Siydikda umumiy oqsil
Kod:7007
| Kabi | Siydikda umumiy oqsil (konsentratsiya) Oqsil ekskresiyasi, 24 soat (hisoblangan) |
|---|
Tahlil ma'lumotlari
Tadqiqot usuli
- Kolorimetrik / fotometrik usul
Kutilayotgan natija topshirish vaqti
1 kun
Maxsus tayyorlik
- Document the total 24-hour urine volume on the requisition.
- Do not consume alcohol for 24 hours before starting the collection.
- If clinically permissible, stop diuretics 48 hours before the collection period.
Qanday foydalanish
Siydikda umumiy oqsil testi (siydik umumiy oqsili; 24 soatlik siydik oqsili) proteinuriyani tasdiqlash va miqdoriy baholash uchun buyuriladi. U minimal o‘zgarish kasalligi, membranoz nefropatiya va fokal segmentar glomeruloskleroz kabi birlamchi glomerulyar kasalliklarni baholashni qo‘llab-quvvatlaydi hamda qandli diabet, sistemali qizil volchanka va amiloidoz kabi tizimli holatlardan kelib chiqadigan ikkilamchi buyrak zararlanishida yordam beradi. Shuningdek, surunkali buyrak kasalligi ehtimoli yuqori bo‘lgan shaxslarda buyrak xavfini baholashga ko‘maklashadi. Ushbu o‘lchov nefrotoksik potensialga ega dori vositalari ta’sirida buyrak holatini monitoring qilish uchun ham qo‘llanadi; bular qatoriga aminoglikozidlar, amfoteritsin B, sisplatin, siklosporin, nosteroid yallig‘lanishga qarshi preparatlar, ACE ingibitorlari, sulfonamidlar, penitsillinlar, tiazid diuretiklar va furosemid kiradi.
Cheklovlar
Normal fiziologiyada siydikdagi oqsil ekskresiyasi minimal bo‘ladi, buning sababi glomerulyar o‘lcham va zaryad selektivligi hamda proksimal naychalarda samarali reabsorbsiya hisoblanadi. Odatda sutkalik oqsil yo‘qotilishi taxminan 40–80 mg ni tashkil etadi, 150 mg/kun dan ortiq ekskresiya esa odatda albumin ustun bo‘lgan proteinuriya hisoblanadi. Proteinuriya o‘tkinchi, funksional bo‘lishi mumkin (isitma, og‘ir jismoniy mashq, stress, o‘tkir infeksiya yoki suvsizlanish bilan), yoki yoshlarda ortostatik bo‘lishi mumkin. Overflow proteinuriya gemoglobin, mioglobin yoki monoklonal yengil zanjirlar kabi past molekulyar massali oqsillarning ortiqcha filtratsiyasini aks ettiradi. Buyrak proteinuriyasi glomerulyar (bazal membrana shikastlanishi tufayli bo‘lib, diabetik nefropatiya va birlamchi glomerulopatiyalarda keng uchraydi) yoki tubulyar (proksimal naychalarda reabsorbsiya buzilishi tufayli bo‘lib, odatda 2 g/kun dan kam) tarzida tasniflanadi. Ifodali oqsil yo‘qotilishi (>3–3.5 g/kun) hipoalbuminemiya, onkotik bosimning pasayishi va shishga olib kelishi mumkin. Doimiy mikroalbuminuriya ishemik yurak kasalligi xavfining ortishi bilan bog‘liq. Tasodifiy siydikdagi umumiy oqsil skrining yondashuv bo‘lib, proteinuriyani subtiplamaydi, 24 soatlik siydik yig‘ilishi esa ekskresiyani miqdoriy baholash imkonini beradi. Bens-Jons oqsili kabi aniq oqsillarni aniqlash maqsadli testlarni talab qiladi, masalan, siydik oqsillarining elektroforezi.
| Referens oraliq |
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|---|---|---|---|---|---|---|---|---|---|---|
| Ko'rsatmalar | Edema of the extremities or periorbital swelling, Ascites (abdominal fluid accumulation), Unexplained weight gain attributable to fluid retention, Elevated blood pressure (hypertension), Micro- or gross hematuria, Diminished urine output (oliguria), Fatigue without alternative explanation, Diabetes mellitus, Systemic connective tissue disorders, for example systemic lupus erythematosus, Amyloidosis and other multisystem conditions where renal involvement is possible, Screening in individuals with chronic kidney disease risk factors (eg, hypertension, smoking, family history, age >50 years, obesity), Cardiovascular risk stratification in patients with kidney disease, Monitoring while receiving potentially nephrotoxic medications, including aminoglycosides, amphotericin B, cisplatin, cyclosporine, NSAIDs, ACE inhibitors, sulfonamides, penicillins, thiazide diuretics, or furosemide |
Natija og'ishlarining mumkin sabablari
Oshgan daraja
- aspirin
- chlorpromazine
- gross hematuria
- penicillin
- pyuria
- radiographic contrast media
- sodium bicarbonate
- sulfonamides
Pasaygan daraja
- alkaline urine
- bence jones proteinuria
- low specific gravity urine
- myoglobinuria
- proteus mirabilis infection
- proteus vulgaris infection
Namunangiz talablari
| Namunangiz | Urina |
|---|---|
| Container | Sutkalik siydik yig'ish idishi |
| Hajm | 20 mL (min 6 mL) |
| Saqlash tayyorlik | Xona harorati, Sovutilgan, Muzlatilgan |
References
Naderi AS, Reilly RF. Primary care approach to proteinuria. J Am Board Fam Med. 2008 Nov-Dec;21(6):569-74.
Johnson DW. Global proteinuria guidelines: are we nearly there yet? Clin Biochem Rev. 2011 May;32(2):89-95.
Chernecky C. C. Laboratory Tests and Diagnostic Procedures / C.C. Chernecky, B.J. Berger; 5th ed. – Saunder Elsevier, 2008.
Kashif W, Siddiqi N, Dincer AP, Dincer HE, Hirsch S. Proteinuria: how to evaluate an important finding. Cleve Clin J Med. 2003 Jun;70(6):535-7, 541–4, 546-7.
Carroll MF, Temte JL. Proteinuria in adults: a diagnostic approach. Am Fam Physician. 2000 Sep 15;62(6):1333-40.