If you suspect some diseases, your doctor will advise you to do an analysis called Reberg's test. This is how the efficiency of blood flow through the kidneys is determined.
In preparation for the analysis, it is recommended thatexercise, and also give up tea, caffeine and alcohol. The above factors affect the outcome indicators, and simple precautions will provide a real picture of the purifying ability of the kidneys.
For the first time, Paul Reberg suggested installingThe filtration rate in glomeruli according to exogenous creatinine in 1926. The test of Reberga at that time was associated with some difficulties. The complexity of the technique consisted in the need to introduce exogenous creatinine intravenously.
Academician Tareyev simplified the procedure, suggesting in 1936 to find the speed
glomerular filtration by clearance(withdrawal from the body) of endogenous creatinine. Then the scientists found that this substance is in the blood in a constant amount. Therefore, pricking this substance intravenously proved to be inexpedient. Since then, the procedure for determining the rate of purification of blood in the kidneys by endogenous creatinine is called, as a test of Reberg, and - the test of Reberg-Tareev.
The analysis technique was developed in three versions
1. The first method is quite informative.The procedure starts in the morning, when the patient wakes up, he is given a drink of about two glasses of water. After 15 minutes he goes to urinate on the toilet, at the time of the completion of urination he writes down the exact time. The patient returns to bed and calmly lies exactly 1 hour, and then urinates in a vessel. At the end of urination, the exact time is recorded again. So get 1 serving of material for analysis
The patient goes to bed, and exactly after 1 hour urinates in a vessel. So get 2 servings of urine.
A test of Reberg includes a venous blood sampling in the amount of 6-8 ml. Blood is taken in the middle of the process of putting urine.
In the laboratory, measure the amount of urine in eachvessel, by these numbers calculate how much fluid is excreted by the kidneys in 1 minute, the indicator is called a minute diuresis. Determine the concentration of creatinine in each sample and plasma of blood taken. To establish the clearance for endogenous creatinine use formula
F1 = (U1 / P) V1.
Thus, the number of creatinine concentrations,(U1) is divided by the number of creatine concentrations found in the blood plasma (P), and the result is divided into a one-minute urine output after the first portion of urine (V1). Get the result - F1, this is the number of filtration rates for the first portion of urine.
According to the same formula, calculate F2, for the second portion:
F2 = (U2 / P) V2.
Experience shows that the data obtained in the firstand the second urine sample will differ. The test of Reberg in some cases is complicated by the fact that the nephrotic syndrome increases the release of creatine in the proximal sections of the tubules. Sometimes the index of pathologically secreted creatinine by the internal epithelium of the tubules is 30% of the total concentration found in the urine, which is much higher than normal. This means that if the kidneys are working poorly in the patient, the filtration capacity of the glomeruli is understated, then pathology may not appear in the analyzes.
2.The sample of Reberg in the second variant is taken in the daily volume of urine. The patient wakes up, the first urination does in the toilet, the rest of the time is pissed in the same vessel, the last portion falls on the morning of the next day. The material is stored in the refrigerator between the time of urination. If the fence was performed at home, after the last urination the patient measures exactly the volume of all urine, records the result, for example: diuretic diuretic 1100 ml, patient weight 75 kg, patient 170 cm. Then the urine is mixed, part is cast for analysis. measure the concentration of creatinine, and pour the rest. Passing urine to the laboratory, they simultaneously give blood. In the second variant, it is in this order that the Rebrag test is performed. The norm varies depending on sex and age.
If the indicator reaches the level of 140 ml / min,the doctor is suspicious, associated with the onset of the development of diabetes, nephrotic syndrome or hypertension. Sedation of the excretory function of the kidneys to 50-30 ml / min and below indicates renal failure.
3. The third version of the sampling of the material for the Reberge test is carried out for a scientific purpose and is divided into 2 or even 3 portions of urine per day.
