Where to make a kidney stone analysis. Analysis of the chemical composition of urinary (renal) stones by infrared spectrometry (Kidney) Stones, Infrared SpectroMetry). Preparation for analysis

[02-055 ] Definition chemical composition Blind of infrared spectroscopy

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Identification of the substance according to its crystal chemical characteristics, the definition of various defects, disorders and other features of the crystal structure.

Russian synonyms

Chemical analysis of blades

Chemical analysis of the concrections

Synonyms English

Calculi (Stone) Analysis

Research method

Infrared spectrometry.

What kind of biomaterial can be used for research?

Urinary stone.

General information for research

Urolithiasis is one of the common urological diseases, occurs at least 3% of the population and occupies one of the leading places among urological pathology in Russia. A special problem of urolithiasis is a high frequency of repeated stone formation and the development of dangerous complications. After 1 year, about 10% of patients have a relapse in five years 50%, and after 20 years, the re-illness is observed more than 75% of patients. Existing methods The removal of stones do not save the patient from possible recurrent stone formation, since they are all essentially exceptionally options for symptomatic treatment. Their action is directed only to eliminate the final product of the impaired metabolism, i.e. Stone (Urolita). Stop recurrence of the disease can understand the causes of the occurrence of stone. According to modern ideas, it is necessary to know the composition of the blade of the blade. In Russian, American and European recommendations for the treatment and prevention of urolithiasis, it is determined that each stone that has moved independently, or its fragments obtained after remote or contact lithotripsy, as well as after laparoscopic and traditional "open" surgery, must be investigated in purposes of determining its mineral composition.

The infrared spectrometry method is one of the recommended methods for studying the composition of the urinary stone. It allows you to determine the composition of the stone and the ratio of chemicals and is a universal physico-chemical method, which is used in the study of the structural features of various organic and inorganic compounds. The method is based on the purification of absorption by groups of atoms of the test object of electromagnetic radiation in the infrared range. The absorption is associated with the excitation of molecular oscillations by quanta infrared light. Under the irradiation of the infrared molecule, only those quanta, the frequencies of which correspond to the frequencies of valence, deformation and libration fluctuations of molecules are absorbed. Analysis of the elementary and phase composition of the blade is an important and mandatory component of the Diagnosis of the ICD. Knowledge of the chemical structure and metabolic disorders in the body allows you to develop adequate drug therapy. Calcium stones are found in 75-85% of patients, more often in men older than 20 years. Recurrement is recorded in 30-40% of cases (brosite - 65%). Triple stones are associated with an infectious agent. It is found in 45-65% of cases, more often in women are accompanied by a high risk of inflammatory complications. In the absence of treatment, recurrence is fast. Uraban stones are more often formed in men.

Thus, the determination of the composition of the stone is a prerequisite for the appointment of further prophylactic and contiguous treatment of patients with urolithiasis.

What is the study?

• To determine the type of stone, which in turn helps a doctor to choose the most appropriate method of treatment or take measures to prevent re-education.
• The quantitative assessment of all chemical components that make up the stone is necessary to ensure complete diagnostic information.

When is the study assigned?

Definition method IR spectrometry

The material under study Samples of stones who have moved with urine or extracted during operational intervention

Urolithiasis, or urolithiasis, is one of the most common diseases. Urolithiasis is based on various types of metabolic disorders and, as a result, the formation of stone (s) in the kidneys and urinary tract. The determination of the chemical composition of the blade allows the attending physician to more fully estimate the metabolic disorders in the patient's body and choose the right therapeutic tactics. In addition, the study of the peculiarities of the chemical composition of urinary stones in the human population is a generally accepted approach in the study of the epidemiology of urolithiasis. Differences in the chemical composition of the urinary stones have a close relationship with the presence of urinary tract infection, urodynamics disorders, changes in metabolism, nutrition character and socio-economic conditions.

In urology, there is a practice of dividing stones on oxalate, urencular, phosphate, cystine, etc., depending on the prevailing mineral component (more than 50% of the composition). The most commonly detectable stones are oxalate, the following frequency - phosphate and uric acid. Education phosphate stones They are associated with the infection of the urinary tract with a gram-negative microflora (E. coli, Proteus Mirabilis, Pseudomonas, Klebsiella). The presence of oxalate and uricular stones is usually due to the consumption of a large number of animal protein and high-calorie products, as well as violations in purine exchange. Cystin stones are formed due to hereditary metabolic disorders.

The table below shows the most common components. kidney stones.

Literature

1. Estepa L.M., Levillain R., Lacour V., Daudon M. Infrared Analysis of Urinary Stones: A Tial of Automated Identification. Clinical Chemistry and Laboratory Medicine. 1999; 37 (11/12): 1043-1052.
2. Golovanov S.A., Sivkov A.V., Anhin N.V., Yezhzheva V.V. Trends in the prevalence of metabolic types of urolithiasis in the Moscow region. Comparative analysis For the period from 2010 to 2013. Experimental and clinical urology. 2014; 4: 54-57.
3. Pushkar D.Yu. et al. Urolithiasis disease. Russian Medical Journal. 2014; 17: 14.

What is a urolithiasis, know many of us, but that the kidney stones are of different origin and does not recognize the composition. But in fact, according to the composition and characteristics of the concrete, you can understand the reason for the formation of stones in the kidneys. Understanding the causes of the disease, in turn, will help the doctor to choose the right and efficient treatment tactics. To find out the composition of education in the kidneys, it is necessary to carry out its chemical analysis. Research can be conducted different ways.

Where do the analysis?

Analysis of the stone from the kidneys can be held in a specialized laboratory

An analysis of the kidney stone can be carried out in a specialized laboratory. As a rule, classical clinical laboratories in hospitals and polyclinics are not engaged in the study of properties and composition of renal concrections. Any medical institution sends material for research into specialized laboratories that are under research institutes and pathologists.

However, the X-ray examination of the renal stone can be carried out not only in the conditions of the laboratory. This applies to urates and oxalates - concrections, which basically have oxalic and urinary acid. These formations are well visualized on the X-ray. If there are calcium ions in their composition, they will also be clearly visible on the radiograph. But if you decide to contact the X-ray department for information about the composition of the stone, then you should know that his staff do not have the necessary knowledge to determine the chemical composition of the congregation in the picture.

To determine the structure and composition of the stone, you need to perform a survey urgent. This procedure is often prescribed with kidney stones and urolithiasis in general. With it, it is possible to draw conclusions about the structure of education, its form, contours and the configuration of the urinary tract.

An analysis of kidney stones can be carried out at some industrial enterprises that work with ceramics, granite and rubble. The following methods can be used:

• Spectroscopy. This method is based on analyzing the degree of spectral light absorption of stone when infrared light through it. This type of research is advisable to conduct multipurrupular concrections when deposited in the kidneys.
• Thermogravimetry is a method based on fixing changes in the sample weight under the influence of different temperatures. This is a pretty expensive method, so it is better to use it only for industrial purposes.
• Wet and dry chemistry. For the analysis, the mineralization of the concrement (ozicing) is performed. After that, the formation structure is investigated by dry chemistry. For this, the stone is crushed and dried on a sheet of paper. This technique allows you to identify the structure of the kernel, heterogeneity and consistency.

Chromatography is a special method of dividing the concrement to the components

• Chromatography is a special method of dividing the concrete into a component of a substance, which is based on the difference in the absorption ability of substances passing through the layer of the absorber.
• Neutron-activation study of education helps to identify small inclusions in its structure. For this, the stone is subject to neutron bombardment.
• Analysis on the definition of porosity. According to the porosity of the dried stone, it is very easy to determine the type of concrement. But with the help of this method, it is impossible to investigate the composition of multiple formations. That is why this technique is better to combine with chromatography at which the object is divided into separate parts, characterized by physico-chemical properties. In this case, chemical analysis is carried out by the distribution of components into two different media.

Important: For analysis in laboratory conditions, the method of polarization microscopy is used.

Its essence is to analyze the structure of the stone on a reflected light beam, which falls on education in different planes. Stones of different density have different polarization. Due to this, it is easy to determine the structure of the concrement.

In most cases, a number of procedures and x-ray structural analysis are quite sufficient to study the structure of the stone:

Preparation for analysis

As a rule, to make a deposit analysis, you do not need some special preparation of the concrete, it is enough to have only a sample of renal stone

As a rule, to make a deposit analysis, you do not need some special preparation of the concrement. It is enough to have only a sample of renal stone. It is possible to obtain a sample after surgical removal of the concreteren or in the case of their self-exit in the process of urination. Usually deposits with urine are displayed after the completion of the crushing procedure of concrections using modern methods.

If the renal stones in the urine are very small, then you can get them as follows:

Indirect ways of analyzing

Since it is not always used to receive renal deposits on the analysis, sometimes used simple ways Diagnostics

Since it is not always possible to obtain renal deposits for analysis, sometimes simple diagnostic methods are used, which allow you to determine the chemical analysis of the accretion with high accuracy. So, one of the following methods can be used:

• X-ray education. As a rule, if the concretion is very well visible in the picture, then most likely it has calcium origins. Just below the contrast will be in trollee and cystine stones. If nothing can be seen in the picture, but there is reason to believe that a person has a renal-stone disease, then the likelihood is that uland or xanthine concrections.
• Since the basis for the growth of stones are microscopic crystals (microliths), by their definition in the urine, it can be drawn conclusions about the presence of urolithiasis. To find crystals, you need to make microscopic analysis of the blade.
• Chemical study to determine urine acidity. If the acidity is increased, it may indicate the presence of urates that grow very well in such a medium.
• Since various microorganisms are the cause of the formation of mixed and protein concrections, urine bacteriological analysis should be made.
• The presence of cystine formations can be drawn by the results of the samples on cystine.

Decoding results

In addition to choosing a method of treatment, a chemical analysis of deposits will allow the doctor to determine the cause of their education

All renal concrections are insoluble deposits. In some cases, with a small size of stones and a certain chemical composition, they can be crushed and softened with medicines, decoctions, infusions and seizures based on medicinal herbs.

Most deposits are formed on the basis of calcium oxalate, tripelphosphate, cystine and uric acid (urates). As a rule, the size of education depends on the location of its localization. The size of the stone can be from a few millimeters and reach a pair of centimeters.

If the formation contains calcium, the following states may be the cause of urolithiasis:

Cystic councils are formed in people suffering from cystinuria.

Important: Most kidney stones consist of calcium and oxalate. The outer shabby layer may contain bacterial inclusions and about 65 different compounds.

Background information on deciphering research and analyzes will help you draw conclusions about the presence of certain types of deposits in the kidneys. However, only the doctor on the basis of these results may pick up proper treatment and the corresponding diet for the patient.

Several types of renal deposits are distinguished:

In addition to choosing a method of treatment, a chemical analysis of deposits will allow the doctor to determine the cause of their education. This will help the patient after effective treatment Avoid in the future recurrence of the disease, as he can use the necessary prophylactic measures.

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Preparation conditions are determined by the attending physician.

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Research method: Infrared spectroscopy

At the heart of the development of urolithiasis (ICD), there are violations of metabolic processes in the body, which occur most often against the background of morphofunctional changes in the urinary system, hereditary predisposition, diseases of the endocrine system.

High risk of stone formation:

• General Factors: Development of the ICD in early age, Family history of the ICD, brush in the composition of the concrections, urinary acid and urates in the composition of the concrections, infectious concrections, the only kidney;
• Diseases associated with the development of the ICD: hyperparathyroidism, nephrolacinosis, diseases and pathology of the gastrointestinal tract, sarcoidosis;
• Genetic reasons: cystinuria, primary hyperoxalura, renal tubular acidosis, 2,8-dihydroxyaityenine, xanthinuria, Lesha-Nihnene syndrome, fibrosis;
• MedicationsCooperating: Allopurinol / Oxypurinol, amoxicillin / ampicillin, ceftriaxone, ciprofloxacin, ephedrine, indinavir, magnesium trisilicate, sulfonylamide, triamtener; Ascorbic acid, furosemide, vitamin D, calcium.
• Anatomical and urodynamic violations: medullary spongy kidneys, obstruction of the gluing ureteral segment, etc.

Research Indications:

• choosing the optimal treatment tactics for urolithiasis
• choosing effective measures for the prevention of repeated formation
• the choice of the most effective measures aimed at braking the process of stone formation during urolithiasis

Interpretation of results:

Classification of councils depending on their etiology:

• Noncommunicable: calcium oxalates, calcium phosphates, uric acid;
• Infectious: magnesium and ammonium phosphate, apatite, urates ammonium;
• Genetic reasons: Cystin, Xanthin, 2,8-dihydroxyajenin.

According to the recommendations of the European and Russian urologists, the analysis of the composition of the concrement should be carried out in all cases of primary diagnostics of the ICD (with uncomplicated and complicated currents), again - according to the testimony. The infrared spectrometry method is one of the recommended methods for studying the composition of the urinary stone. It allows you to determine the composition of the stone and the ratio of chemicals. Analysis of the elementary and phase composition of the blade is an important and mandatory component of the Diagnosis of the ICD. Knowledge of the chemical structure and metabolic disorders in the body allows you to develop adequate drug therapy. Calcium stones are found in 75-85% of patients, more often in men older than 20 years. Recurrement is recorded in 30-40% of cases (brosite - 65%). Triple stones are associated with an infectious agent. It is found in 45-65% of cases, more often in women are accompanied by a high risk of inflammatory complications. In the absence of treatment, recurrence is fast. Uraban stones are more often formed in men. Metaphylaxis (a set of measures aimed at preventing the growth of the existing and emergence of repeated stones in the kidneys) reduces the risk of recurrence.

Example of the result of the study:

We draw your attention to the fact that the interpretation of research results, the establishment of the diagnosis, as well as the purpose of treatment, in accordance with Federal Law No. 323-FZ "On the basics of the health of citizens in Russian Federation"Dated November 21, 2011, should be carried out by a doctor of relevant specialization.

Oksana asks:

I'm 35 years old. Ultrasound found a stone in a kidney of 6 mm. The urologist appointed Bleplen. I accept his week. But reading various articles, I see that you need another diet. And for this it is important to know the type of stone. Is it possible to determine if the urine analysis is analyzing or somehow? Please reply.

Determine the composition of the renal stone is possible by making a general analysis of urine by estimating the salt and biochemical composition.

Oksana asks:

Thank you very much for your reply! But I have a continuation of the question. Could you explain the type of stone according to the analysis? Transparency 01, Specific weight 1015, Achesive reaction, no protein, leukocytes 1-2%, flat epithelium 1-2%.
I really hope for your help!

It is necessary that the urine test contains salt composition - salts that prevail in the urine (urates, oxalates, phosphates, ammonium urates, calcium carbonate). In the presence of an acidic or alkaline medium, these salts have properties to form an insoluble sediment, forming stones.

Oksana asks:

Sorry, but then this is not a general analysis? What you listed is not in the analysis of an analysis response. Please tell me how is the urine analysis correctly called, which should I pass?

The determination of salts in the urine is included in the overall analysis of urine, as well as the determination of urine acidity, organic substances and cellular composition. If the laboratory in which you did this urine analysis cannot carry out this study - the definition of an inorganic sediment and salts in the urine (the absence of the necessary reagents), then it is necessary to apply for analysis to another laboratory.

Oksana asks:

Thank you very much for consultation.

We are always glad to be useful to you in solving medical issues.

Anastasia asks:

Hello. I am 28 years old, about two weeks ago, at the ultrasound, I found a stone in the kidney 10mm. I said that you need to fragrate. But I read that some stones, such as urates, can be dissolved by leeks. I ask, please, what type of stone I have may be? 2 months ago, with pyelonephritis, urine acidity was 6.0 and detected urates in large quantities, a week ago the acidity was 5.5 and discovered oxalates in a small quantity. And still advise if it is not possible to dissolve, then what kind of stones is the most secure and does not cause side Effects?

You need to hand over the urine to determine the content of salts, to consult an nephron and a urologist to determine the tactics of treatment. The choice of the treatment method remains behind the doctor, depending on the degree of urolithiasis and the type of stones.

Ksenia asks:

Hello. Uzi showed the presence of kidney stones. Turning to the urologist, received a direction for urine analysis and a computer tomogram to determine the composition of the stones. Tell me, please, do you need a tomogram? Thank you.

The tomogram allows you to accurately determine the localization of stones and their quantity is therefore it is necessary to conduct this procedure To establish an accurate diagnosis and appointment of correct treatment.

Lada asks:

I had a beat of the kidney stones called the type of coraline, but it passed about half a year and again a nulling pain. Under lithotripsy. I checked again and nothing and pain remained. What should I do?

It is necessary to conduct a comprehensive examination at the doctor of the urologist-nephrologist, only after receiving all the results of the examination of the doctor, the specialist will put an accurate diagnosis and prescribe adequate treatment. Pains may be connected in the same way with the defeat of the spinal column, it is recommended to undergo a survey from a neuropathologist's doctor.

Irina asks:

and here we are trying to pass the analysis on the salt, but the daughter secretly went to the toilet. It makes sense to collect further and it is necessary to re-all?

Ravil asks:

Hello, in my kidney stone. In the first about them I learned 5:30 in the morning when an indescribable pain caused waking up. I went to the doctor and after ultrasound, 4mm stone was told in the bladder, so let's drive it further than. It turned out to be there thanks to the watermelon that in summer a lot of it. In short, I got rid of this, but I was told, in the right, too, crystal 3mm. It was a year and during the examination of the ultrasound showed in the left kidney (where 4mm went out) 3mm stone and crystals 3-4 in the amount of up to 3mm and in the right to 3mm with a number of 4-5 pieces
Saw at one time Blemarmen - (( To take, and the method of microscopic research has 25% of the probability of not exact result. Tell me where it is better to turn and how to be? I'm 23 years old