RU2410015C1 - Diagnostic technique for preclinical stage of doklinichesky stage of renal tissue herdening - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: diagnosis of the preclinical stage of renal tissue hardening is ensured by microscopy of urine mixed with 10% albumin in the ratio 4:1 in the form of a drop dried at temperature 20-25°C and relative humidity 55-60%. Two urine samples are prepared; one of them is exposed to low-intensity laser radiation of wave length 0.67 mcm, power 100 mWt for 1 minute. Then, urine of both samples is mixed with albumin. If observing leaf structure in the exposed sample only, the preclinical stage of renal tissue hardening is diagnosed.

EFFECT: method provides more reliable preclinical diagnosis of renal tissue hardening due to visualisation of hardening markers.

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Description

The invention relates to medicine, namely to laboratory research.

The need to search for markers of the preclinical stage of kidney tissue sclerosis is due to the fact that in Russia, as in many countries of the world, the number of patients with chronic kidney diseases leading to chronic renal failure is growing (Nephrology. Edited by E.M. Shilov. M .: GEOTAR-Media. - 2007 .-- 541-564 p.).

Many chronic nephropathies may remain unrecognized for a long time. With an increase in age and a decrease in the functional activity of the kidneys, the process of sclerosis of the renal tissue can develop dramatically quickly. Therefore, the diagnosis of sclerosis of kidney tissue at the preclinical stage is a priority in nephrology and medicine in general.

A known method for the diagnosis of nephrosclerosis in children (RF Patent No. 2302633, IPC G01N 33/53, publ. 2007), including the selection of daily urine and determination in it using the enzyme-linked immunosorbent method of the content of interleukin-10 and transforming growth factor β1, the calculation of the prosclerotic coefficient as a ratio the concentration of transforming growth factor β1 and interleukin-10, which diagnose the severity of nephrosclerosis.

The disadvantage of this method is the high complexity when conducting research and processing the results, in addition, there is a high proportion of subjectivity in the interpretation of the results. Diagnosis of the preclinical stage of the disease using this method is impossible.

The closest is a method for diagnosing a sclerotic process in renal tissue (RF Patent No. 2199120, IPC G01N 33/493, publ. 2003), including microscopic examination of a mixture of urine with 10% albumin in a ratio of 4: 1 in the form of a drop dried at a temperature of 20 -25 ° C and relative humidity 55-60%, with the identification of structures of the "leaf" type, which are used to judge the sclerosis of kidney tissue.

The disadvantage of this method, as well as the above method, is the inability to make a reliable diagnosis in the preclinical stage of the disease.

The objective of the invention is to eliminate these disadvantages, increase the reliability of the diagnosis at the preclinical stage of the disease by visualizing sclerosing markers, which allows for timely therapy and to reduce the number of chronic and complicated stages of the disease.

To solve this problem, two urine samples are prepared, and one of them is affected by low-intensity laser radiation with a wavelength of 0.67 microns, with a power of 100 mW, for 1 minute. Then prepare a mixture of urine with 10% albumin in a ratio of 4: 1 of both samples. A drop of urine from each sample is dried at a temperature of 20-25 ° C and a relative humidity of 55-60%, and if a microscopic examination reveals "leaf" structures only in the sample after irradiation, then the preclinical stage of kidney tissue sclerosis is diagnosed.

In Fig.1, 2 - urine samples: control without structures in the form of a "sheet" and after irradiation of LLLT with a detected structure of the type "sheet" (example 1); in Fig 3, 4 - urine samples: control and after irradiation, respectively, without revealing structures of the type "sheet" (example 2).

The method is as follows.

Morning urine was taken from patients, poured into two numbered tubes (sample 1 and sample 2). Sample 2 was subjected to low-intensity laser radiation (LLLT) with the following parameters: wavelength - 0.67 μm, power - 100 mW, exposure time - 1 min. Sample 1 was left unaffected (control sample). Then, in both samples, a mixture of urine and a 10% albumin solution was prepared in a ratio of 4: 1, respectively. The resulting mixture of each sample was applied in an amount of 0.01-0.02 ml on a test card of the diagnostic kit “Litos-system” in the form of a drop, dried at a temperature of 20-25 ° C, a relative humidity of 55-60%, and comparative morphological microscopy was performed pictures of facies of a mixture of urine of the first and second samples. At the same time, attention was drawn to the presence of a sclerosing marker — a structure in the form of a “sheet” in the marginal zone of each facies.

The sclerosing marker, a “leaf” structure, was previously described with the development of sclerotic changes in various types of biological fluid, including the facies of urine with polycystic kidney disease, congenital malformations of the urinary system, which was confirmed by the data of surgical interventions or autopsy (Shabalin V .N., Shatokhina S.N. Morphology of biological fluids. M., Chrysostom, 2001, 203 pp.). The presented development allows us to identify the process of sclerosis of kidney tissue at the preclinical stage, when the pathological process did not “declare” itself as a sharp decrease in kidney function and the rapid development of complications from the cardiovascular system, that is, when any treatment methods become ineffective.

The indicated regimen of LILI impact on the urine of the examined is explained by a change in the structure of urine. In this case, the separation of the organic and mineral components occurs already in the liquid phase. During dehydration, there is an even clearer separation of these two components and the smallest components of the sclerotic process (the amorphous component of the intercellular substance containing liquid) are transferred during dehydration to the edge protein zone, where after dehydration of albumin begins to decay (as a result of their subsequent dehydration) and form a structure in the shape of the "sheet".

Example 1

Patient A., 32 g. Examination. A study of urine by the claimed method showed that only in the urine sample in a mixture with albumin after LILT structures in the form of a "sheet" are determined (figure 2).

Conclusion: there is a process of sclerosis of kidney tissue at the preclinical stage of development.

A further focused examination revealed that 3 years ago he had severe pneumonia, as a result of which he took large doses of antibacterial drugs and other drugs. The results of the Reberg test showed a decrease in glomerular filtration rate (GFR).

Conclusion: The preclinical stage of kidney tissue sclerosis caused by the toxic effects of drugs. Decreased GFR without identified markers of renal origin.

Example 2

Patient B., 37 g. Examination. A study of urine by the claimed method showed that in the urine sample in a mixture with albumin after LILI, the structures in the form of a "sheet" are not determined (figure 4).

Conclusion: the process of sclerosis of kidney tissue at the preclinical stage of development is absent.

Upon further examination of the organs of the urinary system of patient B. with the help of clinical and laboratory studies, including the Rehberg test, no deviations from the norm were found.

The proposed method allows to establish the preclinical stage of the sclerotic process of kidney tissue, as a result of which it is possible to conduct timely adequate therapy, which stops the progression of sclerosis of kidney tissue.

Claims (1)

A method for diagnosing the preclinical stage of kidney tissue sclerosis, including a microscopic examination of a mixture of urine with a 10% albumin solution in a 4: 1 ratio in the form of a drop dried at a temperature of 20-25 ° C and a relative humidity of 55-60%, with the identification of structures of the type " leaf ", which is used to judge the sclerosis of kidney tissue, characterized in that two urine samples are prepared, and one of them is affected by low-intensity laser radiation with a wavelength of 0.67 microns, at a power of 100 mW, for 1 min, and then prepare a mixture of urine with albumin om both samples, and when revealing "leaf" structures only in the sample after irradiation, the preclinical stage of kidney tissue sclerosis is diagnosed.

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