Methods of kidney research, their effectiveness and scope
The identification of the functional state of the kidneys is no less important than the definition of the nosological form of the disease. In nephrology, the total and partial renal function is investigated. Methods of studying the kidneys can reveal the state of each of the kidneys and subsequently discuss the work of each department of the nephron.
Instrumental diagnosis
Bladder catheterization - this method is performed using a special catheter that varies by gender - for men, women and children. The use of such equipment is subject to strict rules of antiseptics and asepsis.
Catheterization is not performed if acute inflammation of the urinary system is affected to prevent the spread of the infection process up the urinary canals.
Basically, catheterization is organized for patients with benign enlargement of the prostate gland with delayed urinary retention. In some cases, catheterization is required to determine the amount of residual urine.
Buzzing of the channel of urination - the method is carried out with the purpose of expansion of narrowed passages of the channel of an emiction, for an establishment of degree of narrowing and specification of localization of a stone in the channel. For the organization of diagnostics, bougies of increasing size are introduced, which are introduced at the very beginning of the study. Before starting the diagnosis, a gel is injected into the canal for local anesthesia.
Puncture biopsy - it can be open, which is performed during the operation, or closed, which is an instrumental diagnosis of the kidneys. Closed biopsy is necessary in a situation where the remaining methods did not yield the expected results. Such diagnostics is carried out only under stationary conditions under the supervision of ultrasound.
Cystomanometry - examination is performed to measure the pressure in the bladder. It makes it possible to establish the condition of the wall of the bladder and its operability.
After complete emptying of the bladder, a warm liquid of 50 ml or a gas of a predetermined volume is introduced into it through the catheter. Using this same catheter, the pressure in the bladder is measured during the first urge to urinate. Also, the pressure is measured during urination, which helps to recognize the patency of the canal and sphincter in it.
Uroflowmetry - this examination is performed to identify the functioning of a muscle that pushes urine out of the bladder. Simultaneously, the volumetric flow rate of the urine flow through the urination channel is measured, which is fixed on a separate chart, depending on the time interval. In patients who are characterized by urinary incontinence, the level of maximum pressure is markedly reduced in comparison with normal indices.
Endoscopic examination - thanks to the use of an endoscope, a physician can examine the internal surface of the organ under study. The endoscope can be soft or hard, and modern medicine, with the help of endoscopes, not only examines the internal surface of the organ, but also non-extensive surgical interventions, the volume of which constantly increases as the endoscopic apparatus progresses and becomes more complex.
In urology, an endoscopic examination is conducted to study the condition of the canal, urinary bladder and the renal tubular system.
Instrumental methods of studying the kidneys make it possible to reveal the increase in the size of the organ and the main damaging factors in it.
Functional diagnostics
Methods of studying the kidney function play an important role in the diagnosis of kidney pathologies, because they help to recognize and predict the outcome of the treatment of a particular kidney pathology.
There are a lot of ways to functionally examine the kidneys, but the most popular are the following:
- Concentration and water samples, which together represent an accommodation sample.
- Detection of the presence of residual nitrogen or urea in the blood.
- Simultaneous detection of the presence of residual nitrogen and urea in the blood and subsequent comparison of the indices obtained.
It is important to remember that even the simplest functional examination of the kidneys, which consists in controlling urination, the specific gravity of the separated urine per day with the patient's usual diet and in the habitual situation, helps to get an approximate idea of the quality of the kidneys.
X-ray examination
X-ray examination in urology plays an important and sometimes even decisive role. For the organization of this study, the patient is preliminarily trained. A thorough emptying of the intestine is required, so a few days before the diagnosis, the patient is assigned a special diet with a reduced intake of carbohydrates, and on the eve of the diagnosis, a cleansing enema is performed in the evening.
In some cases, taking activated carbon for a day and laxatives in the evening before the examination. The patient comes to the diagnosis on an empty stomach, but in order to prevent excessive formation of gases in the morning it is recommended to drink strong tea with a cracker, since the gases prevent to see the precise outlines of the kidneys.
Radioisotope examination
A radioisotope study of kidney function is the simplest, fastest and least traumatic method of diagnosis, which makes it possible to examine the work of each kidney separately.
Before the examination, a special substance is intravenously injected into the patient, which is absorbed by the kidneys and is subsequently quickly excreted along with the urine. The patient takes a sitting or lying position, after which equally calibrated sensors are fixed over both kidneys, and the third sensor is installed in the heart zone. The location of the kidneys is detected by palpation or radiologically. Received radiographs are recorded on special devices.
Radionuclide Survey
Radionuclide examination is firmly established in the medical practice of urology and nephrology. Such a diagnosis helps to identify violations of the kidneys at the first stages of their development, which is difficult to diagnose by other methods.
This method is relatively easy to implement and allows for re-examination during treatment without risks to the patient's health condition. Radionuclide compounds can also be used for patients with high sensitivity to various radiopaque substances. From the tasks of the forthcoming diagnostics, the doctor chooses a suitable radionuclide indicator.
The advantages of this method of diagnosis are the ability to simultaneously evaluate the total work of the kidneys and the functioning of each kidney separately. The method is characterized by a low radiation load on the body and does not cause discomfort to the patient, can be realized many times, and this is important for control throughout the course of treatment.
The lack of such diagnostics can be considered the impossibility of identifying the cause of the established violations, as well as errors due to incorrect positioning of the sensors.