentration of nitrogenous compounds in the urine indicates how well the kidneys are doing their job.

The concentration indicator is called relative density, it is it that is evaluated when analyzing samples according to Zimnitsky.

The process of formation of the final urine occurs in the renal glomeruli, tubules and interstitial tissue. Samples according to Zimnitsky allow you to control their functional viability and timely detect pathology.

The Zimnitsky test is designed to diagnose abnormalities in kidney function

The presence in the urine of organic substances that should not normally be present (glucose, epithelium, bacteria, protein) allows, in addition to kidney diseases, to suspect pathologies of other organs in the patient.

Urine for the sample is collected during the day. The amount of fluid released during this time, its density and distribution during the day (day and night diuresis) are analyzed.

When is a study ordered?

Urinalysis according to Zimnitsky is prescribed for adults and children in the following cases:

• with suspicion of an inflammatory process in the kidneys;
• to exclude (or confirm) renal failure;
• with constant patient complaints of high blood pressure;
• if there was a history of pyelonephritis or glomerulonephritis;
• with suspected diabetes insipidus.

Pregnant women are prescribed tests in case of severe edema and impaired protein metabolism. In a planned manner, urine should not be collected by women during menstruation. In emergency cases, the sampling is performed using a catheter. There are no other contraindications for testing.

Preparation and collection of material for analysis

The algorithm for collecting urine for samples according to Zimnitsky is the same for children and adults. Pregnant women should adhere to the following rules:

• do not eat vegetables that color urine and change its smell (beets, horseradish carrots, onions, garlic);
• do not violate the recommended drinking regimen;
• do not take diuretics.

During the day, urine is collected at certain hours in 8 separate containers. Just in case, 1-2 spares should be prepared. The first morning portion at 6 o'clock in the morning merges into the toilet. Further, starting from 9.00, with an interval of three hours, the samples are collected in jars. The last container is filled at 6:00 the next morning.

Urine is collected every three hours

Each jar is signed - the name, surname and time of collection are put on it. If at this time there was no urge to urinate, an empty container is handed over to the laboratory (also with an indication of the time).

If the one-time volume of urine excreted exceeds the size of the container, an additional jar is taken, and the same time is marked on them.

The mode of drinking and eating should be normal. During the day, a diary is kept, in which the amount of fluid taken is noted. Everything is taken into account - water, tea, coffee, juices, juicy fruits, soups and the like. Records are handed over to the laboratory assistant along with biological material.

Tightly sealed jars of collected urine should be stored in the refrigerator. Pharmaceutical containers or sterile glass jars can be used to collect material. Do not use plastic utensils.

Deviations from the norm give rise to further examination of the patient

Table: normal sample values ​​according to Zimnitsky

Normally, morning urine is more concentrated than evening urine. It is diluted with liquid drunk during the day. In all portions, the biological fluid may have a different color and smell. The physiological norm of density can vary from 1001 to 1040 g / l. With a normal drinking regimen, it is 1012–1025.

Deciphering the analysis

The interpretation of the results of the analysis is carried out only by a specialist. Deviation from the norm of any indicator requires close attention of the doctor.

Table: what deviations from the norm say

Equally low values ​​in all eight samples (isohyposthenuria) also indicate a deviation in the work of the kidneys. Maximum fluctuations in the specific gravity of urine less than 0.012-0.016 are one of the early signs of renal failure. The alleged diseases are chronic glomerulonephritis, hypertension, development of an amyloid-wrinkled kidney, hydronephrosis, severe polycystic kidney disease.

The low density of urine in samples according to Zimnitsky may have alimentary reasons - long-term adherence to a salt-free or protein-free diet.

Deviations of some indicators from the norm are not necessarily pathological. An increased separation of urine can be observed with the convergence of edema, the intake of diuretics, an excessive amount of fluid drunk. A small amount indicates the formation of edema, insufficient fluid intake, increased sweating.

Urine samples according to Zimnitsky are designed to detect renal pathologies at an early stage. It is impossible to track the development of the disease by this analysis. Even with the progression of the disease and the increase in the content of nitrogenous slags in the blood, the relative density of urine can remain at the same level for a long time.

Video: urinalysis according to Zimnitsky - indications, collection rules, interpretation of the results

The sample is not intended to make an accurate diagnosis. It only indicates the performance of the kidneys. If the analysis reveals deviations from the norm, the doctor prescribes additional clarifying studies.

Urine is an important diagnostic material for studying the physiological state of the body. There are many techniques for studying it, each of which has its own characteristics. The quantitative and qualitative composition of urine changes during the day and serves as an important characteristic of various states of the body. As a rule, urine sampling for analysis is carried out in the morning, when the concentration of substances in it is the highest. Taking the material during the day occurs according to the Zimnitsky technique and in urgent (urgent) cases.

Laboratory analysis allows not only to determine its chemical composition, physical indicators of specific gravity and acidity, but also the microbiology of the sediment. At the initial stage, the researcher is interested in the organoleptic characteristics of urine: its quantity, color, smell, transparency and foaminess. The natural color of urine is light yellow to dark yellow, depending on the presence of urine pigments called urochromes. A change in the color of urine can signal a number of pathological processes in the body. For example, a violation of the metabolism of mesobilinogen in the liver leads to its sharp darkening. This effect is observed in patients with jaundice, hepatitis or obstructive processes in the bile ducts. Urine staining in the color of meat slops or a reddish color occurs with certain blood diseases and glomerulonephritis. The presence of pus in the urine indicates a bacterial infection in the urinary system. In this case, it will turn grayish-white.

In a healthy person, urine has a characteristic uric odor. A change in the direction of the unusual may give rise to suspect the development of pathology. The acetone smell indicates the presence of ketone bodies in the urine, which happens with diseases of carbohydrate metabolism. With a sharp ammonia smell, cystitis can be suspected. With intestinal infections, the causative agent of which is Escherichia coli, acquires a characteristic fecal odor.

The urine of a healthy person is transparent and has an unstable and not abundant foam. The appearance in the urine of abundant and persistent foam indicates the presence of protein, which is confirmed by laboratory tests.

Normal transparency is changed by the bacteria present in it, salts (urates, oxalates), fat, the presence of epithelial cells and impurities, blood elements.

The density and acidity of urine serve as an important diagnostic feature. Normally, the density is in the range of -1020-1024 g / l, and the pH or acidity ranges from 5.0-7.5. Of these two characteristics, the importance of the value of the specific gravity of urine should be noted. This value is quite labile, has daily changes, depends on the ambient temperature, the amount of fluid taken and a number of pathologies of the body. An increase in its density occurs with dehydration of the body, insufficient kidney function, and some endocrinological disorders. Note the list of urine samples assigned to the patient.

Clinical (general) urinalysis

It is universally prescribed by attending physicians, as it allows you to see the overall picture of the functional state of the urinary system. The method is simple and accessible.

The collection technique is simple. A sterile signed container is prepared in front of the fence, where urine will be collected. All morning urine that has accumulated overnight in the bladder is taken. 70-100 ml is sufficient for analysis. When preparing for the collection of material, a certain rule should be followed: the material should be taken into the container after the hygienic procedure. The patient properly washes the area in the area of ​​urination, in order to avoid the ingress of bacteria and other biological dirt into the material, which will lead to an incorrect study.

Such an analysis provides extensive general information about the work of the kidneys. It allows you to determine not only the density of urine, but also shows the presence of abnormal protein and glucose, ketone bodies, bilirubin and urobilinogen, the presence of epithelial cells, blood elements, bacteria and leukocytes, which is an important clinical characteristic for diagnosing a number of diseases. According to the results of a general urine test, it is possible to diagnose renal pathology and some endocrinological diseases, for example, diabetes mellitus. For a reliable result, you should not give urine after taking diuretic drugs that stain food and menstruating women.

Urine sample according to Nechiporenko

Allows you to detect the hidden process of inflammation in the kidneys. Based on this analysis, it is possible to judge cystitis, glomerunephritis, hematuria. This is a more specific analysis, in which the average portion of morning urine with a volume of 20-25 ml is of diagnostic interest. The algorithm for conducting such a test consists of the morning toilet of the relevant organs. The first and last portions of urine during urination descend into the toilet, and the median is collected in a sterile container. Of interest is the quantitative count of leukocytes, erythrocytes, and cylinders.

The analysis technique is not difficult, but has its own nuances, namely, it is not prescribed to women during menstruation, in order to avoid false results, and after diagnostic procedures on the bladder using contrast agents (cystoscopy), catheterization.

For a more complete result, on the eve of the study, medications, dyes, heavy food and physical activity, which can distort the result, should be excluded.

Urinalysis according to Zimnitsky (Zimnitsky test)

The method allows you to determine the state of the concentration and selection functions. The study of urine according to Zimnitsky allows you to find out the concentration of urine throughout the day with a normal drinking load. Its daily composition and the volume of urination may vary. In the morning it is denser, the concentration of dissolved substances in it is higher, the color is brighter and the smell is stronger.

Normally, the daily diuresis of a healthy adult is in the range of 1.5-2.0 liters.

The limits of 1010-1025 g/l are taken as normal indicators of relative density.

Considering the fact that daytime diuresis should be higher than nighttime, an interesting technique has been developed for portioned urine collection, which allows determining its density in each portion. The analysis is quite laborious, but quite informative.

The Zimnitsky urinalysis algorithm consists of several stages. Preparing to collect material. To do this, you need 8 sterile containers for collecting urine. For convenience, they are signed, indicating on each container the appropriate time at which the next portion will be collected.

It is necessary to collect urine correctly - it is recommended to start at 6:00 in the morning, (this portion is poured out) with an interval of 3 hours, respectively, the numbering of containers occurs according to the time of emptying, namely 9:00 12:00 15:00 18:00 21:00 3:00 6:00.

Related videos

In parallel, it is necessary to keep records of the amount of liquid and liquid food taken at this time. Urine collection should be carried out at a strictly defined time and in an appropriately signed container. The algorithm (sequence) of material collection should be strictly adhered to.

The dishes filled with material are stored closed in the refrigerator. When all portions are ready, they, along with the records, are taken to the laboratory. During the analysis, not only daily diuresis is determined, but also the volumes of urine excreted day and night are considered. The specific gravity of each portion is determined.

During normal functioning of the kidneys, the amount of urine excreted per day will be in the range of 50-80% of the volume of all the liquid drunk.

The share of daytime diuresis accounts for two-thirds, and night one-third of the total diuresis.

The density of urine of each portion is not lower than 1.013 and not higher than 1.025 g/l.

Normally, in a healthy person, an adult or a child, the volume and density of urine have daily fluctuations. Morning urine has a volume of about 300 ml and a density of 1022 g / l, by the evening the figures should decrease to 1012 g / l and 50 ml, respectively.

The main functions of the kidneys are concentration and excretion. Urine formation is a complex physical and biochemical process that includes two stages:

1. Formation of primary urine - filtration in the glomeruli
2. The formation of secondary urine, at this stage it is concentrated.

• All blood in the body is filtered under high pressure in the capillaries of the renal glomeruli. The composition of primary urine is similar to the composition of blood plasma, but without the content of proteins. The daily volume of primary urine is about 170 liters.
• Secondary or final urine is formed as a result of the reverse reabsorption of water and nutrients in the tubules. The walls of the tubules have a unique structure that allows all useful substances to diffuse back into the bloodstream. This is how secondary urine is formed. Its concentration and volume is radically different from the primary one. It lacks proteins and glucose, and an increased concentration of nitrogenous compounds is noted.

The final urine is 95% water, the remaining 5% is the dry residue, consisting of urea, uric acid, ammonia, sodium potassium salts, chlorine. 1.5-2.0 liters of it is released per day, it is more concentrated and has a characteristic smell.

Insufficient work of the kidneys at this stage of urine formation leads to a violation of the process of urine concentration, which is clinically manifested in an increase / decrease in the density of the excreted urine. This is observed in some renal pathologies, toxicosis of pregnant women, metabolic disorders, in particular carbohydrates. The Zimnitsky test will help the attending physician to understand the problem in more detail and make an accurate diagnosis.

When the results of such an analysis deviate from the norm, one can judge a disease.

Low urine density, with results below 1.012 g/l, indicates a violation of the concentrating ability of the kidneys. It is observed in chronic renal failure, exacerbation of pyelonephritis, glomerulonephritis, diabetes insipidus and heart failure stage 3-4. Taking diuretics can cause a decrease in the specific gravity of urine, so this should be taken into account when analyzing the results. Increasing the density of urine, with figures exceeding the norm of 1024 g / l. Occurs when protein and glucose enter the urine in exorbitant concentrations. Similar deviations will be in diabetes mellitus, chronic and acute glomerulonephritis, in which, due to impaired permeability in the renal glomeruli, large molecules of proteins and blood cells penetrate into the urine from the blood into the urine. Clinically, the urine shows an increased content of protein (proteinuria) and blood cells (hematuria) and glucose. A serious danger is hyperstenuria in toxicosis of pregnant women.

There are early and late toxicosis (gestosis). Late toxicosis poses a great danger to the health and life of a pregnant woman. The reasons for its occurrence are not fully understood. At risk are pregnant women with chronic kidney disease, overweight, which is often accompanied by high blood pressure. Too early pregnancy, as well as late, also increase the risk of such a complication of the course of pregnancy. A genetic predisposition to this problem has also been determined. Early toxicosis is observed in the early stages of 4-12 weeks.

Late occurs in the third trimester of pregnancy. First, edema appears, mainly on the hands, on the legs. These are external swellings that are noticeable. Hidden swelling of internal organs is dangerous. The weight of a pregnant woman is growing rapidly, sometimes rising to two kg per week. Gradually, blood pressure rises and the presence of protein in the urine is noted. Such women are observed and treated on an outpatient basis.

With the aggravation of symptoms, the appearance of complaints of persistent headaches, heaviness in the back of the head, cases of a sharp increase in pressure, vomiting caused by a hypertensive crisis, the progression of preeclampsia is judged. This condition requires urgent hospitalization of the patient, as there is a risk of a condition that threatens the life of the mother and the unborn child.

Observation and clinical examination of women preparing for motherhood allows you to control her condition throughout pregnancy, up to childbirth. Timely and periodic blood and urine tests will help assess the health of the expectant mother at various stages of pregnancy. Urinalysis according to Zimnitsky in this case is very relevant, as it allows you to monitor the state of the concentration and excretory function of the kidneys and determine its deviation in time.

This laboratory analysis is successfully used for diagnostics in pediatrics. An increase in urine concentration in children can be caused by developing renal failure, endocrine disease - diabetes and insufficient drinking regimen. Normally, the daytime diuresis of the child significantly exceeds the nighttime diuresis - from 50 to 75% of the total volume. The predominance of nocturnal urination indicates insufficient kidney function. Such children should be properly examined for an accurate diagnosis.

The kidneys remove water and substances dissolved in it from the body. To assess the work and functionality of the organs, the domestic therapist S.S. Zimnitsky proposed a special test based on urine density analysis.

What it is?

The blood entering the kidneys is filtered by special tubules. In this case, the excess liquid diffuses, and with it various amines, salts and other substances.

Primary filtration is replaced by secondary filtration, as a result of which useful compounds, such as proteins and carbohydrates, are absorbed back into the blood from the urine.

The essence of the Zimnitsky method is to determine the density of the fluid excreted from the body, its specific gravity. If the indicators are lower or higher than normal, then doctors talk about a change in the concentration of urine and a violation of the filtration function of the kidneys.

A deep biochemical analysis is not performed in this study, however, if the test result is positive, additional measures are possible.

Why conduct a test according to Zimnitsky?

If a patient turns to a nephrologist with complaints of pain in the kidney area, then he is required to prescribe a urine test for sugar and protein. In addition, an X-ray examination of the excretory organs for inflammation is also carried out.

But there are times when these methods do not work. Those. pain syndrome is present, but the cause of its occurrence is not known.

The physical characteristics of the output liquid (volume and density) will clarify the situation. The study of urine tests according to Zimnitsky is considered very informative, and it is prescribed for suspected pyelonephritis, renal failure, or heart disease.

The technique is not difficult, but the patient needs to collect urine every 3 hours for a whole day.

Algorithm for collecting urine according to Zimnitsky

Any medical analysis has an error. In addition, even with normal health, a change in the concentration of organic and mineral compounds in the urine is observed.

Therefore, in order to obtain the most reliable results, it is necessary to exclude diuretics 1 day before sampling, which significantly affect the physical characteristics of the excreted fluid.

The patient is also forbidden to eat foods that increase the feeling of thirst (salty and spicy), although the usual drinking regimen (1.5-2 liters per day) should not be changed.

How to collect a urine test according to Zimnitsky? First of all, prepare 8 containers. Special containers can be purchased at a pharmacy, but ordinary glass jars up to 0.5 liters are also suitable. They are numbered and signed so that there is no confusion in the laboratory. Urine is collected according to the following algorithm:

1. At 6 o'clock in the morning they are emptied into the toilet.
2. Every 3 hours, starting from 9.00, urine is collected in the appropriate jars.
3. Samples are stored in a refrigerator.

In total, you get 8 jars of urine collected at 9, 12, 15, 18, 21, 24, 3 and 6 hours. If the patient has no urge, then the container is simply left empty.

However, it is not thrown away, but, together with filled containers, is delivered to the laboratory for research. Specialists will conduct the necessary analyzes and decipher the data in accordance with average standards.

Norms of urine analysis according to Zimnitsky

The density of urine varies between 1.013-1.025. This means that in some jars the indicators will be higher, in others - lower. In general, the following results are considered normal:

• the daily volume of urine does not exceed 2 liters;
• in 2-3 containers the density is not less than 1.020;
• daily portions are 3-5 times more than nightly ones;
• the excreted fluid is 60-80% of the consumed;
• there are no indicators above 1.035.

When conducting a urine test according to Zimnitsky, the interpretation of the results will largely depend on compliance with the rules for sampling. If the patient drank too much water, then it will come out in excess of the norm. But the lack of fluid intake will also cause errors in the study. Therefore, on the day of sampling, it is necessary to concentrate on the task at hand so that the procedure does not have to be repeated.

Interpretation of urine tests according to Zimnitsky, table

So, the patient collected the material and sent it to the laboratory, the specialists conducted experiments and received certain information. What's next? Reveal the compliance of indicators of urinalysis according to the Zimnitsky norm. The table clearly demonstrates the diseases characteristic of various deviations.

The table displays brief diagnostic information. A more detailed consideration of the causes of impaired urine density will help to understand the problem.

kidney failure

If a patient has been suffering from renal failure for several years, then the excretory organs simply lose their ability to perform their functions normally.

Accompanying symptoms are often a general deterioration in health and a constant feeling of thirst, which leads to increased fluid intake and, as a result, low urine density and a large daily excretion.

Kidney inflammation

Bilateral or unilateral inflammation of the kidneys also reduces the functionality of the organs due to the ongoing pathological hyperplasia.

It is accompanied by pain in the lumbar region and fever, so the Zimnitsky test is performed to clarify (confirm the diagnosis).

An additional biochemical analysis demonstrates an increased protein concentration, which also indicates a violation of the filtration process.

Heart pathologies

The body is a whole. And if doctors diagnose a violation of the kidneys, then this fact provides grounds for checking cardiac activity. And often suspicions are confirmed on the electrocardiogram.

Congenital or acquired pathology of the heart leads to disruption of blood flow and a change in pressure in the vessels, which, naturally, is also reflected in the filtration process: the volume and density of the excreted fluid are noticeably reduced, and at night a person is disturbed by frequent urges to go to the toilet.

Diabetes

If sufficient reabsorption of glucose is not carried out in the kidneys, then doctors suspect. This disease is also characterized by thirst, increased appetite and other symptoms.

However, the key points are the high density of urine and a large amount of glycosylated hemoglobin in the blood.

diabetes insipidus

And poses a considerable danger. In fact, this is an endocrine failure, expressed in a deficiency of one of the hormones of the hypothalamus - vasopressin.

It is its deficiency that leads to excessive removal of fluid from the body, which is accompanied by a decrease in the density of urine. In addition, a person is very thirsty, and the urge to go to the toilet takes on a pathological character.

Glomerulonephritis

With glomerulonephritis, low permeability of the renal glomeruli is revealed. This naturally complicates the diffusion process, which is why the reverse absorption of compounds into the blood is disturbed - urine acquires a density of more than 1.035.

In addition, tests often show the presence of red blood cells and proteins in the samples.

Features during pregnancy

However, proteins in the urine are not necessarily a pathology. For example, during pregnancy, a woman's body suffers from toxicosis, which provokes a violation of protein filtration.

In addition, the growth of the fetus leads to an increase in pressure and functional load on the kidneys. After childbirth, the situation with excretory and other organs is normalized.

Blood diseases

Blood diseases are considered much more dangerous, accompanied by a change in the quality and quantity of formed elements - in particular, erythrocytes.

Excessively thick plasma, according to the law of diffusion, releases more components into the urine, so its density increases. If anemia is detected in a person, then, among other things, the kidneys suffer from oxygen starvation, which directly affects functionality.

Conclusion

Urinalysis according to Zimnitsky is performed as a primary diagnosis. The method is considered very informative, and a positive test result gives grounds for a more detailed examination of the kidneys, heart and blood.