A method for diagnosing renal dysfunction


(57) Abstract:

The invention relates to medicine, namely to surgery and is intended for the diagnosis of acute pancreatitis. Patients take 2 ml of the morning portion of urine. Determine the maximum electrical conductivity in the frequency range from 1,000 to 120,000 Hz AC. When its value is less than 238 S/m diagnosed with renal dysfunction. The method allows to simplify and improve the accuracy of diagnosis.

The invention relates to medicine, namely to laboratory methods, and can be used for the diagnosis of renal dysfunction in patients with acute pancreatitis.

To diagnose renal failure/dysfunction determine the concentration of creatinine plasma kinetic method and glomerular filtration by the formula F=CcrV, where Ccr- concentration index creatinine (ratio of the concentration of creatinine in the urine to that in the blood); V - min diuresis [Simanco I. I., Musselius S., Acute renal and hepatic failure. - M.: Medicine, 1993, 288 S.]. The increase in creatinine concentration of 200 µmol/l and decreased glomerular filtration rate of 50 ml/min was regarded as a sign of latent period po-38].

The disadvantages of the prototype should include the need for specially trained personnel and equipment, the complexity and duration of the study, the complexity of monitoring control and lack of information content in the initial stage of renal dysfunction.

The invention is directed to solution of the task: improve accuracy and simplify the method.

This is accomplished by examining the maximum specific electrical conductivity (SEC) urine volume of 2 ml in the frequency range from 1000 to 1200000 Hz alternating electric current, and determine the maximum value SEC. The conductivity of this volume is the biophysical characteristics of the urine sample. When the value of the electric conductivity of the urine below 238 S/m (Siemens/meter) diagnosed with renal dysfunction. Urine for the study take the day of surgery or admission and the subsequent 4 days.

The method is as follows

The examined patient on the day of receipt or transaction and the subsequent 4 days of observation take 2 ml portion of morning urine. Urine poured into a test tube and with the help of the device Qualy Tester determines the maximum electrical conductivity in the frequency range per dysfunction.

In healthy persons (control group) and patients with calculous cholecystitis without concomitant renal dysfunction SEC urine during the first 4 days of observation exceeds 238 S/m. In acute pancreatitis the conductivity is below the specified value. The study was conducted with the help of the device Qualy Tester, OJSC Morion, Russia, Perm, RT 940.008 THAT.

Examples of specific performance:

Example 1. Patient, 27 years, case history No. 1115. Diagnosis: Severe acute pancreatitis. Mixed pancreonecrosis. Acute post-traumatic pancreatic pseudocyst of the pancreas. Acute renal failure, oligoanalgesia period.

Received in the emergency Department surgery Bureau 28.08.2000 with complaints of acute girdle pain pain in the upper floor of the abdomen, bloating, weakness, fever up to 37.5 With chills. When applying the General state of moderate severity. Complete blood count: erythrocytes - 3,81012/l, leucocytes - 4,1109l (eosinophils - 5, band - 2, segmented neutrophils - 42, lymphocytes 44, monocytes - 7), platelet - 290109/l, erythrocyte sedimentation rate of 30 mm per hour, the clotting time is 15 minutes urinalysis: specific gravity 1020, color yellow, muddy, neutral reaction, protein - neg., the leukocyte - 3-5, an epithelium flat - entirely, oxalates - creatinine - 0,17 mmol/l, total bilirubin of 12 µmol/l, ALAT - 14 ME, alkaline phosphatase - 130 U/l, amylase - 370 mg/ml, including ultrasound and x-ray computed tomography detected an increase in the echogenicity of the parenchyma of the pancreas, in the projection Trofimovna tail rounded anechoic mass with education 1009083 ml volume of 420 ml isoechogenic suspension in the bottom. The kidneys unchanged.

13.09.2000 operated. In the abdominal cavity 200 ml of hemorrhagic effusion and plaque stefanakos on the greater omentum and the gastrocolic ligament. In the left hypochondrium large size of the cyst solid elastic consistence, with its opening received 800 ml content with amylase activity 19000 mg/ml PM Deleted curtailment of the pancreas. Performed external drainage of the cyst.

In the postoperative period conducted comprehensive treatment. Infusion volume of 2400 ml, daily diuresis in the first 3 days 500-600 ml. Value SEC urine, taken on the day of surgery, amounted to 205 S/m, in the next 4 days its value does not exceed 210 S/m, which was confirmed by renal dysfunction. On day 7 after surgery diuresis in the amount of 1200-1500 ml per day. The magnitude of the electrical conductivity of the urine amounted to 270 S/m, indicating that the normalization of kidney function. General and biochemical and what about the epithelial cells.

Example 2. Patient S., 41,, case history No. 1218. Diagnosis: Acute pancreatitis. Chronic acalculous cholecystitis. The initial period of acute renal failure.

Received in the emergency Department surgery Bureau 11.10.1999, with complaints of severe cutting pain in the upper floor of the abdomen with irradiation to the left departments of the torso, nausea, vomiting, bringing relief, bloating, weakness. The General state of moderate severity. Complete blood count: erythrocytes - 6,110l2/l, leucocytes - 9,6109/l (eosinophils - 1, band - 6, segmented neutrophils - 65, lymphocytes - 20, monocytes - 8), ESR - 6 mm per hour. Urinalysis: specific gravity 1020, color yellow, muddy, neutral reaction, protein - neg., the leukocyte - 1-2, an epithelium flat single - field-of-view, phosphates +++. Biochemical blood test: whole protein - 76 g/l, glucose - 4.5 mmol/l, creatinine - 0,122 mmol/l, total bilirubin - 21 µmol/l (associated with 5 µmol/l), ALT - 33 ME, alkaline phosphatase - 116 U/l, amylase - 15 mg/ml including ultrasound signs of chronic cholecystitis. The pancreas is not increased, contours fuzzy, heterogeneous parenchyma, ahogany density is reduced. The kidneys unchanged.

Conducted complex the AI, 173 S/m, in the next 4 days its value did not exceed 170 S/m, indicating that the presence of renal dysfunction. Before discharge from the hospital daily diuresis in the volume of 2000 ml, the value of the electrical conductivity of the urine amounted to 255 S/m, reflecting the normalization of kidney function. General and biochemical blood analysis - without a pathology, remained neutral reaction of the urine.

Example 3. Patient Z., 47 years old, medical history No. 1355. Diagnosis: cholelithiasis. Chronic calculous cholecystitis, senior aggravation.

Hospitalized in the Department of emergency surgery 18.10.2001, with the attack of biliary colic. The General condition is satisfactory. Complete blood count: erythrocytes - 4,83109/l, leucocytes - 4,5109/l (stab - 4, segmented neutrophils - 44, lymphocytes - 48, monocytes - 4), ESR - 23 mm per hour. Urinalysis: specific gravity - 1030, color yellow, laborota, the reaction of the acidic, protein - neg., the leukocyte - 8-10, an epithelium flat - 3-5 in the field of view, oxalates ++. Biochemical analysis of a blood in norm. Ultrasound signs of lipodystrophy liver, gall bladder 5819 mm, thickened wall, the lumen is determined by many concretions. Common bile duct - 9 mm in diameter. Pancreas Iberoamericana cholangiography. Signs of disturbance of outflow of bile is not detected. Pancreas visually and by palpation is not changed. The magnitude of the electrical conductivity of the urine, taken on the day of surgery, amounted to 255 S/m, in the next 4 days its value ranged 283-295 S/m, indicating the absence of renal dysfunction. Laboratory tests before discharge without deviation from the norm.

Example 4. Patient, 27 years old, healthy.

Complete blood count: erythrocytes - 5,51012/l, leucocytes - 6,2109/l (eosinophils - 2, band - 2, segmented neutrophils - 52, lymphocytes - 33, monocytes - 11), ESR - 5 mm per hour. Urinalysis: specific gravity - 1013, color yellow, transparent, the reaction of the acidic, protein - neg., the leukocyte - 0-1, epithelium flat - 0-3 in the field of view. Biochemical analysis of blood without pathology. On the first day of observation, the magnitude of the electrical conductivity of the urine amounted to 280 S/m, in the next 4 days its value ranged 270-293 S/m, indicating the absence of renal dysfunction.

The advantage of the proposed method are the increased sensitivity of early and latent stages of renal failure/dysfunction, convenience and high performance, non-invasive collection of material simplification issledovanij equipment.

A method for the diagnosis of renal dysfunction in patients with acute pancreatitis by examination of the urine, characterized in that it determines the maximum electrical conductivity in the frequency range 1000 - 120000 Hz alternating current and its magnitude below 238 S/m, diagnose renal dysfunction.


Same patents:
The invention relates to medicine, namely to ophthalmology, and is intended for forecasting of excessive scarring of the newly created pathway for aqueous outflow after antiglaucomatous operations

The invention relates to medicine, more specifically to the field of Microbiology and vaccination and for the assessment of the toxicity of pertussis vaccine

The invention relates to the field of veterinary medicine

The invention relates to medicine, namely to cardiology

The invention relates to medicine, in particular gastroenterology, specifically, to methods for the diagnosis of chronic viral hepatitis And+on the background of opisthorchiasis

The invention relates to medicine, in particular to Oncology

The invention relates to medicine and can be used in clinical biochemistry to determine the severity of oxidative stress and monitoring the effectiveness of its correction in emergencies

The invention relates to medicine, cell biology and biochemistry, namely the determination of the biological activity of substances (BAS)

The invention relates to medicine and can be used to monitor changes in the concentration of cortisol in the blood serum after administration of prednisolone

The invention relates to medicine, in particular to clinical medicine, and can be used in the treatment of surgical wounds, healing by second intention

FIELD: medicine, psychiatry.

SUBSTANCE: one should isolate DNA out of lymphocytes of peripheral venous blood, then due to the method of polymerase chain reaction of DNA synthesis one should amplify the fragments of hSERT locus of serotonin carrier gene and at detecting genotype 12/10 one should predict the risk for the development of hallucino-delirious forms of psychoses of cerebro-atherosclerotic genesis.

EFFECT: more objective prediction of disease development.

3 ex

FIELD: medicine, urology.

SUBSTANCE: one should conduct subcutaneous prevocational tuberculin test and, additionally, both before the test and 48 h later it is necessary to perform the mapping of prostatic vessels and at decreased values of hemodynamics one should diagnose tuberculosis. The information obtained should be documented due to printing dopplerograms.

EFFECT: more reliable and objective information.

1 ex, 1 tbl

FIELD: molecular biology.

SUBSTANCE: the suggested innovation deals with the fact that nucleic acids should be isolated directly out of the sample without pipetting stage but with the help of interconnected reservoirs being prepared beforehand. The above-mentioned vessels should be applied either separately or being interconnected according to standard microtitrating format. The sample should be mixed with a lyzing buffer and nucleic acids are bound with matrix in closed system including, at least, two interconnected reservoirs. Forced movement of sample's mixture and buffer back and forth from one reservoir into another one for several times through narrow passage provides their thorough intermixing. The method provides quick and safe isolation of nucleic acids.

EFFECT: higher efficiency.

44 cl, 4 dwg, 1 ex

FIELD: medicine, phthisiology, microbiology.

SUBSTANCE: diagnostic material is poured preliminary with chlorohexidine bigluconium solution, homogenized, kept at room temperature for 10-12 h and centrifuged. Precipitate is poured with Shkolnikova's liquid medium, incubated at 37oC for 3 days, supernatant part of Shkolnokova's medium is removed, fresh Shkolnikova's medium is added, and precipitate is stirred and inoculated on the dense cellular egg media. Sensitivity of the strain is determined in 3 weeks by the presence of growth in the control tube only. Invention provides enhancing precision and reducing time for assay. Invention can be used in assay for medicinal sensitivity of tuberculosis mycobacterium.

EFFECT: improved assay method.

3 ex

FIELD: medicine, biotechnology, pharmacy.

SUBSTANCE: invention relates to agents used for treatment of pathological states associated with disorder of synthesis of neuromediating substances. Method involves the development of pharmaceutical composition and a method for it preparing. Pharmaceutical composition represents subcellular synaptosomal fractions: synaptic membranes, "light" synaptosomes and "heavy" synaptosomes prepared from gray matter of cerebral hemispheres from experimental animals based on the goal-seeking modification of humoral mediators of nerve endings transformed to synaptosomes in development and regression of malignant processes. The composition provides inhibiting the growth of tumor cells, to elevate span-life of patients with ascite Ehrlich's sarcoma, breast adenocarcinoma Ca-755, Wolker's carcinosarcoma-256.

EFFECT: valuable medicinal and anti-tumor properties of composition.

12 cl, 3 tbl, 3 ex

FIELD: medicine.

SUBSTANCE: method involves carrying out microscopic examination of blood serum samples taken from femoral vein and cubital vein. Femoral vein sample is taken on injured side. The examination is carried out before and after treatment. The blood serum samples are placed on fat-free glass slide in the amount of 0.01-0.02 ml as drops, dried at 18-30°C for 18-24 h. The set of pathological symptoms becoming larger or not changed after the treatment in comparison to sample taken before treatment, and morphological picture of samples under comparison taken from the cubital vein showing no changes or being changed to worse, the treatment is considered to be effective.

EFFECT: enabled medicamentous treatment evaluation in course of treatment to allow the treatment mode to be changed in due time; avoided surgical intervention (amputation); retained active life-style of aged patients.

4 dwg

FIELD: medicine, clinical toxicology.

SUBSTANCE: at patient's hospitalization one should gather the data of clinical and laboratory values: on the type of chemical substance, patient's age, data of clinical survey and laboratory values: body temperature, the presence or absence of dysphonia, oliguria being below 30 ml/h, hemoglobinuria, erythrocytic hemolysis, exotoxic shock, glucose level in blood, fibrinogen and creatinine concentration in blood serum, general bilirubin, prothrombin index (PTI), Ph-plasma, the state of blood clotting system. The state of every sign should be evaluated in points to be then summed up and at exceeding the sum of points being above "+20" one should predict unfavorable result. At the sum of "-13" prediction should be stated upon as favorable and at "-13" up to "+20" - prediction is considered to be doubtful.

EFFECT: higher accuracy of prediction.

2 ex, 3 tbl

FIELD: medicine, juvenile clinical nephrology.

SUBSTANCE: disease duration in case of obstructive pyelonephritis should be detected by two ways: either by detecting the value of NADPH-diaphorase activity, as the marker of nitroxide synthase activity in different renal department and comparing it to established norm, or by detecting clinico-laboratory values, such as: hemoglobin, leukocytes, eosinophils, urea, beta-lipoproteides, lymphocytes, neutrophils, the level of glomerular filtration, that of canalicular reabsorption, urinary specific weight, daily excretion of oxalates, arterial pressure, and estimating their deviation against average statistical values by taking into account a child's age.

EFFECT: higher efficiency of detection.

7 dwg, 1 ex, 6 tbl

FIELD: medicine, urology.

SUBSTANCE: the present innovation deals with differential diagnostics of prostatic cancer and other prostatic diseases at the stage of primary inspection. The method includes the detection of PCA and calculation of probability coefficient for prostatic cancer (PCC) by the following formula: where e - the foundation of natural logarithm (e=2.718…), PCA - the level of total blood PCA in ng/ml, V - patient's age in years. At PCC value being above 0.2 one should diagnose prostatic cancer and to establish final diagnosis one should perform polyfocal prostatic biopsy. The method enables to increase accuracy of diagnostics at decreased number of unjustified prostatic biopsies.

EFFECT: higher efficiency of diagnostics.

2 ex

FIELD: medicine, biology.

SUBSTANCE: invention relates to nutrient medium used for accumulation of cells for the following cytological and/or immunocytochemical analysis carrying out. Invention relates to medium containing salts NaCl, KCl, anhydrous CaCl2, MgSO4 x 6 H2O, MgCl2 x 6 H2O, Na2HPO4 x 2 H2O, KHPO4, NaHCO3, and also glucose and Henx's solution, 10% albumin solution and polyglucin taken in the ratio 1:1:1. Invention provides enhancing the preservation of cells.

EFFECT: improved an valuable properties of nutrient medium.

3 ex