The kidneys in the human body perform the function of purifiers, as they are engaged in continuous filtering of the blood. Such filters are called glomeruli, thanks to them, the released toxins penetrate into the urine and are excreted with it. Such creatinine can be determined by doing the Rehberg-Tareev test.
A bit of history
In 1926, a Danish physiologist Poul Kristian Brandt Rehberg (1895-1989) pioneered a method for detecting glomerular filtration rate by exogenous creatinine clearance by the kidneys. However, initially there were difficulties with the results of the study. Since there was a need for the introduction of intravenous creatinine from the outside. True, it was later found that creatinine in blood plasma practically does not change and does not undergo significant fluctuations.
Thus, the Soviet doctor E. M. Tareev (1895-1986) began to improve the Rehberg method, and began to determine the glomerularfiltration by clearance of endogenous (“own”) creatinine. That is, the substance began to be determined in the blood plasma, and not administered intravenously, as before. Since that time, this study has been called the Reberg-Tareev test.
Medical indications for sampling
The doctor may prescribe a Reberg-Tareev test if you suspect a disease of the urinary system. So the following violations may become indications for the study:
- Appearance of edema in different parts of the body.
- High blood pressure for no particular reason.
- Reduced daily urine output.
- Appearance of cramps in the limbs.
- Muscle weakness and lethargy.
- Instances of loss of consciousness.
- Bouts of nausea and vomiting.
- Tachycardia.
- Changes in the color of urine, it may become dark or cloudy, or a change in its consistency.
- Presence of pus, mucus or blood in the urine.
- Lower back pain or pain in the lower abdomen.
Also, such a test is carried out to track the dynamics of the treatment of already known diseases, such as:
- diabetic nephropathy;
- nephrotic syndrome;
- diabetes insipidus;
- diseases of the heart and blood vessels;
- glomerulonephritis;
- pyelonephritis and others
If the analysis is carried out correctly, it will allow you to choose the right treatment for such common kidney diseases as pyelonephritis, diabetic type nephropathy,amyloidosis, renal failure, etc. In addition, it is possible to monitor the work of the kidneys in endocrine and cardiovascular disorders. The Reberg-Tareev analysis is used as a differential diagnosis for cancerous tumors.
What is a Rehberg test?
Creatinine is a metabolite of creatine phosphate in muscle cells. Its level will directly depend on the weight of the person. Creatinine may change with age. The substance is filtered by the glomeruli of the kidneys. After that, part of it enters the urine and is excreted with it. If pathological obstruction of the renal tubules is observed, then the main part of creatinine is released into the bloodstream. As a result, a person experiences various he alth abnormalities, for example, increased blood pressure, or impaired glucose metabolism.
Rehberg's test is able to determine the cleansing ability of the glomeruli of the kidneys. Renal clearance is carried out by calculating the speed and quality of the removal of an element from the body.
Peculiarities of preparing for Rehberg's analysis
Blood and urine are donated for analysis, but this study requires special preparation. So, one day before urine sampling, it is necessary to adhere to such an algorithm of actions, which will allow you to reliably determine the rate of creatinine in the urine in the Rehberg sample:
- Do not drink alcohol, coffee or even strong tea.
- Compliance with dietary nutrition, which involves the exclusion of protein, meat and fishfood.
- Abstain from physical activity and sports.
- Don't be nervous, avoid stress.
- Regarding the liquid, the usual drinking regime is maintained, that is, up to 1.5 liters of water per day.
- It is forbidden to take any medications, as they will distort the study data.
- If it is impossible to postpone taking medication even for a couple of days, then you should inform the doctor about this, who will take this moment into account when deciphering the analysis.
- You can not take medicinal diuretic herbal preparations, so that the norms of the Reberg test in the urine do not change.
Rules for preparing for the analysis
In order for the result to be as accurate as possible, and the treatment for the disease to bear fruit, you need to know about the rules for preparing for analysis:
- Diuretics are excluded 48 hours before the study.
- During the day, heavy proteins are excluded from the diet, which are found in meat, legumes, fish. As well as smoked meats, pickles and alcohol.
- On the eve of the analysis, eliminate stress, physical stress.
- Before blood sampling, it is necessary to maintain the meal interval, it should be 8-12 hours.
- Liquid, in the form of water, is taken 6-8 hours before analysis. Avoid coffee, tea and carbonated drinks.
- Urine is not collected on critical days.
Normal indicators of the Reberg-Tareev test: transcript
The results of the test will directly depend on the state of creatinine. Below are the normal valuesRehberg-Tareev tests:
- From birth to one year for both boys and girls, 70-100 ml/min is considered normal.
- From 1 year to 30 years, creatinine data practically does not change. For women they are equal to 85-146 ml/min, for men - 50-150 ml/min.
- Starting from 40 to 50 years of age, the creatinine rate will be slightly reduced. Normal indicators of the Reberg test in women are 62-115 ml / min, in men - 65-124 ml / min.
- At 50-60 years old for women - 57-109 ml/min, for men - 60-120 ml/min.
- Decrease occurs after 60 years and up to 70 years - for women, these data are reduced to 55-105 ml / min, for men the figure will be slightly higher - 59-110 ml / min.
- Well, and finally, from 70 to 90 years old, the creatinine norm for women is 48-98 ml / min, and the Reberg test norm for men is 51-100 ml / min.
What do you need to change?
Durable urine is involved in laboratory studies. Therefore, it is worth adhering to certain collection rules in order for the analysis to determine the normal indicators of the Reberg-Tareev sample. The first morning urine is not taken, the first trip to the toilet is recorded on a piece of paper. After that, throughout the day, urine is collected in a certain clean container. All this time, the liquid is in a cool place.
After the doctor receives the material, he measures the volume of urine. Then 60 ml is sent for analysis. Along with measuring the volume of urine, the doctor measures the height and weight of the patient. On the same day, blood is also given to determine the level of creatinine in it. Time for a full studyReberg-Tareev takes an average of 3 hours.
Features of the survey
When taking blood from a vein, special preparation and compliance with the rules is not required. Blood is taken from a vein on an empty stomach. Therefore, they hand it over in the morning hours.
The collection of urine is carried out according to two schemes. If daily urine is required, then you need to collect it, adhering to the following rules:
- As soon as a person wakes up, you need to drink a glass of clean water.
- First urine not collected.
- This is the best time to donate blood. However, if she will give up after taking daily urine, then this is also acceptable.
- When starting to collect urine, you need to fix the time, as it will take exactly 24 hours to collect urine. The drain container must be sterile.
- Biomaterial stored in refrigerator.
The rest of the sequence was described above.
Method of hourly portions of urine
There is also a more simplified method of collecting urine to determine the normal parameters of the Reberg-Tareev test, it is carried out as follows:
- Water is also drunk in the morning, but you need to drink at least 500 ml at a time.
- First urination is also done without urine collection.
- After half an hour you can donate blood from a vein.
- After 30 minutes, you need to collect the urine in full.
This method is convenient if a person is in a hospital, sometimes the method is also used on an outpatient basis.
Reduce values
Usually indicators are loweredwith chronic or acute renal failure. With a compensated and subcompensated form of the disease, the indicators decrease from 30 to 15 ml / min. In the stage of decompensation, the creatinine content decreases to 15 ml/min.
Creatinine clearance will be reduced in the following pathologies:
- congestive heart failure;
- arterial hypertension developed against the background of a malignant process;
- glomerulonephritis;
- other diseases associated with kidney damage.
But the norms of the Rehberg test during pregnancy in women can be slightly overestimated.
Increasing values
If the rate of the Reberg-Tareev test is overestimated, then most likely this is not associated with a pathological condition, perhaps the person intensively went in for sports before the analysis, or ate protein foods. The level of creatinine clearance increases during certain periods of pregnancy. Thus, the normal values of the Rehberg test in pregnant women may be slightly overestimated.
A pathological increase in the Reberg-Tareev test can be observed at the initial stage of diabetes mellitus, nephrotic syndrome or hypertension. The glomerular filtration rate will show the norm in men and women in different digital data. For men, on average, this is 97-137 ml / min, for women, the figure is slightly less - 88-128 ml / min.
Surveying the analysis will reveal various pathologies at an early stage, which will determine the success of further treatment. After all, the treatment of diseases in advanced stages is difficult due to the appearance of complications.
