Pyelonephritis what tests to take a man. Pyelonephritis. Video: what is computed x-ray tomography

Pyelonephritis does not occupy a leading position in the group of diseases of the urinary system. Often asymptomatic, sluggish exacerbations do not force patients to go to the clinic.

Pyelonephritis is detected in a timely manner if the necessary tests are done. Urine in pyelonephritis is the main marker of pathology, so the analysis is of extreme diagnostic value.

With pyelonephritis, the main analysis is the study of urine. But doctors are also interested in blood indicators that characterize human health and the functioning of internal organs.

Blood test (from a vein)

A blood test is prescribed by doctors who treat patients with pyelonephritis. They donate biological fluid in the morning, fasting for at least ten hours before passing the analysis.

The use of alcoholic beverages and smoking is strictly prohibited. With pyelonephritis, a blood test will show characteristic changes in the human body with inflammatory pathology.

When deciphering the results of the analysis, doctors pay attention to the following blood characteristics:

hemoglobin - falls with pyelonephritis;
erythrocytes - with illness, the level decreases;
erythrocyte sedimentation - the indicator rises, characteristic of inflammatory processes occurring in the body;
leukocytosis - an increase in the number of leukocytes, signaling the body's fight against infection;
shift of the leukocyte formula - shifts to the left, the concentration of young neutrophils in the blood is diagnosed.

A blood test for pyelonephritis also gives additional characteristic indicators. Change in protein content - the indicator will be reduced (the norm is 65-85 g / l).

An increase in the presence of gamma globulins in the blood (at a rate of 12-22%) indicates an infectious process.

Inflammatory pathologies localized in the kidneys provoke an increase in the level of alpha-2 globulins in the blood, the amount may be exceeded. With an increase in uric acid, doctors suspect diseases of the urinary system.

The result in the diagnosis of renal pathologies gives urine analysis. It will be decisive in the diagnosis.

To get the right results from the laboratory, they are competently prepared and tested.

Rules for submitting biomaterial for research:

the day before, do not eat foods that can change the color index of urine, sugar or beets;
do not take diuretic drugs - drugs that activate the excretion of urine from the body;
in women, emphasis is placed on refraining from urinalysis during critical days;
before collecting biological material, it is necessary to carefully process the genitals so that the result becomes reliable.

In addition to typical indicators, the results of a urine test determine other components, bacteria, fungi.

Doctors make the diagnosis by taking urine values, but are more interested in white blood cells, acidity and density levels, the presence of bacteria or nitrites.

Analysis according to Zimnitsky

In addition to OAM - a general urinalysis, patients also undergo a urinalysis according to Zimnitsky. What to prescribe and which of the tests will be indicative - the doctor will determine, but patients should know how to properly take biomaterial according to Zimnitsky.

Urine according to Zimnitsky is a method for studying urine, which allows you to evaluate the work of the kidneys. With the help of such a study, the ability of the organs to concentrate and remove urine from the body is established.

Urine in the kidneys appears as a result of the passage of blood through them. Indicators of the norm of excreted urine - from one and a half to two liters.

The kidneys excrete metabolic waste products that appear in the blood. By removing urine to the outside, water balance is maintained.

If the body receives too little fluid, the urine will be concentrated, and if there is more fluid, then the concentration of urine will decrease. If the work of the kidneys is disturbed, then these elementary laws are no longer observed - the balance of H2O is disturbed, the general composition of the blood changes. Such changes are reflected in the state of the body.

If a patient is suspected of having pyelonephritis, urine tests per day allow us to understand how much urine the kidneys give in 24 hours and what is the concentration. Doctors prescribe a study in case of:

if the patient has signs of kidney failure;
an unconfirmed diagnosis appeared - diabetes;
the patient suffers from high blood pressure;
kidney inflammation is suspected.

It is necessary to collect material for research according to Zimnitsky according to the schedule - for this, 8 containers are prepared with a mark on the time of urine collection with an interval of every three hours.

Urine collection begins in the morning, and at the first urination, the biomaterial does not need to be collected.

The second portion of urine is collected in a jar starting from 9:00 am of the current day and until 9:00 am of the next day, each portion has its own container.

The collected urine samples are stored in the cold, and after collecting the last container, the biological material is transferred to the laboratory for research.

It is not necessary to prepare for the Zimnitsky study - it is carried out typically, on the eve of the study, diuretics are not recommended for patients, and on the day of urine collection, patients should eat as usual, maintain the same daily routine and drink the usual amount of water.

At the same time, it is worth considering the presence of liquid dishes, soups or jelly in the diet. In the laboratory, laboratory assistants will evaluate the following indicators:

the amount of test material in each container;
biomaterial density;
the total volume of urine collected per day;
density of urine in each container;
the total amount of urine excreted from 6 am to 6 pm, and its volume for the night period - from 6 pm to 6 am.

Normally, the patient provides from one and a half to two liters of urine. If in 24 hours the volume is more than 2 liters, polyuria disease is diagnosed - it is a marker of diabetes, indicates problems with the functioning of the kidneys.

The ratio of the amount of excreted urine to the volume of liquid consumed per day is 65-80%. When indicators are violated, this signals fluid retention. Edema appears in the body of patients, the pathology progresses.

The daily portion exceeds the volume of nighttime urine in a ratio of 2 to 1. If urine output is increased at night, this indicates a pathology in the work of the heart, the same ratio indicates that the kidneys do not respond to the patient's activity, and with an increase in urine density, doctors suspect a change in the balance of H2O .

Low urine density indicates problems with concentration - hypostenuria, which appears with chronic renal failure, pyelonephritis, vasopressin deficiency and heart problems.

An increase in the density of urine - hyperstenuria - indicates the ingress of impurities with a higher density into the urine, sugar or protein is determined - this becomes a marker of the infectious process in the body.

Analyzes for pyelonephritis give an indicative picture of what happens to the urinary organs.

If you collect urine correctly, the laboratory will give a reliable result, which will be the key to successful treatment of pyelonephritis.

Video

Pyelonephritis, like a number of other diseases, requires accurate diagnosis. A blood test for pyelonephritis is considered an indispensable clinical study that will confirm or refute the presence of the presented disease.

Preparation for delivery

In order to obtain a reliable result after passing the tests, a number of rules must be observed:

Blood sampling is performed on an empty stomach. The last meal should be ten hours before the procedure.
Before taking the test, it is forbidden to take alcoholic beverages. The last alcohol consumption was two days before the diagnostic study.
It is required to reduce physical activity and try to refrain from getting into stressful situations.
Testing is done in the morning.

Types of analyzes

When diagnosing inflammation of the kidneys, several types of blood tests are used, the most common of which are general and biochemical.

Passing a complete blood count is the very first action that a patient with suspected pyelonephritis performs. It is characterized by the fact that it can be carried out not only for the diagnosis of the disease, but also for preventive purposes. A timely study makes it possible to identify the presence of a disease in a patient at an early stage, as well as to determine the likelihood of a particular pathology.

A series of such tests allows you to follow the course of the disease, as well as evaluate how effective the therapy is and how well the blood performs its functions:

ensuring the quality of the immune system;
nutrition of cells with useful substances and oxygen;
coagulation state;
maintaining homeostasis.

Blood sampling with this diagnostic method is performed from a finger and allows you to find out if an inflammatory process is observed in the body, which is inherent in the presented disease. The presence of pathology is mainly indicated by the number of leukocytes, their rate is increased. In turn, the amount of hemoglobin and erythrocytes in pyelonephritis is reduced.

Biochemical

The presented blood test is one of the most popular diagnostic methods. Thanks to him, you can assess the state of internal organs, identify the lack of trace elements, control the metabolic rate.

When pyelonephritis is detected using this diagnostic method, it is possible not only to identify the presence of the disease, but also to determine the causes that provoked the development of the pathology and the severity. Therefore, the presented procedure is prescribed simultaneously with a general blood test.

Blood is taken from a vein. Thanks to these manipulations, the presence of an increased amount of nitrogenous products in the blood is determined. In the absence of pyelonephritis, urea is excreted fairly quickly. In the presence of the disease, an increased amount of urea is observed.

Other

Also, if you suspect the presence of pyelonephritis in a man, woman or child, they practice taking the following types of tests:

Immunological. The presented analysis makes it possible to control the state of individual links of immunity, contributes to the diagnosis of the disease even before it passes into an acute or chronic form. For blood tests, it is taken from a vein, the analysis is performed on an empty stomach.

In the presence of pyelonephritis, the number of lymphocytes increases, and the number of red blood cells and hemoglobin decreases, and this has a direct effect on blood clotting. As a result of this, we can conclude that thanks to the presented study, pyelonephritis can be detected. The disadvantage of this analysis in the diagnosis of inflammation of the kidneys is that the deterioration of blood clotting can be caused by a number of other diseases.

Analysis indicators

In the presence of pyelonephritis, a number of main indicators should be identified that will enable the doctor to make an adequate assessment of the situation. At this stage of time, it is noted that the result of the analysis does not always indicate a decrease in hemoglobin and erythrocytes, the presented indicators may even correspond to the norm. Decreased values are not considered to be due to the presence of pyelonephritis, they may well result from damage to the kidney filter through which red blood cells leak.

There is a medical table that indicates the transcripts inherent in the general blood test, their norm and values \u200b\u200bfor pyelonephritis. The table contains the following information:

The number of leukocytes. In a healthy state, this value is from 5 to 9 * 109 liters for adults, and from 7 to 11 * 109 liters for children. In the presence of pyelonephritis, the values are as follows: more than 9 * 109 liters in adults and above 11 * 109 liters in children.
The number of young leukocytes. Normally, this value is from two to six percent of all white cells. In the presence of pyelonephritis, this value is more than 6% of the presented cells.
The rate of erythrocyte sedimentation. For males, this value should normally be from 1 to 10 mm / h, for women - from 2 to 15 mm / h (the figure may be slightly exceeded in pregnant women). With pyelonephritis, in men this figure is more than 10 millimeters per hour, and in women it is more than 15 millimeters per hour.

As for the biochemical analysis, the presence of pyelonephritis provokes the development of a number of changes in the biochemical properties of the blood. In a detailed study of the blood, in the presence of an inflammatory process in the kidney area, an increased amount of immunoglobulin proteins can be noted, while in the absence of the disease, the bulk of the proteins are albumins.

Allocate the following decoding of biochemical parameters present in the norm, and in the presence of pyelonephritis:

The value of creatinine. In the absence of pathologies, this figure ranges from 42 to 97 micromoles per liter for females and from 62 to 124 for males. In the presence of an inflammatory process, this indicator exceeds the value of 97 micromoles per liter for females and 124 micromoles per liter for males.
The amount of urea. In the absence of inflammation, the reported value varies from 2.5 to 8.3 mmol per litre. In the presence of pyelonephritis, the number of urea exceeds the value of 8.3.
The amount of potassium. In the absence of inflammation in the kidney area, the presented indicator is 3.35-5.35 mmol per liter. With pyelonephritis, this indicator exceeds 5.35.

Especially dangerous is the increased amount of potassium in the body, since this symptom indicates that the kidneys are no longer able to function properly, so the doctor must begin to take measures aimed at cleaning the blood of harmful substances in an artificial way.

All presented analyzes are created in order to determine with an accuracy of 99% the presence of a particular disease in a patient. Thanks to these studies, it is possible to identify the inflammatory process in the kidneys and start treating the problem in a timely manner, preventing the development of serious complications. Of the presented analyzes, the main ones are general and biochemical, the rest occupy a secondary role.

In no case should you hesitate with the delivery of tests, otherwise you can not determine the presence of an inflammatory process in the kidneys in time and provoke the development of serious complications.

A blood test for pyelonephritis, along with a urinalysis, is a necessary clinical study to establish an accurate diagnosis and prescribe the necessary treatment.

Let's try to find out what tests are taken if pyelonephritis is suspected and what they show.

Pyelonephritis is a type of urinary tract infection in which one or both kidneys become infected with bacteria or a virus. It makes people feel bad and requires treatment.

The genitourinary system includes: 2 kidneys, 2 ureters, bladder and urethra.

Healthy kidneys work day and night to purify our blood. Every day they produce 1-2 liters of urine, which usually passes from the kidneys down to the bladder, from where it is excreted through the urethra.

Once infected, the kidneys can no longer function normally and require treatment. Pyelonephritis, especially in its acute form, is a serious disease, the delayed treatment of which can lead to more serious consequences. But with timely diagnosis, they can be avoided. This disease is easily treated with a course of antibiotics.

As a rule, women are more likely to suffer from pyelonephritis. This is primarily due to the fact that their urethra is much shorter than that of men.

In most cases, the causative agent of the disease is Escherichia coli. Enterobacteria, group B streptococci, Pseudomonas aeruginosa, enterococci can also provoke the disease.

Main symptoms

As a rule, pyelonephritis begins with pain during urination and frequent urination. With the further development of the disease may appear:

High fever or chills.
Nausea and vomiting.
Pain in the side or even in the back.
Clouded consciousness.
Turbid color and a sharp unpleasant odor of urine.

This disease can develop against the background of other serious diseases of the urinary tract, which reduce the flow of urine, thereby contributing to the development of pyelonephritis. It can be:

Stones in the bladder, kidneys, or ureters.
Benign prostatic hyperplasia (BPH).

There is also a high risk of developing the disease in people with diabetes.

At the first symptoms of pyelonephritis, you should immediately consult a doctor to diagnose the disease and its subsequent treatment.

Diagnosis of the disease

There are several effective studies and analyzes to diagnose the disease:

Physical examination by a doctor and study of the medical history.
Urinalysis (general, analysis according to Nechiporenko, daily analysis according to Zimnitsky, for urogenital infection, urine culture for sterility).
Blood tests (general, biochemical, for the determination of C-reactive protein (CRP) in blood serum, blood culture for sterility).
Computed tomography (CT) of the abdomen and kidneys.
Ultrasound examination (ultrasound) of the kidneys.

Blood tests for pyelonephritis

A blood test is carried out as part of an additional diagnosis. The presence of the disease is usually detected by urine tests.

General blood analysis

A general blood test first of all allows you to find out if there is inflammation in the body that is inherent in the disease (blood is taken from a finger). The inflammatory process is primarily indicated by the number of leukocytes in the blood. With pyelonephritis, their level is increased. They also look at the indicators of red blood cells and hemoglobin, the level of which is reduced in this disease.

Blood chemistry

This analysis is taken from a vein. It reveals whether there is an increased content of nitrogenous products in the blood. With proper functioning of the kidneys, the excretion of urea occurs quickly. Its increased amount indicates a violation and development of pyelonephritis.

Preparing for a blood test

Before passing the analysis, certain conditions must be met for its reliability:

The analysis is handed over on an empty stomach. The last meal should be no earlier than 10 hours before delivery.
Alcohol is not allowed before donation. It is necessary to refrain from it, at least 2 days before the analysis.
It is necessary to limit active physical activity and stressful effects on the body.
Testing is recommended in the morning.

Analysis indicators

Deciphering the results of the analyzes can only be carried out by a specialist and in no case independently. Common indicators that indicate the development of the disease are:

Leukocytosis, or an increased number of white blood cells.
Shift to the left of the leukocyte formula, i.e. its change.
Decreased levels of red blood cells and hemoglobin.
Increased content of nitrogenous products.
The erythrocyte sedimentation rate (ESR) is increased.
An increase in uric acid levels.
The amount of total protein is reduced.
An increased amount of alpha-2 globulins and gamma globulins in the blood.

Urinalysis

Urinalysis allows you to more reliably identify the disease and its current picture. The study is carried out to determine the following important indicators:

The level of leukocytes. If their number differs from the norm (0 - 6), this may indicate the presence of an inflammatory process in the genitourinary system or pyelonephritis.
The level of erythrocytes. If their content also does not correspond to the norm, this indicates a disease of the kidneys or the genitourinary system.
The presence of nitrites, which confirm the presence of bacteria in the body.
The presence of urea. Exceeding its norm indicates kidney disease.
Acidity. Its deviation from the norm may indicate the risk of renal failure.
Thickness of urine, especially in the morning. Its increase indicates pyelonephritis, a decrease indicates renal failure.
Detection of bilirubin, which serves as an indicator of infection and inflammation.
The color and smell of urine.

After the tests and diagnosis, the doctor prescribes the necessary treatment. Pyelonephritis is a serious infection that can only be treated with antibiotics. Traditional medicine, so popular in everyday life, is powerless and ineffective here.

In most cases, hospitalization is not required. It is possible only for more severe forms of the disease, when intravenous administration of drugs is necessary for them to reach the kidneys more quickly.

The course of taking antibiotics in total does not exceed 7 days. Some drugs can be administered intravenously in the clinic, while others can be taken at home in the form of tablets.

After treatment with antibiotics, there is rarely any damage to the kidneys. Most people, having got rid of this disease, never remember it. Recurrences are very rare.

Prevention

Simple preventive measures can help reduce the risk of developing kidney and urinary tract infections. Their observance is especially important for women:

Drink plenty of fluids to help the body get rid of bacteria through urination. Well stimulates the urinary canal cranberry juice.
Urinate after intercourse.
Don't resist the urge to urinate.
Replace taking a bath with a shower.
After defecation or urination, wipe the genitals. Wiping from the front to the back reduces the chance of bacteria from the rectum entering the urethra.
Carefully observe the hygiene of the genitals.

Pyelonephritis is an inflammatory process that affects one kidney or both paired organs at once. It occurs in 10% of people on the planet, including children. To make a diagnosis, doctors have a series of studies.

Laboratory diagnostic methods are considered the main ones. They are used both to recognize the disease and to evaluate the effectiveness of treatment.

KLA, OAM - blood and urine tests, respectively, which are prescribed for the diagnosis of any disease, a standard medical examination. If abnormalities are detected, a kidney problem can be suspected.

Inflammation develops due to the attack of bacteria or viruses. To understand the essence of the problem, you need to delve into the work of the kidneys. The human urinary system consists of 2 kidneys, bladder, 2 ureters, urethra.

The kidneys work around the clock, purifying the blood, producing 1-2 liters of urine. From the kidneys, fluid enters the bladder, from it - out through the urethra.

When the body is stricken with an infection, the kidneys can fail. Acute pyelonephritis is a serious illness that requires urgent treatment. If you miss the time, the process will go into a chronic form, provoke complications. When the diagnosis is made on time, for sure, a course of antibiotics will help eliminate the problem.

Women are more likely to suffer from pyelonephritis, which is associated with the anatomy of their urinary organs. A common causative agent of infection is E. coli, after it - streptococci, enterobacteria, enterococci, Pseudomonas aeruginosa.

You can recognize the onset of inflammation by increased urge to urinate, painful urination. As the disease progresses, additional symptoms appear:

hematuria;
nausea up to vomiting;
urine becomes cloudy, smells unpleasant;
consciousness becomes clouded;
chills, fever;
pain in the back, side.

Given that the disease can develop from prostate hyperplasia, stones in the urinary organs, diabetes, the clinical picture will vary, supplemented by symptoms of the underlying pathology. You should not engage in self-diagnosis, if the above signs appear, you need to visit a nephrologist, urologist, and undergo an examination.

Suspecting a patient with pyelonephritis, the doctor, after studying the anamnesis, examination, will prescribe the following diagnostic measures:

CT of the kidneys and other organs of the peritoneum;
Ultrasound of the kidneys;
urinalysis - OAM, according to Nechiporenko, Zimnitsky, seeding tank;
blood test - UAC, biochemistry, C-reactive protein, sterility.

Urinalysis is the main one, but this is not always enough. Then a blood test is crucial. Its decoding is performed by a doctor; you should not try to make a diagnosis yourself.

Patients collect urine on their own, but donate blood in a medical facility, in sterile conditions. The simplest method is to sample from capillaries located close to the fingertips.

The laboratory assistant uses a scarifier, selects the required amount of material into a test tube. Another option is a vein sample. It is somewhat more complicated, but it is carried out quickly and safely.

When the diagnosis seems obvious, which is confirmed by urine tests, there is no need to evaluate a number of blood markers, it is enough to evaluate its main parameters, changes in which are characteristic of pyelonephritis:

Some of these parameters are detected with the help of KLA, others - on blood biochemistry. For the result to be reliable, you need to follow the rules:

the analysis is taken from 8 to 10 in the morning on an empty stomach, the last time having a light snack 12 hours before the material was taken;
48 hours before the analysis, refuse fatty, spicy foods, alcoholic beverages;
stop taking medication within 24 hours. The only exceptions are vital drugs;
drink enough fluids;
24 hours to eliminate excessive physical activity;
directly in the laboratory you need to sit for 10 minutes, calm down, and then go to the laboratory assistant.

The study determines the increase in the number of leukocytes. This indicates the presence of inflammatory processes. The material is handed over from the finger on the right hand. If pyelonephritis is suspected, attention is paid to a number of parameters.

Hardware measure the number of hemoglobin, erythrocytes. Sometimes with pyelonephritis they do not deviate from the norm. Underestimated numbers do not become a direct confirmation of the presence of inflammation of the kidneys, it is possible that the kidney filter is damaged, from which red blood cells enter the urine.

The next assessed indicator is ESR, i.e., at what rate erythrocytes settle. It is calculated simply - the blood is left in a test tube, after the required period of time, the sedimentation rate is recorded on a special scale. Against the background of pyelonephritis, the indicator greatly exceeds normal numbers.

Another parameter is the number of leukocytes. Detected using medical devices. With inflammation of the structures of the organ, this indicator greatly increases, but it is more important for the laboratory assistant to identify the leukocyte formula.

This is the composition of white blood cells. To do this, examine a drop of blood, placing it on glass under a microscope. For pyelonephritis, a characteristic picture is an increased number of granulocytes, the predominance of young cells, which differ significantly from already mature ones.

Given that pyelonephritis changes the chemical properties of the blood, it is important to conduct a biochemical analysis to establish options for deviations. Medical devices count the amount of protein.

It corresponds to normal values, but if the sample is examined in detail, more immunoglobulins are detected. A healthy body is characterized by the predominance of albumins.

A study on C-reactive protein allows you to identify the inflammatory process. The blood of a healthy person does not contain such a component. On the form, the level of such a protein is indicated by crosses, as the volume increases, from 1 to 4. The last figure indicates a serious inflammatory process affecting the kidneys.

During a biochemical analysis for pyelonephritis, the level of creatinine and urea is assessed. This test will show how well the kidneys are able to clear the blood of toxic substances.

The norms of the elements vary according to the gender, age of the patient, his body weight. Such features must be taken into account by the doctor in order not to get false results. An increase in both indicators indicates violations that have affected the filter of the organ.

Another parameter of biochemical analysis is the number of electrolytes. They are distributed inside the cell, in the surrounding fluid. For the body to function properly, the ratio of electrolytes must be in balance. If there are deviations, the tissues of the myocardium and brain suffer.

One of the most important indicators is the amount of sodium, potassium. The kidneys remove excess potassium from the body, and if its value is higher than normal, this indicates that the body cannot cope with the function. In this case, blood purification is carried out by hemodialysis, otherwise the accumulated harmful substances will poison the body and lead to consequences.

A specialist with a medical background can decipher the results of blood tests. On their own, the patient can see an excess of indicators, suspect inflammation, but the decision is made by the doctor.

Deciphering indicators indicating pyelonephritis:

leukocytes are above normal;
increase in ESR;
alpha-2 globulins more than 13%;
reduction in specific gravity;
increase in uric acid more than 0.4 mmol per 1 liter;
decrease in red blood cells, hemoglobin;
decrease in the amount of total protein;
gamma globulins more than 23%.

Deciphering the results, the specialist takes into account the gender, age, condition of the patient, the presence of pathologies, the medications taken. Evaluating the data, the doctor compares them with the norms:

alpha-2-globulin 7-13%. An increase indicates inflammation of the kidneys;
erythrocytes. Men 0-1, women 0-3. Excess - pathology of the kidneys, urinary organs;
gamma globulin 12-22%. An increase speaks of severe inflammation;
protein. Its identification signals problems with the kidneys, tubules, their nodes;
creatinine 53-115 µmol/l;
bilirubin. Exceeding the indicators indicates inflammation, the presence of infection, intoxication;
protein, urea. Exceeding the parameters indicates the onset of renal failure.

Doctors say that before going to the laboratory, pyelonephritis can be suspected by changing the color of urine. With an increase in the number of red blood cells in it, it acquires a red color of varying intensity, taking into account the number of red blood cells.

In addition to color, the smell of the secreted liquid also changes - it becomes sharp, during the infectious process, urine smells unpleasantly of acetone. Faced with such manifestations, you need to go to the doctor, take simple tests and assess the state of the body, including the kidneys.

Summing up, it must be recalled that pyelonephritis is a serious disease that requires timely diagnosis and immediate treatment. If you ignore the problem, refuse prevention, treatment, neglect hygiene and diet, the inflammation will become chronic, remain forever and will periodically torment the patient with symptoms, which can cause serious consequences.

a source

Pyelonephritis (inflammation of the kidneys) is a fairly common disease, and quite dangerous, because it can lead to chronic renal failure. Sometimes the patient may practically not feel unpleasant symptoms, and the presence of some minor signs of the disease can be attributed to other causes. Therefore, timely and accurate diagnosis is very important, for which an examination is required. Thanks to a blood test, specialists can quickly specify the disease, excluding the presence of other diagnoses similar in symptoms, and quickly begin treatment, preventing serious complications in the patient.

Pyelonephritis is a non-specific (of unknown origin) inflammatory disease of an infectious nature, in which the lesion can affect one or both kidneys, and not only the renal pelvis and calyces, but also the tissue itself (parenchyma). Pathology is caused by direct entry into the kidneys of bacteria or mycoplasmas and viruses, which is less common. It is most often caused by Escherichia coli, less often by staphylococci, enterococci, Klebsiella and others, in 20% of cases the disease is caused by a mixed infection. Infectious agents can enter the kidneys in two ways:

Together with the blood flow from a focus located outside the urinary system, for example, with tonsillitis, pneumonia, etc.
Ascending way (in 95% of cases), when bacteria enter the kidneys along with infected urine from the bottom up from the perineum and vagina through the urethra (urethra), then into the bladder, and then through the ureters into the pelvis of the kidneys, this is due to violations of the process of urination and urinary reflux (reverse flow of urine).

The second way of infection occurs more often in women and girls, especially in childhood and adolescence, due to the shorter urethra and its proximity to the vagina, in which, if the normal microflora is disturbed, conditions for the reproduction of pathogenic bacteria appear. In the male part of patients, pyelonephritis is more common after the age of 60 due to prostatic hypertrophy, which leads to obstructive (characterized by the presence of an obstruction to the outflow of urine) urinary tract disorders that become inflamed with increasing pressure, the outflow of urine becomes difficult, and the normal functioning of the kidneys is impaired. .

In pyelonephritis, inflammation of an infectious nature affects the calyces, pelvis, and in severe cases, the parenchyma (tissue) of the kidney

Pyelonephritis is classified according to the following forms:

And depending on the characteristics of the form of leakage, it has a very wide range of symptoms:

pain in the lumbar region,
swelling,
temperature increase,
chills,
tachycardia,
fatigue,
nausea and vomiting due to rapidly growing intoxication,
the appearance of blood in the urine (hematuria), urination disorders (dysuria).

Lower back pain is one of the symptoms of pyelonephritis

But not every patient has a complete picture of the signs; there is an almost asymptomatic course of the disease. Therefore, the laboratory diagnosis of pyelonephritis, which demonstrates objective changes in the main parameters, is of decisive importance. The doctor necessarily prescribes urine and blood tests to the patient.

To study various blood parameters, tests are prescribed:

The first two are prescribed mandatory, the last - if necessary, it has a clarifying character.

Before talking about the parameters of a blood test, it is worth dwelling on what the substance under study is. Blood consists of a suspension of various cells (they are also shaped elements) in a special fluid (plasma) moving through the circulatory system with the bloodstream, where each shaped element has its own special appearance and is responsible for its specific field of activity, performing important and specific (for each their own) tasks in ensuring the vital activity of the human body. Against the background of any disease, various changes occur in the blood, both quantitative (the number and mutual ratios of shaped elements change) and qualitative (the outlines and size of shaped elements change, and, consequently, their performance of their functions).

The general, also known as a clinical blood test (KLA, AS), demonstrates what kind of changes occur with blood cells, because various diseases change the indicators each in their own way. Separate parameters of clinical analysis are designed to identify and demonstrate what specific deviations from the norm in one direction or another can occur with blood elements.

UAC is mandatory for any diagnostic studies.

In the lumen of a blood vessel, a suspension of blood cells (cells) is in a liquid medium (plasma)

What is hidden behind the numbers in the table of the complete blood test form, what parameters and why are of interest for the study? Usually, depending on the complexity of the diagnosed case, the doctor (therapist or nephrologist) may prescribe a laboratory test to analyze the biological material for signs that require laboratory analysis; the more difficult the case to diagnose, the more information the doctor will need.

A specialist nephrologist decides whether to examine the blood according to the maximum number of parameters: pay attention to the erythrocyte sedimentation rate (ESR) and their number, hemoglobin and hematocrit (the volume of red blood cells in the blood), the total number of leukocytes and the ratio of their types to each other (i.e. . leukocyte formula), platelet count and other parameters, or a “minimal set” of the most important ones is enough: ESR, hemoglobin, total number of leukocytes and their formula.

What blood cells are most often honored to be examined under a laboratory microscope?

Erythrocytes, or red blood cells (RBC), are vital to the body, because they carry the oxygen molecules necessary for respiration and supply them to cells and tissues, and on the way back they get rid of unnecessary carbon dioxide. Clinical analysis examines the following parameters:

the total number of red blood cells, measured in pieces, more precisely, the number of cells per liter of blood is determined;
an indicator of the level of hemoglobin (English HGB or Hb) - the very protein that is contained inside the red blood cells and gives them a characteristic red color and, in fact, carries oxygen molecules, is measured in grams per liter;
hematocrit, expressing the ratio of the volume (share) of red blood cells to the total volume of blood plasma, is measured in percent or mass fractions;
erythrocyte sedimentation rate (ESR) at the bottom of the tube, it allows you to judge the inflammatory processes occurring anywhere in the body, measured in millimeters per 1 hour.

With pyelonephritis, erythrocyte mass indices (the number of red blood cells, hemoglobin, hematocrit) moderately decrease, while ESR, on the contrary, increases.

With pyelonephritis, the erythrocyte sedimentation rate (ESR) to the bottom of the tube increases

Platelets, or platelets (PLT), are responsible for stopping bleeding when blood vessels are damaged. KLA shows their number in units per liter of blood, with pyelonephritis it sometimes rises, because the level of fibrinogen protein in plasma increases.

Leukocytes (white blood cells, eng. WBC) are very important elements of the blood, there are several varieties of them that differ in shape, size, appearance and tasks, but all leukocytes guard the body from infections. In the KLA, in the diagnosis of pyelonephritis, the following parameters are examined:

the total number of leukocytes (their conditional number is calculated per 1 liter of biological material), in this test all white blood cells, regardless of type, are subject to registration, this is important, since the presence of an infection (and pyelonephritis is exactly that) confirms the fact of leukocytosis, i.e. - increase in the number of leukocytes;
leukocyte formula - this concept expresses as a percentage how leukocytes of different groups correlate with the total number of all leukocytes, i.e. how many percent of lymphocytes, basophils, eosinophils, neutrophils and monocytes, if all leukocytes are 100% (can be expressed in fractions, where the unit is total number of leukocytes).

The number of white blood cells of certain types in relation to the total number of white blood cells is an important indicator for a blood test.

Options for changes and deviations from a healthy state are called a shift in the leukocyte formula, it can shift to the right or left (based on the fact that the norm is in the middle). In the case of acute and chronic forms of pyelonephritis, the leukocyte formula is shifted to the left, i.e., towards an increase in the number of young forms of neutrophils, which are located on the left side of the table of the leukocyte formula of the standard form on which the general blood test is recorded. That is, it is young neutrophils that are more than normal.

The result of counting the leukocyte formula cannot be used for self-diagnosis due to its non-specificity (ambiguity): shifts may have a similar appearance, although the diseases that caused such a picture are completely different, or, conversely, with the same diagnosis in different patients, changes in the leukocyte formula may differ, also when shifting the formula, the age norm should be taken into account.

The concept of shifting the leukocyte formula to the left means an increase in the number of those types of neutrophils (young cells) that are on the left side of the table

Why is the number of young forms rapidly increasing in pyelonephritis? Neutrophils are the first to "rush into battle" and die in the fight against foreign microorganisms. In the case of inflammatory processes, many of them die, performing a “combat mission”. This means that the need for new neutrophils increases, and their reproduction increases (the so-called neutrophil response to inflammation).

The results of a clinical blood test according to the parameters requested by the attending physician are obtained after studies of the biological material of the blood in the laboratory and are recorded on a standard form, these figures should be interpreted by the physician who ordered the study. Self-diagnosis in this matter is unacceptable. Only a specialist can say for sure whether there is enough information for a correct diagnosis and whether the laboratory parameters reliably indicate the disease with pyelonephritis or another diagnosis is possible. If necessary, the doctor prescribes additional tests and examinations.

For a general blood test, the laboratory assistant takes the biological material from the capillaries, piercing the skin on the terminal phalanx of the finger with a scarifier (less often, using a syringe from a vein in the elbow bend of the arm). In case of pyelonephritis, it is informative to repeatedly take blood samples daily (4–6 times), as well as to take material from both hands to compare indicators, for example, the total number of leukocytes is always higher on the part of the inflamed organ.

With a general blood test, biological material is taken from the capillaries of the last phalanx of the finger

So, the possible presence of pyelonephritis can be indicated by clear indicators of the inflammatory process, with KLA they are:

increased erythrocyte sedimentation rate (ESR),
decrease in the number of red blood cells,
reduced hemoglobin,
elevated levels of white blood cells (leukocytosis),
shift of the leukocyte formula to the left, i.e., the identification of young forms of neutrophils.

A blood test for biochemical parameters can accurately determine the presence and concentration of biologically significant substances in the blood plasma (as opposed to a general one, which studies the number or characteristics of certain cells):

protein molecules (transport proteins, hormones, immunoglobulins, etc.),
residual decomposition products of organic nitrogen compounds (creatinine, urea, uric acid and other compounds),
electrolytes: potassium, sodium, calcium, phosphorus, magnesium ions,
other biologically important substances.

A biochemical blood test allows you to determine with great accuracy the presence and level of biologically significant substances in the blood plasma.

With pyelonephritis, a biochemical analysis of blood plasma can show a deviation of significant indicators, and it can manifest itself significantly or remain practically within the normal range (the stronger the change, the more acute the process of inflammation of the kidney tissue).

The fact that kidney function is impaired and this may be due to the obvious presence of an infection is indicated by the following characteristics of a detailed biochemical blood test:

reduced amount of total protein in the blood serum;
violation of the normal ratio of various functional protein groups in the blood plasma (dysproteinemia) - an increase in the proportion of any of the protein fractions (immunoglobulins, various hormones, etc.) has its own diagnostic value;
an increase in the concentration of nitrogen metabolism products in the blood plasma (excluding nitrogen contained in protein molecules), residual nitrogen is normally contained in an amount of about 0.2–0.4 g / l, therefore, an increase in this indicator makes it possible to assess how the kidneys cope with excretory function (because normally they quickly remove excess nitrogen in the urine);
anomalies in the concentration of electrolytes: sodium, calcium, potassium ions (a strong increase in the number of the latter indicates the onset of renal failure);
increase in the concentration of sialic acids.

Blood for biochemistry is taken with a syringe from the veins at the elbow of the arm.

An analysis for serological (i.e., serum) blood parameters is very indicative for detailing the pathogen by antigens and antibodies. It is prescribed for diseases of infectious origin. This method helps:

indirectly detect the presence and increase in the concentration of antigens and serum proteins-antibodies in the blood plasma to certain infectious pathogens that caused inflammation, i.e. using a serological study, you can determine the culprit of the infection;
directly identify the genes of bacteria that caused the inflammatory process in the kidneys.

In the first case, the main method is the reaction of indirect hemagglutination (it is also the reaction of passive hemagglutination, RPHA, RNGA). In the test tube where the patient's blood samples are placed, in which the erythrocytes have adsorbed (captured) the antigen, and this is exactly what the reaction to the infection looks like, the immune serum corresponding to this antigen (specific proteins inherent only to specific pathogens) is added.

If erythrocytes with antigens of a suspected bacterium are exposed to control serum with antibodies to this bacterium, then the erythrocytes stick together with each other, that is, they agglutinate. The reaction is registered only with a complete match. It is possible to analyze for different infectious agents, adding to the samples of the material under study each time new samples of proteins of different cultures of pathogenic microorganisms until a positive result is obtained.

The result of an indirect hemagglutination reaction, in which erythrocytes cover the entire bottom of the tube, is considered positive; with a negative result, red blood cells in the form of a small disk are located in the center of the bottom of the test tube

According to the results of RPGA, it is possible to determine whether the acute or chronic form of pyelonephritis. In acute pyelonephritis, the titer of antibacterial antibodies (the maximum degree of dilution of a blood serum sample at which antibody activity is detected using any serological reaction) in the passive hemagglutination reaction (RPHA) is increased in 60–70% of patients, in the latent phase (with a chronic process) - fine.

The main method for detecting bacterial genes is polymerase chain reaction (PCR, PCR). This is an ultra-sensitive method for determining infection, which allows many times to reproduce a DNA fragment, chosen indicative of an accurate diagnosis, without involving the resources of the host cell, i.e., a living microbe.

At the first stage, using a special enzyme, copies of the studied material (a repeating DNA fragment) are repeatedly created. The second stage is the determination of whether this sample belongs to a specific type of pathogens. After finding out who is to blame for the infection, the doctor has the opportunity to prescribe adequate targeted treatment for a patient suffering from pyelonephritis.

Accurate molecular diagnostics PCR allows you to determine the presence of the causative agent of the disease, even if only a few molecules of its DNA are present in the sample

If the case is not very complicated and you only need to confirm the diagnosis established by urinalysis, and they are more priority in relation to blood tests, then there is no diagnostic need to check an extended list of blood markers (indicators) in the laboratory. Enough signal parameters that are needed to confirm pyelonephritis are:

hemoglobin,
leukocyte formula,
the total number of leukocytes,
creatinine content,
plasma protein level,
electrolyte balance.

The first four parameters are learned from the clinical, the last three - from the biochemical blood test.

ESR analysis is a key non-specific (inaccurate) marker for identifying any foci of inflammation in the body (it will help to accurately determine the presence of the process, but will not show the place of the course). The rate at which erythrocytes settle (sediment) to the bottom of a special test tube is measured with a ruler in millimeters per hour. This reaction of red blood cells is due to the fact that certain proteins can glue red blood cells into conglomerates (stacks), which are heavier than single cells and therefore settle faster. The rate of fall of glued groups of erythrocytes makes it possible to draw conclusions about the presence and intensity of inflammation, since it is able to reflect the concentration of inflammatory proteins in the blood plasma, the higher it is, the more intense the inflammation and the higher the ESR.

Under the influence of inflammatory proteins, which are produced the more, the more intense the process, erythrocytes stick together into groups that fall to the bottom of the tube faster than individual cells, and this increases the ESR.

In acute pyelonephritis, ESR can increase by 2–2.5 times.

for kids:
- newborns - 0–2;
- up to a year - 4–10;
- 1–17 years - 0–15;
for men:
- 17–50 years - 2–15;
- after 50 years - 2–20;
for women:
- 17–50 years - 2–20;
- after 50 years - 2–30 mm/h;
after 60 years, the upper limit of the ESR norm is calculated by the formula:
- for men - age divided by 2;
- for women - add 10 to the number of years and divide by two.

A blood test for ESR shows the presence of an inflammatory process if the erythrocyte sedimentation rate is high

The values of the total number of leukocytes and the leukocyte formula are important markers of the inflammatory process (pyelonephritis).

There are different types of leukocytes, each of which has its own function in the process of the immune response.

The most important role of the kidneys in the overall harmonious picture of the functioning of the body is to be a selectively working filter that purifies the blood from metabolic products, which are constantly given to it by other organs. When proteins are broken down, nitrogen compounds are released, which the body must get rid of. Therefore, the study of what substances of nitrogen metabolism and in what concentration are present in the blood, can assess the extent to which the kidneys cope with the function of excretion. Analyzed the number of substances such as:

urea (the norm is from 2.5–8.3 mmol / l), its content is about 50% of the total residual nitrogen;
creatinine (normal - 42–132 µmol / l);
creatine (normal - 102-408 µmol / l);
ammonia (norm - 11–32 µmol / l);
uric acid (the norm is from 0.14 to 0.54 mmol / l), its amount in the blood increases and is one of the first signs of the development of renal failure, and earlier than the urea content, which increases the diagnostic value of this criterion.

The kidneys filter waste products from the blood to form urine

The most commonly studied is the amount of urea and creatinine present in the blood. Their high level is a threatening indicator, indicating a violation of the filtering function of the kidneys.

Hemoglobin carries oxygen from the lungs to body tissues

With pyelonephritis, laboratory studies show a decrease in the amount of total protein (the mass of all protein molecules) in the blood plasma (the norm is 65–85 g / l). This decrease (albuminuria) with functional disorders of the kidneys in the chronic phase is sometimes kept in the lower limits of the norm, but with diseases in the acute stage, a sharper drop in the level of protein in the blood is observed.

Also, in the analysis for plasma proteins, it is noted whether there is an imbalance between the individual fractions of proteins in the plasma (dysproteinemia), with pyelonephritis, immunoglobulin proteins predominate, while there are normally more albumins. The disease is characterized by such phenomena:

an increase in the level of gamma globulins (the norm is from 12 to 22%);
an increased amount of alpha-2 globulins (the norm is from 7 to 13%);
the appearance of C-reactive protein, which belongs to the group of beta-globulins, and this suggests that pyelonephritis occurs in an acute form (normally this protein is absent), and from the onset of the chronic stage of the disease, C-reactive protein sometimes disappears until the next exacerbation , this phenomenon allows us to conclude how intense the inflammatory process is (measured from + to ++++);
decreased albumin levels;
an increase in fibrinogen levels.

These indicators accompany the inflammatory process, they are automatically calculated by modern laboratory diagnostic devices, and specific numerical characteristics are analyzed individually by a nephrologist.

Maintaining the correct level of electrolytes and their distribution between the intracellular and intercellular environment is the basis of the vital activity of a healthy organism. Even small deviations from the norm have a negative impact on the cardiovascular system, primarily on the work of the myocardium, as well as the brain and spinal cord, and the conduction of impulses through the nervous system. Sodium and potassium ions play an important role in maintaining the electrical potential of cells and the active properties of the cell membrane; they form the main part of the intra- and extracellular composition of ions. The concentration values of sodium and potassium are the most important indicators, the level of these substances is analyzed first.

The adult human body contains about 100 g of sodium. Of this amount, 90% is located outside the cells in the intercellular environment, about 70% of sodium ions are involved in active metabolism.

The total amount of potassium is slightly higher, about 150 g. The predominant part, up to 98%, is contained inside the cells, in the cytoplasm, and only about 2% is dissolved in the extracellular environment, which also includes blood plasma. Considering that the work of the kidneys also consists in ridding the body of excess potassium, an increase in the amount of this substance in the blood plasma is an alarming sign of insufficient kidney function.

An excess of potassium in the blood plasma is a cause for concern

The rules for preparing for laboratory blood tests are the same for everyone, regardless of gender and age of patients:

A blood test should be taken only on an empty stomach, the last meal before the study should be no earlier than 11–12 hours, because after food enters the stomach, a short-term release of a certain number of leukocytes into the blood follows, and other parameters may decrease, which masks the disease . This phenomenon occurs in any healthy person, and its purpose is to protect the body from infectious agents that may be in food. A few hours after a meal, the number of circulating cells drops to normal, but a blood test taken after a meal will show a false inflammatory picture and may distort the diagnosis.
Testing takes place in the morning (8.00–10.00).
Two days before the analysis, it is necessary to strictly refrain from alcohol, fatty and spicy foods.
Observe the drinking regimen and water balance, because if you drink little, then the blood temporarily thickens (the concentration of formed elements in the plasma increases), therefore, the quantitative parameters checked during the analysis increase and can be interpreted as signs of a pronounced inflammatory process.
For a day, limit the intake of medicines, except for those that are taken for health reasons, because they can change the blood picture.
For a day to do without active physical activity and stress.
Right before the analysis, you need to calm down and sit in a relaxed position for about 10-15 minutes to normalize the rhythm of breathing and heartbeat.

Stress can trigger the release of white blood cells, which will distort the results of a blood test; a day before the study, you should try to avoid situations that cause nervous tension

But still, sometimes the patient's belonging to the strong or fair sex can affect the results of the study. For example, in women, an increased number of leukocytes will be noted in the blood test if the test is done before menstruation, and immediately after the hemoglobin level and the number of red blood cells will be lowered, so it is optimal to do a blood test in the middle of the cycle or a week and a week later. Also, hormonal changes during pregnancy and lactation make their own adjustments to the blood picture, it is necessary to warn the doctor about these conditions before the analysis, so that he can correct for them when interpreting the data.

Men who experience heavy physical exertion should refrain from them 5-7 days before the tests, because excessive physical activity can significantly increase the release of leukocytes as a stress response, you need to take a blood test in the most calm state.

Timely diagnosis of pyelonephritis can greatly facilitate the treatment of this serious disease and speed up recovery. Changes in blood counts can be caused by various reasons. Therefore, at the slightest suspicion of inflammation of the kidneys, you need to consult a doctor and take tests, their results in the overall picture of the disease should be interpreted only by a specialist.

a source

In the structure of inflammatory diseases of the kidneys, pyelonephritis does not occupy a leading position, but is still considered a rather dangerous pathology. In most cases, it is asymptomatic, and mild signs and sluggish exacerbations do not always encourage patients to go to the clinic. Nevertheless, it is extremely important to undergo an examination, since this will allow you to quickly identify the pathological process, begin its timely treatment, and also exclude the presence of other diseases with similar symptoms. A blood test for pyelonephritis is considered an indispensable and highly informative clinical study that will confirm or refute the presence of the disease.

In the presence of typical symptoms, the diagnosis is not in doubt, especially if it is confirmed by the results of laboratory tests. Fever, pain, increased urination, increased muscle tone, blood in the urine with pyelonephritis, symptoms of intoxication directly indicate the development of an inflammatory process in the renal tubules.

Doctors identify a number of the most important manipulations in order to confirm or refute the disease of the urinary system organ.

Sample according to the method of Nechiporenko and Zimnitsky;
Bacteriological culture of urine.
General analysis of blood and urine.
Biochemical study of blood.

All of them are of equal value for the initial diagnosis. Changes in the main indicators can tell about the prevalence of the inflammatory process, as well as about what type of pathogen the disease was provoked. For a more detailed and detailed examination, the specialist may prescribe a number of additional tests.

The main role in the diagnosis is played by a general analysis of urine and blood in pyelonephritis. A thorough study of the latter allows you to identify signs of inflammation and the presence of other pathological processes. Patients are encouraged to collect urine on their own, but blood is taken in laboratories or treatment rooms under particularly sterile conditions.

The simplest method is to obtain the finished material from capillaries located on the fingertips close to the surface. To select the right amount of anatomical fluid, the laboratory assistant uses a scarifier. Another option is to obtain a blood sample from a vein. A needle is used to puncture a vessel at the bend of the elbow joint or the back of the hand, and the required volume is taken with a syringe. Taking material in these places is considered the most convenient, since the veins are located close to the surface of the skin.

In the presence of specific signs, the diagnosis becomes obvious, so it is not necessary to examine a number of blood markers.

It is considered sufficient to assess its main parameters, changes in which are characteristic of pyelonephritis. This:

Some of these indicators are detected with KLA, the rest with a biochemical study. To obtain a clear and reliable result, it is necessary to follow the established rules.

The main option for diagnosing the disease was and remains the method of studying the characteristics of urine, but in some cases the data obtained as a result of its implementation is not enough. Then, during the examination, several blood tests are used for pyelonephritis, the indicators of which make it possible to draw up a general picture of the pathology.

The method is leading, because it demonstrates what changes blood elements undergo during the development of a particular disease. During the study, attention is paid to the erythrocyte sedimentation rate (ESR), the total number of platelets and leukocytes, hematocrit. The presence of an inflammatory process is evidenced by leukocyturia (an increase in the level of leukocytes), the number of erythrocytes and hemoglobin is reduced.

The presumptive presence of pyelonephritis is evidenced by clear indicators of the inflammatory process:

an increase in the erythrocyte sedimentation rate - ESR;
decrease in the amount of hemoglobin;
decrease in the number of red blood cells;
increased levels of leukocytes;
detection of young forms of neutrophils.

For a general analysis, the laboratory assistant takes blood from the capillaries, piercing the skin of the finger of the right hand with a scarifier.

Biochemical analysis is considered the most in demand, since it allows you to assess the state of internal organs, control the rate of metabolic processes and identify the lack of trace elements. With it, you can determine the increase in the amount of nitrogenous metabolic products and urea, which, with kidney damage, is slowly excreted from the body. The fence is made from a vein on the elbow of the left arm in the morning on an empty stomach.

A specialist can learn about damage to the filtering ability of the kidneys by the characteristics of a detailed biochemical analysis of the anatomical fluid.

Increasing the concentration of sialic acids.
Decreased amount of total protein in the blood serum.
The development of azotemia is an increase in the blood plasma concentration of substances released as a result of nitrogen metabolism.
Anomalies in the concentration of electrolytes, in particular, a change in the ratio of calcium, sodium and potassium ions, and an increase in the amount of the latter indicates the development of a pathological process.

Serological analysis is one of the modern types of diagnostics. For detailing the causative agent of the infectious process for antibodies and antigens, this study is considered very indicative. The task of the analysis is: firstly, the direct identification of the genes of the bacteria that caused the disease. Secondly, indirect confirmation of the presence and increase in the concentration of antibodies and antigens to certain types of infectious agent. It is carried out using the reaction of indirect (passive) hemagglutination - RNHA or RPHA.

According to the results of the reaction, the form of the disease can be determined. Acute pyelonephritis is highly likely to be confirmed if the titer of antibacterial bodies is increased in 60-70% of patients, while in the chronic stage it does not exceed the norm.

Of the above analyzes, the first two are assigned without fail, the third - if necessary, since it is of a clarifying nature.

If you only need to confirm the diagnosis, then there is no need to check the extended list of markers in the laboratory. It is enough just to study the signal parameters to identify pyelonephritis. There is a specific table that indicates all their types, their norm and values. A specialist with a medical education can decipher the results of the tests, the patient is only able to notice the excess of indicators.

The values of the total number of leukocytes are leading in determining the inflammatory process. In a healthy state, the level of these components of the anatomical fluid in a child is from 7 to 11 * 109 liters, in adult patients - from 5 to 9 * 109 liters. In the case of pyelonephritis, the number of leukocytes exceeds the upper limits of values. The number of young forms is normally 2-5%, in the presence of the disease - more than 6%.

The task of this component is to carry oxygen from the lungs to the tissues. With the development of an acute inflammatory process, its content in the blood decreases, in the chronic stage it decreases slightly, or even stays within the boundaries of the lower level. Normally, the concentration in the representatives of the weaker half is 120, and in men - 140 g / l. With renal disorders, it changes depending on the form, and is noted at the level of 85 and 150 in women, and 95 and 135 in the representatives of the stronger sex.

The most important role of the kidneys is to filter the blood, cleansing it of metabolic products. During the breakdown of proteins, nitrogenous compounds are released, which, with the normal functioning of the excretory apparatus, are quickly excreted from the body. By the presence of nitrogen metabolism substances and their quantity, the ability of the kidneys to cope with their duties is assessed. In the absence of the disease, the level of creatinine fluctuates in the range of 42-47 micromoles per liter in the fairer sex, and 62-104 in men. In the case of the development of a pathological process, this indicator exceeds the values, respectively:

in women - 97 micromoles;
in the representatives of the stronger sex - 124 μmol.

As for urea, in the absence of inflammation, the normal value does not go beyond 2.5-8.3 mmol / l. The content of ammonia in the blood is normally 11-32 µmol/l, and creatine - 102-408 µmol/l.

With pyelonephritis, albuminuria develops - a decrease in the amount of total protein (the mass of all molecules of a substance) in the blood plasma. If functional disorders occur in the chronic stage, then the indicators remain in the lower limits of the norm, with an acute development of the process, a sharp drop in protein is observed.

The following phenomena are considered characteristic of the disease:

increase in the level of gamma globulins (normally it is 12-22%);
an increase in the number of alpha-2 globulins (in the absence of pathology 7-13%);
decreased albumin levels;
an increase in the amount of fibrinogen;
the appearance of C-reactive protein, which indicates the development of the acute phase, since it disappears during the transition to the chronic stage until the next relapse.

All of these indicators accompany the inflammatory process and are automatically calculated by special laboratory equipment. Specific parameter values are analyzed individually by the nephrologist.

Electrolytes play an important role in human life. Even minor deviations from the norm can cause the development of cardiovascular pathologies, affect the functioning of the myocardium, brain and spinal cord, and worsen the conduction of nerve impulses. Maintaining the optimal ratio of ions of various substances, and above all sodium and potassium, in the body is the task of the filtering organ.

The most important indicators are the values of the concentration of these elements. The body of an adult contains about 100 g of sodium. In the intercellular environment is up to 90% of this substance. Approximately 70% of the total is involved in active ion exchange.

In an adult human body, the total amount of potassium is about 150 g. The vast majority (almost 98%) is contained inside the cells, and only 2% is present in the intercellular space, including blood plasma. Since the task of the kidneys is to remove excess of this substance from the body, the exceeded analysis indicators indicate a decrease in their functionality.

To get a reliable result after taking a blood test, you need to properly prepare for the procedure and follow a number of rules.

Anatomy fluid must be taken in the morning. In exceptional cases, the sampling is carried out immediately after the patient arrives at the hospital.
For the reliability of the indicators, finger sampling should be carried out on an empty stomach, and fasting before the procedure should last at least 10-12 hours. Moderate consumption of clean water without gas is allowed.
Before donating blood, it is not recommended to load the body with various physical exercises; you should also refrain from stressful influences.
It is considered unacceptable to take any alcohol on the eve of the procedure. In general, this break should be at least 2-3 days.
Before donating blood, you do not need to stretch your fingers or elbow joint, as this will provoke an increase in the number of leukocytes, which will negatively affect the results of the analysis.

The sampling of anatomical fluid from a vein is also performed in the morning on an empty stomach. Preparatory manipulations are similar when analyzing from a finger.

To understand the magnitude and severity of kidney disease, you should learn about some interesting facts and figures.

At autopsy, pyelonephritis is found in every tenth person who died for unspecified reasons, and during life she was not even suspected. It is in this regard that the diagnosis of the disease is of particular importance.

Doctors identify a number of the most important manipulations in order to confirm or refute the disease of the urinary system organ.

Sample according to the method of Nechiporenko and Zimnitsky;
Bacteriological culture of urine.
General analysis of blood and urine.
Biochemical study of blood.

Blood test and its specifics

In the presence of specific signs, the diagnosis becomes obvious, so it is not necessary to examine a number of blood markers.

It is considered sufficient to assess its main parameters, changes in which are characteristic of pyelonephritis. This:

Some of these indicators are detected with KLA, the rest with a biochemical study. To obtain a clear and reliable result, it is necessary to follow the established rules.

Types of analyzes, features and purposes of conducting

General blood analysis

The presumptive presence of pyelonephritis is evidenced by clear indicators of the inflammatory process:

an increase in the erythrocyte sedimentation rate - ESR;
decrease in the amount of hemoglobin;
decrease in the number of red blood cells;
increased levels of leukocytes;
detection of young forms of neutrophils.

For a general analysis, the laboratory assistant takes blood from the capillaries, piercing the skin of the finger of the right hand with a scarifier.

It's important to know! Reusable sampling is considered informative, as well as taking material from both hands for comparative characteristics of indicators.

Biochemistry

A specialist can learn about damage to the filtering ability of the kidneys by the characteristics of a detailed biochemical analysis of the anatomical fluid.

Increasing the concentration of sialic acids.
Decreased amount of total protein in the blood serum.
The development of azotemia is an increase in the blood plasma concentration of substances released as a result of nitrogen metabolism.
Anomalies in the concentration of electrolytes, in particular, a change in the ratio of calcium, sodium and potassium ions, and an increase in the amount of the latter indicates the development of a pathological process.

Serological study

Of the above analyzes, the first two are assigned without fail, the third - if necessary, since it is of a clarifying nature.

Deciphering indicators

Leukocytes

Hemoglobin

Creatinine and urea

in women - 97 micromoles;
in the representatives of the stronger sex - 124 μmol.

As for urea, in the absence of inflammation, the normal value does not go beyond 2.5-8.3 mmol / l. The content of ammonia in the blood is normally 11-32 µmol/l, and creatine - 102-408 µmol/l.

Plasma proteins

It's important to know! Albumin makes up about 60% of the total amount of the protein substance, it participates in metabolic processes, supports the transport of elements and maintains normal fluid properties of the blood.

The following phenomena are considered characteristic of the disease:

increase in the level of gamma globulins (normally it is 12-22%);
an increase in the number of alpha-2 globulins (in the absence of pathology 7-13%);
decreased albumin levels;
an increase in the amount of fibrinogen;
the appearance of C-reactive protein, which indicates the development of the acute phase, since it disappears during the transition to the chronic stage until the next relapse.

All of these indicators accompany the inflammatory process and are automatically calculated by special laboratory equipment. Specific parameter values are analyzed individually by the nephrologist.

electrolytes

Potassium level

Preparing for a blood test

To get a reliable result after taking a blood test, you need to properly prepare for the procedure and follow a number of rules.

Anatomy fluid must be taken in the morning. In exceptional cases, the sampling is carried out immediately after the patient arrives at the hospital.
For the reliability of the indicators, finger sampling should be carried out on an empty stomach, and fasting before the procedure should last at least 10-12 hours. Moderate consumption of clean water without gas is allowed.
Before donating blood, it is not recommended to load the body with various physical exercises; you should also refrain from stressful influences.
It is considered unacceptable to take any alcohol on the eve of the procedure. In general, this break should be at least 2-3 days.
Before donating blood, you do not need to stretch your fingers or elbow joint, as this will provoke an increase in the number of leukocytes, which will negatively affect the results of the analysis.

It's important to know! In exceptional cases, the laboratory assistant makes a comparative analysis of the indicators of three blood samples that were taken from the finger and both sides of the lumbar zone. An increased level of leukocytes in the area of the damaged organ indicates the development of an inflammatory process.

The sampling of anatomical fluid from a vein is also performed in the morning on an empty stomach. Preparatory manipulations are similar when analyzing from a finger.