RU2038598C1 - Method for performing urinodiagnosis of urologic diseases - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves determining protein contents by using diuretic method and test with sulfasalycilic acid, as well as urea nitrogen, creatinine, phosphorus and potassium contents in urine samples taken in prescribed time points in the state of rest and after being exposed to physical and saluretic loads. The so obtained data are subjected to computer analysis, the results of which are used to make conclusions whether there are pathologic changes present in kidneys. In the process of examination of 500 patients with proved diagnosis 90% specificity and sensitivity were reached, supported by morphologic comparisons carried out in laboratory. The method is non-invasive. Biomaterial can be collected in different geographic points and its analysis and computer processing are performable in large diagnostic centers, regarding the possibility of carrying out the biochemical examination of the urine 5-7 days later after its having been collected, even if the samples were kept in domestic refrigerator. EFFECT: enhanced accuracy and improved diagnostic capabilities of the method. 13 tbl

Description

 The invention relates to medicine, in particular to laboratory diagnosis of kidney diseases, and can be used in the examination of any contingent of patients to obtain information about the presence and nature of the pathological process in various departments of the nephron (glomeruli, tubules, interstitium), for verification of different types of renal pathology, as well as to clarify the mechanisms of proteinuria.

 One of the methods that allows you to most objectively assess the condition of the renal parenchyma is a morphological study of a puncture or intraoperative biopsy. However, the invasiveness of obtaining the material, the need to often use methods of morphological analysis, which are often not available for practical departments, limit its widespread use.

 Various laboratory studies appear to be more accessible, which have a significant place in the comprehensive diagnosis of kidney disease. Functional stress tests with the study of proteinuria (ed. St. N 1055477, N 1588135) occupy a special place among them. In both cases, a saluretic with a fairly well-known mechanism of action was used as a provoking agent. Studying the features of proteinuria under these conditions turned out to be very promising and made it possible to determine the level of nephron damage and verify some kidney diseases (renal amyloidosis, glomerulonephritis) without resorting to a puncture biopsy. However, in both methods, the presence of proteinuria, established by a sample with sulfosalicylic acid on a photoelectrocolorimeter, was a prerequisite (Handbook of Clinical and Laboratory Research. M. Medgiz, 1975, p. 222). This sharply limited the number of patients who could be examined, since proteinuria exceeding 0.02 g / l (the lower threshold of sensitivity of the method) is often absent not only in surgical diseases of the kidneys, but also in some nephrological patients (latent forms of glomerulonephritis , preproteinuric stage of renal amyloidosis). In the presence of significant proteinuria in control portions, technical difficulties arose in the study of urine collected at the time of drug polyuria, when, against the background of diuresis formed by the saluretic, the protein concentration does not exceed 0.01-0.02 g / l, i.e. almost can not be objectively determined by the above method.

 The aim of the invention is to improve the accuracy and diagnostic capabilities of the method, based on functional, stress tests of urine, as well as the expansion of the examined contingents.

 The goal is achieved by collecting urine according to a special scheme for 34 hours at rest, during physical and saluretic stress; processing of biomaterial on modern biochemical autoanalyzers (such as Spectrum, F. Abbott) according to special methods that allow you to set the concentration of protein, urea nitrogen, creatinine, phosphorus and potassium in the urine; by determining the protein concentration on the autoanalyzer, both a breakdown with sulfosalicylic acid and a biuret method, which determines the presence of all proteins, including low molecular weight proteins, which makes it possible to stably detect any amount of protein excreted in the urine not only in patients with renal pathology, but also in healthy individuals (table . 1); repeated (not less than 3-fold) determination of the concentration of the studied ingredients, followed by mathematical analysis and averaging of indicators, taking into account their variability; the development of a package of special calculation programs that convert 42 initial indicators (hourly urine output, the concentration of urea, creatinine, phosphorus, potassium and uroproteins determined by the biuret method or a breakdown with sulfosalicylic acid in each of 7 portions of the test) into 209 indicators of the array of the Diagnostic Model of the kidneys "and 55 indicators of the array" Excretion test profile "; the creation of a package of original diagnostic programs, including over 50 algorithms with a description of changes in derivatives, equivalent to various morphological changes in renal tissue during various pathological processes in the kidneys.

 Calculation programs and diagnostic algorithms are combined in a single computer complex "Functional load test system" AnSh ".

 The concentration of uroproteins (g / l), established on the Spectrum autoanalyzer in healthy individuals and with certain types of renal pathology (when testing with sulfosalicylic acid according to the standard method, proteinuria is not determined).

 The method is as follows.

1. In stationary conditions under the supervision of medical staff (the correctness of the final result depends on the quality of the material taken), the patient collects seven portions of urine:
1) at 22 h (on the eve of the examination) empties the bladder and goes to bed; all urine during the night (up to 7 a.m. inclusively) is collected in one dish by the I (control) portion;
2) from 7 to 8 hours walking indoors. At 8 o'clock collects in a separate bowl II (control) portion;
3) at 10 o'clock empties the bladder, after which he is injected intramuscularly with 20 mg of furosemide; within an hour from the moment of injection, walking and collecting urine (as needed) in one dish III portion (polyuric test period);
4) at 16 h empties the bladder. From 4 p.m. to 5 p.m. walking; at 17 h, collects the IV portion (post-polyuric test period 6 hours after the administration of furosemide);
5) at 21 h empties the bladder; from 21 to 22 hours walking; at 22 h, collects V portion (post-polyuric test period 12 hours after the administration of furosemide);
6) at 22 o'clock goes to bed; all urine during the night (up to 7 o'clock in the morning inclusive) collects VI portion in one dish (post-polyuric period at rest);
7) walking from 7 to 8 hours; at 8 h, collects a VII portion in a separate dish (post-polyuric period 22 h after the administration of furosemide).

 Mandatory is the same type of load when collecting III, IV, V and VII servings. The intensity of the load is determined by the general somatic state of the patient: walking, sitting, or alternating walking and sitting, the horizontal position of the body is unacceptable at the time of collection of loading portions.

 Accurate accounting of the collection time of individual portions is also necessary: optimally accurate implementation of standard recommendations; if they are violated, information about atypical collection time should be entered into the source data generation program.

 The primary treatment, including a thorough measurement of the urine output of each of the portions and the removal of shaped elements from the urine, is carried out immediately after collecting the biomaterial. In case of urate precipitation at the time of initial treatment, as well as before biochemical analysis, the urine should be warmed up to their complete dissolution. The shaped elements are eliminated by centrifugation of the urine, after which the supernatant is stored in a household refrigerator (without freezing) and subjected to analysis on a biochemical automatic analyzer at the same time after completion of sampling.

 Qualified microscopy of the urinary sediment of each portion is highly desirable, since information on its qualitative and quantitative features is an additional criterion for the objectivity of the final result and can be taken into account when forming the conclusion.

 2. The concentration of the studied elements: protein (biuret method and breakdown with sulfosalicylic acid), urea nitrogen, creatinine, phosphorus, potassium, is determined on a biochemical autoanalyzer. A 3-fold determination of the concentration of each of the elements (three parallels) in each of the samples of the biomaterial seems optimal.

 As one of the options for carrying out this stage of the method, it is possible to use the Spectrum autoanalyzer, F. Abbott. In this case, a biochemical study of urine is carried out according to the following special methods.

1) Determination of urine protein concentration by biuret method
Not available in the standard set of autoanalyzer techniques.

 Reagents: a standard set of reagents for determining protein F. Abbott; standard control normal human serum Labsystems, Behringer Mannheim.

Definition Parameters:
a) the volume of the sample of native urine 25 μl;
reagent volume 236 μl;
serum calibration solutions with a protein content of 3.4 g / l, 6.4 g / l and 8.4 g / l;
b) the measuring wavelength range is 564/660 nm;
c) the first reading time is 240 s;
last read time 420 s;
reading interval 60 s;
g) Incubation temperature 30 ^° C

Characteristic of the procedure: lower limit of determination 0; upper limit above 15 g / l; coefficient of variation 3.54 + - 0.25%
2) Determination of the concentration in the urine of a protein breakdown with sulfosalicylic acid
Not available in the standard set of autoanalyzer techniques.

 Reagents: 3% aqueous solution of sulfosalicylic acid (H.H.); standard control normal human serum Labsystems, Behringer Mannheim.

Definition Parameters:
a) the volume of the sample of native urine 2.5 μl;
reagent volume 236 μl;
serum calibration solutions with a protein content of 0.2 g / l, 0.4 g / l and 1.0 g / l;
b) the measurement wavelength range is 516/604 nm;
c) the time of the first reading is 60 s;
last read time 180 s;
reading interval 60 s;
g) Incubation temperature 30 ^{° C;}
Characteristic of the procedure: lower limit of determination 0; upper limit up to 5 g / l; coefficient of variation 5.42 + - 0.35%
The correlation coefficient between the two methods for determining the concentration of urine protein in the range of 0 5.0 g / l is 0.9994.

3) Determination of urea nitrogen concentration in urine
Not available in the standard set of autoanalyzer techniques.

 Reagents: a standard set of reagents for the determination of urea nitrogen f. Abbott (cat. N 6098), multi-calibrator F. Abbott.

Definition Parameters:
a) the volume of the sample of native urine 1.25 μl;
reagent volume 436 μl;
calibration with multi-calibrators 1.2.3 3.4 g / l, 11.3 g / l and 19.6 g / l;
b) the measurement wavelength range is 364/652 nm;
c) the first reading time is 240 s.

360 s last read time,
reading interval 60 s;
g) Incubation temperature 30 ^{° C;}
Characteristic of the procedure: lower limit of determination 0; upper limit to 30 g / l; coefficient of variation 3.33 + - 0.37%
4) Determination of urinary creatinine concentration
Not available in the standard set of autoanalyzer techniques.

 Reagents: a standard set of reagents for the determination of creatinine F. Abbott, creatinine F. Sigma.

Definition Parameters:
a) the volume of the sample of native urine 1.25 μl;
reagent volume 236 μl;
calibration solutions of creatinine 0.5, 1.0 and 2.0 g / l;
b) the measurement wavelength range is 516/604 nm;
c) the first reading time is 180 s;
last read time 180 s;
reading interval 60 s;
g) Incubation temperature 30 ^{° C;}
Characteristic of the procedure: lower limit of determination 0; upper limit up to 5 g / l; coefficient of variation 2.59 + - 0.39%
5) Determination of concentration in the urine of phosphorus
Not available in the standard set of autoanalyzer techniques.

 Reagents: a standard set of reagents for the determination of phosphorus F. Abbott, potassium phosphate disubstituted (H.Ch.).

Definition Parameters:
a) The volume of the sample of native urine 1.25 μl;
The reagent volume is 436 μl;
calibration solutions of potassium phosphate disubstituted 0.02 g / l, 0.3 g / l and 0.7 g / l;
b) measuring wavelength range 340/380 nm;
c) the time of the first reading is 120 s;
last read time 360 s;
reading interval 60 s;
g) Incubation temperature 30 ^{° C;}
Characteristic of the procedure: lower limit of determination 0; upper limit of 2.6 g / l; coefficient of variation 5.31 + - 0.38%
6) Determination of urinary potassium concentration
It is produced using an ion-selective electrode according to the standard technique of an autoanalyzer.

All information received on the autoanalyzer is archived outside the computer in a special map, after which they start calculating the initial test data using a special program for entering parallels and generating initial data that estimates the variability of the indicators obtained on the autoanalyzer. The program generates a text file called a diagnostic card, which is stored in the corresponding department of the data bank disease and has the following structure. The first line contains some passport data of the patient. This is an arbitrary text, including the name of the patient, the date of the examination and other additional information at the discretion of the user. The next line shows the hourly urine output of each portion, formed from information on the diuresis of each of the seven portions of the test and the time of their collection. This is followed by six lines, in each of which the name of the indicator and seven numbers are the average values of this indicator in each of the 7 portions of the test. These data are formed after the operator enters into the computer all the information about the concentration of the studied elements obtained on the autoanalyzer. Phased processing of 6 types of indicators is provided:
Ab protein (biuret method)
As protein (sulfosalicylic acid test)
Urea nitrogen
With creatinine
R phosphorus
K potassium
All indicators are entered identically, while the name and parallel number of the input element are constantly recorded on the screen. The principle of operation of this section of the program is as follows: the variability of all parallel values is estimated and the closest of them are averaged.

 The data entered by the operator into the computer can also be saved as a separate file (file of parallels). If errors are found in it, it is enough to correct them directly on the disk, avoiding re-entering more than 100 indicators, and then re-form the initial test data using a special program.

 The averaged data file contains indicators of protein concentration determined by both the biuret method (Ab) and the breakdown with sulfosalicylic acid (As). At the subsequent stages, a selective analysis of two source data options is provided: b when establishing proteinuria using the biuret method and s when establishing proteinuria, a breakdown with sulfosalicylic acid, for which two copies of the file are created: * b. * And * s. *, Where the first asterisk (*) denotes the file name of the averaged data, and the second extension of the same file. From copy * b. * the string As is deleted, and from the copy * s. * the string Ab. These final source data files are a kind of visiting card of each patient examined. They are automatically included in the protocols of all subsequent stages of computer processing.

 3. At the first stage of computer processing of the initial data, a package of special calculation programs creates two arrays of derived indicators "Diagnostic model of the kidneys" and "Excretion profile of the functional load test."

 The first array consists of 209 relative indicators and is the result of comparing the urine output, the concentration of control elements (protein, urea nitrogen) and marker elements (creatinine, renal glomeruli, proximal phosphorus and potassium-distal tubules). The principle of its calculation is as follows.

First of all, in each of the portions of the test, a number of auxiliary derived indicators are calculated:
1) excretion of each element (g / h) (product of its concentration (g / l) and hourly urine output) five indicators in each of the seven portions of the test;
2) special creatinine, phosphorus, and potassium-dependent indices reflecting the relationship of protein and urea excretion with one of the intra-nephron ways of their excretion and representing the ratio of excretion of one of the control elements and the corresponding marker element six indicators in each of the seven portions of the test.

Then, 11 comparisons (0,1,2,3,4,5,6,7,8,9,10) of indicators of 7 portions of the test (I, II, III, IV, V, VI, VII) are carried out, which allows visualization impact results:
1) Physical activity before and after the introduction of furosemide (load test period) 0 (II-I), 6 (VII-VI), 10 (VII-I);
2) saluretic during the first hour from the moment of its introduction (polyuric test period) 1 (III-II), 7 (III-II);
3) saluretic in 6 and more hours after its introduction without taking into account the factor of physical activity (post-polyuric period of the test) 2 (IV-II), 3 (V-II), 4 (VI-I), 5 (VII-II);
4) saluretic after 6 hours or more after its administration, taking into account the factor of physical activity (load-post-polyuric test period) 8 (IV-I), 9 (VI), 10 (VII-I).

 Then, in each of 11 comparisons, the dynamics of protein, urea nitrogen, creatinine, phosphorus, potassium, as well as six predefined indices (c) are calculated. Additionally, the values of the latter are established after correction for the negative dynamics of marker excretion and the so-called interstitial index is calculated, the difference between the dynamics of the control element and the average sum of indicators of the dynamics of the indices (after correction for reduced marker excretion). As a result, in each of the 11 comparisons, 19 derived indicators are obtained: 5 dynamics of excretion of the studied elements, 12 dynamics of protein and urea creatinine, phosphorus, potassium-dependent indices before and after the corresponding correction, 2 protein-, urea-interstitial indices.

 The indicators of this array are the input information for multifunctional topical and nosological programs. For the convenience of working with text files of the latter, the array map of the "Diagnostic Model of the Kidneys" is designed so that each indicator can be standardly indicated by a specific alphanumeric character. This map represents 11 vertical (by the number of comparisons) and 19 horizontal (by the number of indicators) stripes. The latter are grouped in three aggregates: protein (a), urea (b) and marker elements: creatinine (c), phosphorus (f), potassium (k).

The indicators of this array are denoted as follows: dynamics of protein and urea (a, b) X 0 dynamics of marker elements (c, f, k) X dynamics of creatinine-dependent indices (a, b) X 1 or 2 dynamics of phosph - forzavisimy indices (a, b) X 3 or 4 dynamics of potassium dependent indices (a, b) X 5 or 6
interstitial indices (a, b) X 7, where X is the serial number
vertical strip, 0,1,2,3,4,5,6,7 serial number
the horizontal strip
relevant
lumps.

The second array visualizes the features of excretion of each of the elements during the functional load test. It consists of 55 indicators, which are the input to the multifunctional excretion program. The map of the “Excretion profile of the test” array consists of 11 vertical and 5 horizontal (by the number of elements) stripes. Some indicators represent the absolute values of excretion in g / h (the product of concentration in g / l per hour diuresis) of protein (a), urea nitrogen (b), creatinine (c), phosphorus (p) and potassium (k) in certain portions Test: 0-I, 1-II, 3-III, 6-VI and 8-averaged IV, V, VII. The remaining six vertical stripes show relative indicators characterizing the dynamics of excretion (c) under the influence of:
physical activity 2 (comparison of indicators of II-I servings),
saluretics in the polyuric period, taking into account 4 (III-I) and excluding 5 (III-II) effects of physical activity,
saluretics in the post-polyuric period, taking into account 9 (averaged (IV + V + VII-I) and excluding 7 (VI-I), 10 (averaged IV + V + VII-II) effects of physical activity.

 In the text of excretion algorithms, each of the 55 indicators is indicated by a symbol consisting of a letter (a, b, c, p, k) indicating the name of the element and a number (0-10) indicating the serial number of the vertical strip.

 Calculation programs are included in the AnSh Functional Load Test System computer complex. To run them, you need to go sequentially to the menu items "Raw Data Processing" and then "Visualization of Derived Indicators". They are provided as selective calculation of arrays of the "Diagnostic Model of Kidneys" and "Excretion test profile", and the creation of a single map of both arrays of calculated indicators. In the latter case, it also includes a map of the source data of the examined patient. When you select the menu item "View results At the processing stage, a card with derivative indicators, at the discretion of the user, can be displayed on a computer screen or on a printing device.

 4. The final stages of computer processing provide for the examination of arrays of derived indicators with special programs in search of a "morphological or anatomical-functional image", formulated earlier and included in the algorithm. The texts of these diagnostic algorithms were improved during the examination of more than 500 patients with a morphologically verified diagnosis of various kidney diseases and contain the “key of the algorithm”, the main distinguishing feature and the “restrictive information” that eliminates the possibility of false positive answers.

 Depending on the functional purpose, array and volume of the analyzed derivative indicators, all the algorithms are grouped in three multifunctional programs; topical, nosological and excretory.

The topical program contains descriptions of the various anatomical and anatomical and functional changes in the glomeruli, tubules, and interstitium, as well as the patterns determined by extra-venous proteinuria. The source of its input information is an array of "Diagnostic model of the kidneys", and for each of the algorithms its own range of the studied indicators is defined:
creatinine-dependent in describing the condition of the glomeruli,
phosphorus-dependent in the description of the state of the proximal tubules,
potassium-dependent in describing the condition of the distal tubules,
interstitial indices in describing the state of interstitium,
indicators of the load period of the test in the description of options for extranatural proteinuria.

 The nosological program analyzes all 209 indicators of the array of the "Diagnostic Model of the Kidney" and contains a description of the patterns previously determined in patients with renal amyloidosis, glomerulonephritis, tuberculosis of the kidney, chronic pyelonephritis, xanthogranulomatous pyelonephritis, and diabetic angionephropathy, which is far from exhaustive, which is far from exhaustive, which is far from clear Algorithms of almost any diseases associated with changes in the renal parenchyma can be formed.

 The excretion program was created later than others on the basis of the results of the variational-statistical analysis of the excretion indices of the studied elements (test excretion profile). Its algorithms contain a description of statistically significant patterns that have been established for kidney tuberculosis, nephrological diseases and some types of malignant neoplasms.

 The most appropriate form of operation of this rather capacious software product turned out to be the grouping of algorithms in the corresponding diagnostic complexes.

I. Multiprogram diagnostic complex of renal amyloidosis:
1) diagnostic algorithm (has 4 sections characterizing the characteristics of indicators in different periods of the test),
2) a program characterizing the special mechanisms of proteinuria in patients with renal amyloidosis (prerenal proteinuria?),
3) a program characterizing the features of urinary excretion of elements in patients with renal amyloidosis.

II. Multi-program diagnostic complex of glomerulonephritis:
1) diagnostic algorithm (has 4 sections characterizing the characteristics of indicators in different periods of the test),
2) the diagnostic algorithm of various morphological types of glomerulonephritis (mesangio-proliferative, lobular, mesangio-capillary, membranous, focal segmental hyalinosis, minimal morphological changes),
3) a program characterizing some of the anatomical and functional features of the glomeruli (enhanced glomerular protein filtration, protein diffusion, their combination, fibroplastic transformation and glomerular sclerosis),
4) a program stating a special condition of the proximal tubules with nephrotic syndrome.

III. Multiprogram diagnostic complex of kidney tuberculosis:
1) diagnostic algorithm (has 4 sections characterizing the characteristics of indicators in different periods of the test),
2) a program characterizing the special condition of the glomeruli in patients with tuberculosis of the kidney,
3) a program characterizing the special state of interstitium in patients with kidney tuberculosis,
4) a program characterizing the features of urinary excretion of elements in patients with kidney tuberculosis.

IV. Multi-program diagnostic complex of pyelonephritis:
1) the diagnostic algorithm (has 4 sections characterizing the special state of the interstitial tissue, the features of “false” proteinuria, the characteristics of the indicators of the polyuric and post-polyuric periods of the test,
2) the diagnostic algorithm of xanthogranulomatous pyelonephritis.

V. Multi-program diagnostic complex of malignant neoplasms:
1) a program characterizing the features of urinary excretion of elements in patients with renal cell carcinoma,
2) a program characterizing the features of urinary excretion of elements in patients with papillary tumor of the pelvis,
3) a program characterizing the features of urinary excretion of elements in patients with severe intoxication with extrarenal localization of malignant neoplasms.

VI. Multi-program diagnostic complex for diabetic angionephropathy:
1) diagnostic algorithm for severe proteinuria,
2) a program characterizing the features of urinary excretion of elements in patients with type 1 diabetes.

VII. A set of programs characterizing the state of various departments of the nephron and the genesis of proteinuria:
1) algorithms for various lesions of the glomeruli and blood vessels of the kidneys (plethora of glomeruli, sclerosis of part of the glomeruli, sclerosis and hyalinosis of vessels, widespread sclerosis of glomeruli with nephrosclerosis and pyelonephritic wrinkling),
2) algorithms for the defeat of the proximal and distal tubules,
3) renal interstitium lesion algorithms (inflammation, edema, small, moderate or severe sclerosis, nephrosclerosis, pyelonephritic wrinkling),
4) algorithms of various mechanisms of proteinuria (false, extra-natal, load, functional, due to functional insufficiency of the proximal tubules).

 All diagnostic algorithms are included in the AnSh Functional Load Test System computer complex. To run them, you must go to the menu items "Processing Initial Data", "Analysis of Derived Indicators", and then "Multiprogram Diagnostic Complexes" or "AnSh System" " In the first case, the user gets access to each of the diagnostic complexes as a whole or to the algorithms that compose them, in the second, the initial data will be processed by all algorithms of all diagnostic complexes, and a map of the initial data of the examined patient will be included in the response form. At the same time, the user has access to any information in the data bank, including about 1,000 diagnostic cards, grouped according to the nosological principle.

 When you select the menu item "View processing results", the data of the examination of derived indicators at the discretion of the user can be displayed on a computer screen or on a printing device.

 The principle of operation of this section of the "AnSh" Functional Load Test System is as follows: In the arrays of calculated indicators on IBM PC XT / AT, patterns are found that correspond to a particular pathological process. Then, within each of the diagnostic complexes, except the last (VII ), a special program calculates the number of points of positive answers and generates a special resume.

 For the diagnostic complexes Glomerulonephritis, Amyloidosis of the kidneys and Tuberculosis of the kidney, a 4-degree gradation of the significance of the volume of positive answers is provided: “Negative result” less than 2 points “Doubtful result” from 2 to 4 points + - “Suspiciously the presence of the process "from 4 to 6 points +" It is extremely suspicious that the process is "6 or more points ++.

 For the diagnostic complexes Pyelonephritis, Malignant neoplasms, and Diabetic angionephropathy, a 2-degree gradation of the significance of the volume of positive answers is provided: “Negative result” less than 2 points “Suspiciously the presence of the process” - from 2 points and above +.

The possibility of obtaining two possible answers: when determining the protein concentration by the biuret method b and the breakdown with sulfosalicylic acid s gives additional guarantees of the objectivity of the final information. The final conclusion is formulated by the doctor responsible for the examination, in accordance with the "Summary" of both answers and the clinical picture of the disease according to the following principle: "It is highly likely that there is a process", if ++ ++
or ++ + "It is very likely that there is a process" if ++ + -
or + +
or + + - “Probably there is a process”, if + - + -
or ++ or + "It is unlikely that the process is available" if + - "Data for the presence of the process is not available", if -.

The answer of the functional load test system "AnSh" includes:
1) printouts of 2 answer options (* b. * And * s. *);
2) a conclusion on a special form, on the back of which the rules for forming a conclusion are given.

 Embodiments of the invention.

 PRI me R 1. Bnoy S-new V.F. 40 years.

I.b. 1671 / 9850-91 g. (Clinic of therapy and occupational diseases of MMA)
Clinical diagnosis: chronic glomerulonephritis with intact renal function, treated with prednisolone.

Morphological study of puncture biopsy of the kidney N 7774/90:
mesangio-proliferative glomerulonephritis,
stroma foci of severe sclerosis, edema.

 Computer urinodiagnosis of kidney diseases.

 Date 16.04.91 (see the appendix).

 A special laboratory examination was carried out to clarify the condition of the renal parenchyma in clinical and laboratory remission in a patient with morphologically verified mesangio-proliferative nephritis (in the analysis of urine: protein traces, white blood cells up to 25 in p / er cylinders are single in the preparation) the absence of significant proteinuria excluded the possibility conducting a previously known method.

According to a special scheme, seven portions of urine were collected:
At 22 hours 15.04 the patient emptied the bladder.

 I for 9 hours of night sleep (up to 7 hours 16.04) 294 ml.

 II after an hour of walking at 8 h 30 ml.

 At 10 hours 16.04 (immediately after urination) 20 mg of furosemide was intramuscularly administered to the patient.

 III after an hour of walking at 11 h 574 ml.

 At 16.00 the patient emptied the bladder.

 IV after an hour of walking at 17 h 110 ml.

 At 21.00 the patient emptied the bladder.

 V after an hour of walking at 22 h 47 ml.

 VI for 9 hours of night sleep (up to 7 hours 17.04) 285 ml.

 VII after an hour of walking at 8 h 52 ml.

 After measuring diuresis, 10 ml of urine of each portion is centrifuged, the supernatant is placed in the refrigerator. 04/17 after primary processing of the biomaterial of the last portion, all samples were transferred to the biochemical laboratory and a Spectrum autoanalyzer, using special methods, carried out a 3-fold determination of the concentration of all the studied elements in each portion of urine (Table 2). Then, using the program for inputting parallels and generating initial data, mathematical processing was performed to evaluate the variability of indicators, a file of averaged data was generated (Table 3), and then two copies of it “b” were created, where the protein was determined by the biuret method and s, where the protein was determined by breakdown with sulfosalicylic acid. These files are subjected to computer processing "Functional load test system."

 In both versions of her response, there was no data (the number of positive response points of the corresponding diagnostic complexes was less than 2) for the presence of renal amyloidosis, renal tuberculosis, malignant neoplasms, and diabetic angionephropathy.

 The results of the analysis of arrays of derivative indicators by the “Diagnostic Complex of Glomerulonephritis” in both response options were of the same type (the number of points for positive answers was 8.5) and were evaluated as extremely suspicious for the presence of glomerulonephritis (++). At the same time, regularities were established that were determined in the load, post-polyuric and load-post-polyuric periods of the test, as well as changes in indicators specific for mesangio-proliferative glomerulonephritis. The low number of positive responses of the algorithm characterizing the anatomical and functional features of the renal glomeruli attracted attention: the absence of glomerular mechanisms of proteinuria in a patient with normal protein excretion at the time of the examination.

 The answers of the Diagnostic Complex of Pyelonephritis (typical changes in the indicators of the polyuric period, the number of points of positive answers 2, suspiciously the presence of a process) and programs characterizing the state of various departments of the nephron (lesions of the tubular apparatus, sclerosis and inflammatory infiltration of the interstitium were also similar in both variants). was not established during a morphological study of puncture biopsy specimen of the kidney tissue in 1990 but was consistent with the result of "Di Gnostic complex pyelonephritis "the development of urinary infection as a result of treatment with prednisolone.

Conclusion according to the "Functional load test system" AnSh ":
1) the presence of mesangioproliferative glomerulonephritis is extremely likely (++ ++),
2) the presence of chronic pyelonephritis is very likely (+ +),
3) established a lesion of the tubular apparatus, inflammation and sclerosis of interstitium.

 PRI me R 2. Bnoy Sr V.E. 56 years old.

I.b. 3606/90 g. (Clinic of therapy and occupational diseases MMA)
Clinical diagnosis: primary renal amyloidosis? (a biopsy of the gum and rectal mucosa was not found).

 Computer urodiagnosis of kidney diseases.

 Date: 10/14/91 (see annex).

 A special laboratory examination was carried out to clarify the nature of the pathological process in the kidneys of a patient with severe "load" proteinuria and the absence of protein in the urine collected at rest and against the background of diuresis formed by the saluretic, which excluded the possibility of carrying out the previously known method.

 According to a special scheme, seven portions of urine were collected (see Example 1); after the last portion was taken, all samples of the biomaterial were transferred to the biochemical laboratory. Using special techniques, a Spectrum autoanalyzer carried out a 3-fold determination of the concentration of all the studied elements in each portion of urine (Table 4). Then, using the program for inputting parallels and generating initial data, mathematical processing was performed to evaluate the variability of indicators, a file of averaged data was generated (table 5), and then two copies of it were created b, where the protein was determined by the biuret method and s, where the protein was determined by a breakdown with sulfosalicylic acid . These files are subjected to computer processing "Functional load test system."

 In both variants of her response, there was no data (the number of positive response points of the corresponding diagnostic complexes was less than 2) for the presence of glomerulonephritis, inflammatory kidney diseases (chronic pyelonephritis and tuberculosis), malignant neoplasms, and diabetic angionephropathy.

 The results of the analysis of the derived indicators of the test carried out by the "Diagnostic complex of amyloidosis of the kidneys" when determining the protein concentration in the urine by the biuret method (option * b. *) And the breakdown with sulfosalicylic acid (option * s. *) Turned out to be different: in the first, specific changes in the indicators were not established were (0 points negative response of option b -), in the second, patterns were previously detected in patients with renal amyloidosis in the load and in the post-post-polyuric test period (4 points), which allowed us to evaluate variant s response as suspicious for the presence of renal amyloidosis (/ +).

Conclusion according to the data of the "Functional load test system" ANSH ": 1) probably (- +) the presence of kidney amyloisode,
2) established a lesion of the tubular apparatus, inflammation and severe sclerosis of interstitium.

 Against the background of progression of cardiovascular failure in January 1992, the patient died.

 Pathologic conclusion: renal amyloidosis.

 PRI me R 3. B-naya S-va M.F. 36 years.

 I.b. 1869/92 (urological clinic of MMA).

 Clinical diagnosis: coral stone of the right kidney, proteinuria above 1 g / l, (history of toxicosis of the 2nd half of pregnancy).

 Computer urinodiagnosis of kidney diseases.

 Date 23.02.92 (see the appendix).

 A special laboratory examination was performed on the patient in the preoperative period to clarify the genesis of proteinuria.

 According to a special scheme, seven portions of urine were collected (Example 1), after the last portion was taken, all samples of the biomaterial were transferred to the biochemical laboratory. Using special techniques, a Spectrum 3-time analyzer was used to determine the concentration of all the studied elements in each portion of urine (Table 6). Then, using the program for inputting parallels and generating initial data, mathematical processing was performed to evaluate the variability of indicators, a file of averaged data was generated (Table 7), and then two copies of it were created b, where the protein was determined by the biuret method and s, where the protein was determined by a breakdown with sulfosalicylic acid. These files are subjected to computer processing by the "Functional load test system" AnSh ".

 In both versions of her response, there was no data (the number of positive response points of the corresponding diagnostic complexes was less than 2) for the presence of renal amyloidosis, kidney tuberculosis, pyelonephritis, malignant neoplasms, and diabetic angionephropathy.

 The results of the analysis of the derivative indicators of the test carried out by the Diagnostic Complex of Glomerulonephritis for both answers were almost the same: the number of points of positive answers in the first 6.75 is extremely suspicious of the presence of glomerulonephritis (++): regularities typical for the load, polyuric periods of the test and for mesangio-proliferative glomerulonephritis, in the second 4.75, the presence of glomerulonephritis is suspicious (+): only the patterns characteristic of exercise and polyuri are established test periods.

 The responses of programs characterizing the state of various parts of the nephron of the tubular apparatus lesion and small sclerosis of interstitium were similar in both test variants.

Conclusion according to the data of the "Functional load test system" ANSH ": 1) it is very likely (++ +) the presence of mesangio-proliferative glomerulonephritis,
2) established the defeat of the tubular apparatus and small sclerosis of interstitium.

 Morphological study of intraoperative biopsy of kidney tissue (3452/92): mesangio-proliferative nephritis, focal sclerosis and minor lymphohistiocytic interstitial infiltration (the latter did not establish a false-negative test system response during a special laboratory examination).

 PRI me R 4. B-naya A-on V.U. 46 years old.

I.b. 10131/91 (urological clinic MMA)
Clinical diagnosis: tumor of the right kidney (accidentally detected by ultrasound performed for preventive purposes).

 Computer urinodiagnosis of kidney diseases.

 Date 12.05.91 (see annex).

 A special laboratory examination was carried out in the preoperative period to clarify the nature of the tumor process and the state of the renal parenchyma (in the general analysis of urine: there is no protein, white blood cells, red blood cells are single in p / vision).

 According to a special scheme, seven portions of urine were collected (Example 1), after the last portion was taken, all samples of the biomaterial were transferred to the biochemical laboratory. By special techniques, a Spectrum autoanalyzer carried out a 3-fold determination of the concentration of all the studied elements in each portion of urine (Table 8). Then, using the program for inputting parallels and generating initial data, mathematical processing was performed to evaluate the variability of indicators, a file of averaged data was generated (Table 9), and then two copies of it were created b, where the protein was determined by the biuret method and s, where the protein was determined by breakdown with sulfosalicylic acid. These files were subjected to computer processing by the "AnSh" functional load test system.

 In both variants of her response, there was no data (the number of positive response points of the corresponding diagnostic complexes was less than 2) for the presence of glomerulonephritis, renal amyloidosis, kidney tuberculosis, chronic pyelonephritis, and diabetic angionephropathy.

 The results of the analysis of derivative indicators of the test carried out by the "Diagnostic complex of malignant neoplasms" in both response options were almost the same: the number of points of positive responses in the first 2.0, and in the second 4.0 the presence of renal cell carcinoma is suspicious (+): patterns were established, indicating enhanced creatinine excretion and a special ratio of protein and potassium excretion in the polyuric period of the test).

 The responses of programs characterizing the state of various departments of the nephron of the tubular apparatus lesion and severe interstitial sclerosis were also of the same type.

Conclusion according to the "Functional load test system AnSH":
1) the presence of renal cell cancer is very likely (+ +),
2) established lesion of the tubular apparatus and severe sclerosis of interstitium.

 Morphological examination of the removed right kidney (2157/91): renal cell carcinoma (clear cell cystic variant), outside the tumor: sclerosis, glomeruli preserved, blood vessels unchanged.

 PRI me R 5. B-Naya T-va N.I. 32 years old.

 I.b. 13265/91 (urological clinic of MMA).

 Wedge. diagnosis: nephrolithiasis, stones of the upper and middle calyx of the left kidney, chronic pyelonephritis.

 Computer urinodiagnosis of kidney diseases.

 Date 24.06.91 (see the appendix).

 A special laboratory examination was carried out in the preoperative period to clarify the nature of the pathological process in the renal parenchyma and the genesis of proteinuria (in the general analysis of urine: protein up to 2.0 g / l, white blood cells, red blood cells, whole field of view).

 According to a special scheme, seven portions of urine were collected (Example 1), after the last portion was taken, all samples of the biomaterial were transferred to the biochemical laboratory. Using special techniques, a Spectrum 3-time analyzer was used to determine the concentration of all the studied elements in each portion of urine (Table 10). Then, using the program for inputting parallels and generating initial data, mathematical processing was performed to evaluate the variability of indicators, a file of averaged data was generated (Table 11), and then two copies of it were created b, where the protein was determined by the biuret method and s, where the protein was determined by a breakdown with sulfosalicylic acid. These files are subjected to computer processing by the "Functional load test system" AnSh ".

 In both variants of her response, there was no data (the number of positive response points of the corresponding diagnostic complexes was less than 2) for the presence of glomerulonephritis, renal amyloidosis, kidney tuberculosis, malignant neoplasms, and diabetic angionephropathy.

 The results of the analysis of derivative indicators of the test carried out by the Diagnostic Pyelonephritis Complex in both response options were of the same type and were assessed as suspicious for the presence of chronic pyelonephritis. The number of points of positive answers was 4.0 (+): regularities were established that were previously determined in the post-polyuric period of the test, and also special changes in the indicators of the load period, indicating a false, extra-genital genesis of proteinuria.

 Programs characterizing the state of the various parts of the nephron established a lesion of the tubule apparatus, inflammatory infiltration and severe sclerosis of interstitium in option b, and in option s, in addition, patterns indicating sclerosis of part of the glomeruli, their fullness and false, extranatural proteinuria.

Conclusion according to the "Functional load test system AnSH":
1) it is very likely (+ +) the presence of chronic. pyelonephritis,
2) established the defeat of the tubular apparatus, inflammation and severe sclerosis of interstitium,
3) revealed patterns that are determined in sclerosis of part of the glomeruli, as well as their plethora,
4) regularities are revealed that testify to the “false” (extranatural) mechanisms of proteinuria due to a significant admixture in the urine of blood and pus.

 Morphological study of intraoperative kidney biopsy (8777/91): chronic pyelonephritis, focal nephrosclerosis (sclerosis and accumulations of lymphohistiocytic elements with an admixture of neutrophils, individual glomeruli are full-blooded, sclerosis and atrophy of a small number of glomeruli, protein dystrophy of the tubules).

 PRI me R 6. B-naya R-va Z.A. 55 years.

 I.b. 4374/92 (urological clinic MMA).

 Cl. diagnosis: non-functioning left kidney, arterial hypertension.

 Computer urinodiagnosis of kidney diseases.

 Date: 02/27/92 (see the appendix).

 A special laboratory examination was performed in the preoperative period to clarify the nature of the pathological process in the renal parenchyma (in the general analysis of urine: protein up to 0.33 g / l, white blood cells up to 15-40 in p / vision).

 According to a special scheme, seven portions of urine were collected (see Example 1); after the last portion was taken, all samples of the biomaterial were transferred to the biochemical laboratory. Using special techniques, a Spectrum autoanalyzer made a 3-fold determination of the concentration of all the studied elements in each portion of urine (Table 12). Next, using the program for inputting parallels and generating initial data, mathematical processing was performed to evaluate the variability of indicators, a file of averaged data was generated (Table 13), and then two copies of it were created b, where the protein was determined by the biuret method and s, where the protein was determined by breakdown with sulfosalicylic acid. These files are subjected to computer processing "Functional load test system" ANSH ".

 In both variants of her response, there was no data (the number of positive response points of the corresponding diagnostic complexes was less than 2) for the presence of glomerulonephritis, amyloidosis of the kidneys, chronic pyelonephritis, malignant neoplasms, and diabetic angionephropathy.

 The results of the analysis of derivative indicators of the test carried out by the "Diagnostic Complex of Kidney Tuberculosis" in both answers turned out to be almost the same and were estimated as the dubious number of points of positive answers in the first 2, 25, and in the second 2.5 (+ -): regularities were established previously determined in the post-polyuric period of the test in patients with kidney tuberculosis.

 The responses of programs characterizing the state of various departments of the nephron of the tubular apparatus lesion and severe interstitial sclerosis were also of the same type.

Conclusion according to the "Functional load test system AnSH":
1) probably (+ - + -) the presence of tuberculosis of the kidney,
2) established lesion of the tubular apparatus and severe sclerosis of interstitium.

 Morphological study of a removed kidney (3933-38 / 92): against the background of diffuse sclerosis of the stroma, focuses of caseosis and partially encapsulated tuberculous granulomas with macrophages and Pirogov-Langans cells. Polycavernous tuberculosis of the kidney with loss of function.

 The above examples illustrate the high diagnostic capabilities and accuracy of the proposed method, which allows not only to correctly identify kidney disease, but also to obtain information previously provided only by morphological examination of the renal tissue: type of glomerulonephritis, the nature of the tumor process, the state of interstitium and renal glomeruli, etc. In this case, computer urinodiagnosis can be carried out both with severe proteinuria and in the absence of changes in the general analysis of urine (examples 1 and 4). The expediency of determining the concentration of protein on the autoanalyzer is obvious by two methods that establish different types of protein substances: only in the answer of option b (biuret method) was the type of glomerulonephritis verified in patient C-howl (example 3), only in option s (test with sulfosalicylic acid) were obtained adequate data on the presence of renal amyloidosis in patient Cp (example 2) and the condition of the renal glomeruli in patient T-th (example 5). The proposed method was also almost the only method that allows in the preoperative period to suspect the presence of tuberculosis of the kidney in a patient with P-howl (example 6).

 Unlike the previously known similar method for diagnosing kidney pathology accompanied by proteinuria (copyright certificate N 1588135), the proposed method can be applied regardless of the presence or absence of changes in the general analysis of urine, including proteinuria, established by a unified laboratory method breakdown with sulfosalicylic acid on photoelectrocolorimeter.

 The developed method is called "Computer urinodiagnosis of kidney diseases", since the only source of diagnostic information in it is only a biochemical study of urine collected by the patient according to a special scheme; Interpretation of the results is provided by a multifunctional, unparalleled software package operating on the basis of IBM PC AT / XT.

 The universality of the method, which allows in almost all cases to obtain information about the presence and nature of the pathological process in the renal parenchyma, is achieved through the development of special methods for determining the concentration of the studied elements, primarily uroproteins, on modern biochemical autoanalyzers designed for blood testing.

 The developed method is a fundamentally new, functional area of laboratory diagnosis of kidney disease. It is non-invasive and allows you to get more than 90% of the examined patients a result that is almost equivalent to the morphological study of the renal parenchyma.

 Computer-assisted urinodiagnosis of kidney diseases allows: a significant number of patients with kidney diseases to refuse from morphological studies of renal tissue obtained by a rather traumatic kidney biopsy procedure; determine indications and treat a number of kidney diseases; controlling its effectiveness by the results of repeated examinations; organize periodic examinations of contingents that are at risk of cancer and kidney tuberculosis; accelerate and simplify the recognition of renal pathology in many patients, including children, young people with stress (functional) proteinuria, women with toxicosis of the 2nd half of pregnancy, patients with hypertension and other somatic diseases.

 The method has high technical and economic efficiency, because it is easy to collect biomaterial can be carried out in a 2-day hospital, while patients can be located in remote locations from the analysis point, since the concentration of the determined elements does not change for 5-7 days even when storing urine in domestic refrigerators; does not require special purchase of expensive equipment, since as a base for biochemical studies, you can use diagnostic centers equipped with auto-analyzers of the corresponding class (f.f. Abbott, Kone, Hitashi, Bakmann) the cost of reagents for examining one patient does not exceed 10 DM; it is possible to constantly increase the number of biochemical research databases by adapting the AnSh Functional Load Test System to different types of autoanalyzers; there are no problems ensuring a qualified interpretation of the results, since the latter is carried out standardly using a special computer program complex, the improvement and updating of which can be centralized; it is possible to create and constantly replenish a single database of the examined patients, which will allow not only more efficient but to improve the existing diagnostic algorithms, but also to constantly create new ones that meet the specifics of different regions, as well as conduct research work on the pathogenesis of various types of renal pathology; in many cases, it will make it possible to refuse from a histopathological examination of the puncture biopsy of the renal tissue by the invasive method, which allows to obtain a detailed answer only after 8-10 days, requiring highly qualified specialists and expensive reagents.

 Application.

 PRI me R 1. Bnoy S-new V.F.

 Computer urinodiagnosis of kidney diseases.

 Date of examination 04.16.91.

Patient S-nov (clinic of therapy and occupational diseases of MMA) 04.16.91 (14b.nef)
Computer urinodiagnosis of kidney disease
Functional load test system "AnSh" to the Spectrum autoanalyzer, f.Abbott
Version 0001
Initial data of the functional stress test Urine dose 1st 2nd 3rd 3rd 4th 5th 6th 7th Diuresis / ml / h 32.6 30.0 574.0 110.0 47.0 31, 6 52.0 Protein / g / l 1.38 1.64 0.09 1.22 0.95 1.47 1.43 Urea nitrogen / g / l 17.16 16.36 2.69 13.87 16, 69 16.26 16.00 Creatinine / g / L 1.66 2.05 0.27 1.53 1.50 1.53 2.05 Phosphorus / g / L 1.04 0.87 0.05 0.57 1.01 1.15 1.00 Potassium / g / L 1.34 1.11 0.67 1.27 1.53 1.30 1.23 Urea protein determined * b. * By biuret method
* s. * breakdown with sulfosalicylic acid
The results of the examination of arrays of derivative test indicators:
Diagnostic complex "Amyloidosis of the kidneys"
1. Diagnostic algorithm for renal amyloidosis
No specific changes found.
2. Special proteinuria in renal amyloidosis
No specific changes found.
3. Features of excretion of elements in renal amyloidosis
No specific changes found.
Summary: the number of points of positive answers is 0,
negative result.

Diagnostic complex "Glomerulonephritis"
1. Diagnostic algorithm for glomerulonephritis
Features of the load period
01 YES + *
Features of the post-polyuric period
03 YES + *
Features of the post-post-polyuric period
04 YES +
2. Morphological forms of glomerulonephritis
Mesangio-proliferative type
MPN YES + * * * *
3. Anatomical and functional changes in the renal glomeruli
Enhanced Protein Filtration
GL / FIL HET + * * * *
Enhanced Protein Filtration and Diffusion
GL / FIL + DIF HET + * * *
4. Special condition of the proximal tubules
No specific changes found.
Summary: the number of points of positive answers is 8.5,
the presence of a process is highly suspicious.

Diagnostic complex "Tuberculosis of the kidney"
1. Diagnostic algorithm for kidney tuberculosis
No specific changes found.
2. Special condition of the renal glomeruli
GL / TUB HET + * * * *
3. Changes in interstitium in kidney tuberculosis
No specific changes found.
4. Features of excretion of elements in kidney tuberculosis
No specific changes found.
Summary: the number of points of positive answers 0.25,
negative result.

Diagnostic complex "Pyelonephritis"
1. Diagnostic algorithm for chronic pyelonephritis
Features of the polyuric period
03 YES + * * * * * *
2. Diagnostic algorithm for xanthogranulomatous pyelonephritis
No specific changes found.
Summary: the number of points of positive answers 2,
suspicious process presence.

Diagnostic complex "Malignant neoplasms"
1. Features of excretion of elements in renal cell carcinoma
No specific changes found.
2. Features of excretion of elements in papillary tumor of the pelvis
No specific changes found.
3. Features of the excretion of elements during extranatural localization
No specific changes found.
Summary: the number of points of positive answers is 0,
negative result.

Diagnostic complex "Diabetic angionephropathy"
1. Diagnostic algorithm for diabetic angionephropathy
No specific changes found.
2. Features of the excretion of elements in diabetic angionephropathy
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Nephron state and proteinuria mechanisms"
1. Algorithms for some changes in the glomeruli and blood vessels of the kidneys
No specific changes found.
2. Algorithms for the defeat of the renal tubules
The defeat of the proximal tubules
TUBUL / PR HET + + + + + + +
The defeat of the distal tubules
TUBUL / D YES + + + + + * * *
3. Algorithms for renal interstitium
Inflammatory infiltration
LGI YES +
Severe sclerosis
SCL / ++ YES + * *
4. The algorithm of hyperuricemia or hyperuricuria
No specific changes found.
5. Algorithms of some mechanisms of proteinuria
No specific changes found.
Patient S-nov (clinic of therapy and occupational diseases of MMA) 04.16.91 (14s.nef)
Computer urinodiagnosis of kidney disease
Functional load test system "AnSh" to the Spectrum autoanalyzer, f.Abbott
Version 0001
Initial data of the functional stress test Urine dose 1st 2nd 3rd 3rd 4th 5th 6th 7th Diuresis / ml / h 32.6 30.0 574.0 110.0 47.0 31, 6 52.0 Protein / g / l 0.21 0.31 0.09 0.20 0.20 0.15 0.20 Urea nitrogen / g / l 17.16 16.36 2.69 13.87 16, 69 16.26 16.00 Creatinine / g / L 1.66 2.05 0.27 1.53 1.50 1.53 2.05 Phosphorus / g / L 1.04 0.87 0.05 0.57 1.01 1.15 1.00 Potassium / g / L 1.31 1.11 0.67 1.25 1.53 1.30 1.23 Urea protein determined * b. * By biuret method
* s. * breakdown with sulfosalicylic acid
The results of the examination of arrays of derivative test indicators:
Diagnostic complex "Amyloidosis of the kidneys"
1. Diagnostic algorithm for renal amyloidosis
No specific changes found.
2. Special proteinuria in renal amyloidosis
No specific changes found.
3. Features of excretion of elements in renal amyloidosis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Glomerulonephritis"
1. Diagnostic algorithm for glomerulonephritis
Features of the load period
01 YES + *
Features of the post-polyuric period
03 YES + *
Features of the post-post-polyuric period
04 YES +
2. Morphological forms of glomerulonephritis
Mesangio-proliferative type
MPN YES + * * * *
3. Anatomical and functional changes in the renal glomeruli
Enhanced Protein Filtration
GL / FIL HET + * * * *
Enhanced protein filtration and diffusion.

GL / FIL + DIF: HET + * * *
4. Special condition of the proximal tubules
No specific changes found.
Summary: the number of points of positive answers is 8.5,
the presence of a process is highly suspicious.

Diagnostic complex "Tuberculosis of the kidney"
1. Diagnostic algorithm for kidney tuberculosis
No specific changes found.
2. Special condition of the renal glomeruli
GL / TUB HET + * * * *
3. Changes in interstitium in kidney tuberculosis
No specific changes found.
4. Features of excretion of elements in kidney tuberculosis
No specific changes found.
Summary: the number of points of positive answers 0.25, a negative result.

Diagnostic complex "Pyelonephritis"
1. Diagnostic algorithm for chronic pyelonephritis
Features of the polyuric period
03 DA + * * * * * *
2. Diagnostic algorithm for xanthogranulomatous pyelonephritis
No specific changes found.
Summary: the number of points of positive answers 2,
suspicious process presence.

Diagnostic complex "Malignant neoplasms"
1. Features of excretion of elements in renal cell carcinoma
No specific changes found.
2. Features of excretion of elements in papillary tumor of the pelvis
No specific changes found.
3. Features of the excretion of elements during extranatural localization
No specific changes found.
Summary: the number of points of positive answers is 0,
negative result.

Diagnostic complex "Diabetic angionephropathy"
1. Diagnostic algorithm for diabetic angionephropathy
No specific changes found.
2. Features of the excretion of elements in diabetic angionephropathy
No specific changes found.
Summary: the number of points of positive answers is 0,
negative result.

Diagnostic complex "Nephron state and proteinuria mechanisms"
1. Algorithms for some changes in the glomeruli and blood vessels of the kidneys
No specific changes found.
2. Algorithms for the defeat of the renal tubules
The defeat of the proximal tubules
TUBUL / PR HET + + + + + + +
The defeat of the distal tubules
TUBUL / D YES + + + + + * * *
3. Algorithms for renal interstitium
Inflammatory infiltration
LGI YES +
Severe sclerosis
SCL / ++ YES + * *
4. The algorithm of hyperuricemia or hyperuricuria
No specific changes found.
5. Algorithms of some mechanisms of proteinuria
No specific changes found.
Computer urinodiagnosis of kidney disease
Functional load test system "AnSh"
to the Spectrum autoanalyzer, f. Abbott
Version 0001
B-noy S-new V.F. 40 years. I.b. 1671 / 9850-91 g.

 MMA them. I.M.Sechenova, clinic of therapy and occupational diseases.

Date of the survey (code N in the database):
04.16.91 (14.nef).

Conclusion
The results of the analysis of the derived indicators of the test performed by the test system when determining the protein concentration in the urine by the biuret method (option * b. *) And the breakdown with sulfosalicylic acid (option * s. *) Are of the same type.

A comparison of both answers allows us to draw the following conclusion:
1) the presence of mesangioproliferative glomerulonephritis is extremely likely (++ ++),
2) the presence of chronic pyelonephritis is very likely (+ +),
3) established a lesion of the tubular apparatus, inflammation and sclerosis of interstitium.

Leading Researcher
MMA named after I.M.Sechenov, MD

 Shapiro S.B.

Verte!
The principle of forming a conclusion on the results of the functional load test system "AnSh"
For the diagnostic complexes Amyloidosis of the kidneys, Glomerulonephritis and Tuberculosis of the kidney, a 4-degree gradation of the significance of the volume of positive answers is provided:
"Negative result" (less than 2 points -),
"Doubtful result" (from 2 to 4 points + -),
"Suspiciously the presence of a process" (from 4 to 6 points + -),
"The presence of a process is extremely suspicious" (6 or more points ++).

For the diagnostic complexes "Pyelonephritis", "Malignant neoplasms" and "Diabetic angionephropathy" there is a 2-degree gradation of the significance of the volume of positive answers:
"Negative result" (less than 2 points -),
"Suspiciously the presence of a process" (from 2 points and above +),
The test system allows you to get 2 answers: when determining the protein concentration using the biuret method (b) and a breakdown with sulfosalicylic acid (s), which gives additional guarantees of the objectivity of the information received. The final conclusion is formulated in accordance with the Summary of both responses:
“It is highly likely that there is a process” if ++ ++ or ++ +
"It is very likely that there is a process" if ++ + - or + + or + + -
"Probably the presence of a process" if + - + - or ++ or +
"It is unlikely that there is a process" if + -
"No process data available" if -.

 PRI me R 2. Bnoy Sr V.E.

 Computer urinodiagnosis of kidney diseases.

Date of examination 14.10. 91
Bnoyu Sr (clinic of therapy and occupational diseases of MMA) 10/14/91 (84b.amy)
Computer urinodiagnosis of kidney disease
Functional load test system "Ansh" to the "Spectrum" autoanalyzer, f.Abbott
Version 0001
Initial data of the functional stress test Urine dose 1st 2nd 3rd 3rd 4th 5th 6th 7th Diuresis / ml / h 80.1 21.0 507.0 41.0 24.0 77, 2 11.0 Protein / g / l 0.84 4.37 0.51 2.05 3.76 0.88 5.08 Urea nitrogen / g / l 1.94 4.25 0.58 5.93 8, 45 2.55 5.38 Creatinine / g / L 0.50 1.79 0.21 1.34 2.21 0.57 2.27 Phosphorus / g / L 0.16 0.82 0.01 0.21 0.19 0.18 0.19 Potassium / g / L 0.49 1.82 0.59 1.47 1.54 0.54 1.56 Urea protein determined * b. * By biuret method
* s. * breakdown with sulfosalicylic acid
The results of the examination of arrays of derivative test indicators:
Diagnostic complex "Amyloidosis of the kidneys"
1. Diagnostic algorithm for renal amyloidosis
No specific changes found.
2. Special proteinuria in renal amyloidosis
No specific changes found.
3. Features of excretion of elements in renal amyloidosis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Glomerulonephritis"
1. Diagnostic algorithm for glomerulonephritis
No specific changes found.
2. Morphological forms of glomerulonephritis
No specific changes found.
3. Anatomical and functional changes in the renal glomeruli
Enhanced Protein Filtration
GL / FIL HET + + * * * *
Enhanced Protein Filtration and Diffusion
GL / FIL + DIF HET + * * *
4. Special condition of the proximal tubules
No specific changes found.
Summary: the number of points of positive answers is 0.75, a negative result.

Diagnostic complex "Tuberculosis of the kidney"
1. Diagnostic algorithm for kidney tuberculosis
No specific changes found.
2. Special condition of the renal glomeruli
No specific changes found.
3. Changes in interstitium in kidney tuberculosis
No specific changes found.
4. Features of excretion of elements in kidney tuberculosis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Pyelonephritis"
1. Diagnostic algorithm for chronic pyelonephritis
No specific changes found.
2. Diagnostic algorithm for xanthogranulomatous pyelonephritis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Malignant neoplasms"
1. Features of excretion of elements in renal cell carcinoma
No specific changes found.
2. Features of excretion of elements in papillary tumor of the pelvis
No specific changes found.
3. Features of the excretion of elements during extranatural localization
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Diabetic angionephropathy"
1. Diagnostic algorithm for diabetic angionephropathy
No specific changes found.
2. Features of the excretion of elements in diabetic angionephropathy
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Nephron state and proteinuria mechanisms"
1. Algorithms for some changes in the glomeruli and blood vessels of the kidneys
No specific changes found.
2. Algorithms for the defeat of the renal tubules
The defeat of the proximal tubules
TUBUL / PR HET + + + + + + +
The defeat of the distal tubules
TUBUL / D YES + + + + + * * *
3. Algorithms for renal interstitium
Inflammatory infiltration
LGI YES +
Severe sclerosis
SCL / ++ YES + * *
4. The algorithm of hyperuricemia or hyperuricuria
No specific changes found.
5. Algorithms of some mechanisms of proteinuria
No specific changes found.
Bnoyu Sr (clinic of therapy and occupational diseases of MMA) 10/14/91 (84s.amy)
Computer urinodiagnosis of kidney disease
Functional load test system "AnSh" to the "Spectrum" autoanalyzer, f. Abbott
Version 0001
Initial data of the functional stress test Urine dose 1st 2nd 3rd 3rd 4th 5th 6th 7th Diuresis / ml / h 80.0 21.0 507.0 41.0 24.0 77, 2 11.0 Protein / g / l 0.01 2.16 0.01 0.28 1.52 0.02 3.09 Urea nitrogen / g / l 1.94 4.25 0.58 5.93 8, 45 2.55 5.38 Creatinine / g / L 0.50 1.79 0.21 1.34 2.21 0.57 2.27 Phosphorus / g / L 0.16 0.82 0.01 0.21 0.19 0.18 0.19 Potassium / g / L 0.49 1.82 0.59 1.47 1.54 0.54 1.56 Urea protein determined * b. * By biuret method
* s. * breakdown with sulfosalicylic acid
The results of the examination of arrays of derivative test indicators:
Diagnostic complex "Amyloidosis of the kidneys"
1. Diagnostic algorithm for renal amyloidosis
Features of the load period
01 YES +
Features of the post-post-polyuric period
04 YES + * *
2. Special proteinuria in renal amyloidosis
No specific changes found.
3. Features of excretion of elements in renal amyloidosis
No specific changes found.
Summary: the number of points of positive answers 4,
suspicious process presence.

Diagnostic complex "Glomerulonephritis"
1. Diagnostic algorithm for glomerulonephritis
No specific changes found.
2. Morphological forms of glomerulonephritis
Membrane type
MN HET + * * * * *
3. Anatomical and functional changes in the renal glomeruli
Enhanced filtration and diffusion of the protein GL / FIL + DIF HET + + * * *
4. Special condition of the proximal tubules
No specific changes found.
Summary: the number of points of positive answers 1,
negative result.

Diagnostic complex "Tuberculosis of the kidney"
1. Diagnostic algorithm for kidney tuberculosis "
No specific changes found.
2. Special condition of the renal glomeruli
GL / TUB HET + * * * *
3. Changes in interstitium in kidney tuberculosis
No specific changes found.
4. Features of excretion of elements in kidney tuberculosis
No specific changes found.
Summary: the number of points of positive answers 0.25, a negative result.

Diagnostic complex "Pyelonephritis"
1. Diagnostic algorithm for chronic pyelonephritis
No specific changes found.
2. Diagnostic algorithm for xanthogranulomatous pyelonephritis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Malignant neoplasms"
1. Features of excretion of elements in renal cell carcinoma
No specific changes found.
2. Features of excretion of elements in papillary tumor of the pelvis
No specific changes found.
3. Features of the excretion of elements during extranatural localization
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Diabetic angionephropathy"
1. Diagnostic algorithm for diabetic angionephropathy
No specific changes found.
2. Features of the excretion of elements in diabetic angionephropathy
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Nephron state and proteinuria mechanisms"
1. Algorithms for some changes in the glomeruli and blood vessels of the kidneys
No specific changes found.
2. Algorithms for the defeat of the renal tubules
The defeat of the proximal tubules
TUBUL / PR HET + + + + + + +
The defeat of the distal tubules
TUBUL / D YES + + + + + * * *
3. Algorithms for renal interstitium
Inflammatory infiltration
LGI YES +
Severe sclerosis
SCL / ++ YES + * *
4. The algorithm of hyperuricemia or hyperuricuria
No specific changes found.
5. Algorithms of some mechanisms of proteinuria
No specific changes found.
Computer urinodiagnosis of kidney disease
Functional load test system "AnSh" to the Spectrum autoanalyzer, f.Abbott
Version 0001
B-Noi C.V.E. 56 years old. I.b. 3606/90.

 MMA them. I.M.Sechenova, clinic of therapy and occupational diseases.

Date of the survey (code N in the database):
10/14/91 (84.amy).

Conclusion
The results of the analysis of the derivatives of the test performed by the test system when determining the protein concentration in the urine by the biuret method (option * b. *) And the breakdown with sulfosalicylic acid (option * s. *) Are different.

A comparison of both answers allows us to draw the following conclusion:
1) probably (- / +) the presence of renal amyloidosis,
2) established a lesion of the tubular apparatus, inflammation and severe sclerosis of interstitium.

Leading Researcher
MMA named after I.M.Sechenov, MD

 Shapiro S.B.

Verte!
The principle of forming a conclusion on the results of the functional load test system "AnSh"
For the diagnostic complexes Amyloidosis of the kidneys, Glomerulonephritis and Tuberculosis of the kidney, a 4-degree gradation of the significance of the volume of positive answers is provided:
Negative result "(less than 2 points -),
"Doubtful result" (from 2 to 4 points + -),
"Suspiciously the presence of a process" (from 4 to 6 points +),
"The presence of a process is extremely suspicious" (6 or more points ++).

For the diagnostic complexes "Pyelonephritis", "Malignant neoplasms" and "Diabetic angionephropathy" there is a 2-degree gradation of the significance of the volume of positive answers:
"Negative result" (less than 2 points -),
"Suspiciously the presence of a process" (from 2 points and above +),
The test system allows you to get 2 answers: when determining the protein concentration using the biuret method (b) and a breakdown with sulfosalicylic acid (s), which gives additional guarantees of the objectivity of the information received. The final conclusion is formulated in accordance with the Summary of both responses:
“It is highly likely that there is a process” if ++ ++ or ++ +
"It is very likely that there is a process" if ++ + - or + + or + + -
"Probably the presence of a process" if + - + - or ++ or +
"It is unlikely that there is a process" if + -
"No process data available" if -.

 PRI me R 3. B-naya S-va M.F. 36 years.

 Computer urinodiagnosis of kidney diseases.

 Date of examination 02/23/92.

B-naya St. (Urological Clinic MMA) 02/23/92 (150b.nef / 69b.uro)
Computer urinodiagnosis of kidney disease
Functional load test system "AnSh" to the Spectrum autoanalyzer, f.Abbott
Version 0001
Initial data of the functional stress test Urine dose 1st 2nd 3rd 3rd 4th 5th 6th 7th Diuresis / ml / h 22.2 13.0 700.0 25.0 19.0 18, 9 14.0 Protein / g / l 1.54 4.09 0.37 2.37 2.68 2.16 2.15 Urea nitrogen / g / l 8.83 9.47 0.99 7.62 9, 31 10.76 11.81 Creatinine / g / L 1.59 2.91 0.20 2.38 2.81 2.60 3.00 Phosphorus / g / L 1.25 1.20 0.04 1.19 1.58 1.54 1.20 Potassium / g / L 1.04 1.98 0.81 1.77 1.63 1.40 1.41 Urea protein determined * b. * By biuret method
* s. * breakdown with sulfosalicylic acid
The results of the examination of arrays of derivative test indicators:
Diagnostic complex "Amyloidosis of the kidneys"
1. Diagnostic algorithm for renal amyloidosis
No specific changes found.
2. Special proteinuria in renal amyloidosis
No specific changes found.
3. Features of excretion of elements in renal amyloidosis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Glomerulonephritis"
1. Diagnostic algorithm for glomerulonephritis
Features of the load period
01 YES + *
Features of the polyuric period
02 YES +
2. Morphological forms of glomerulonephritis
Mesangio-proliferative type
MPN YES + * * * *
3. Anatomical and functional changes in the renal glomeruli
Enhanced Protein Filtration
GL: FIL HET + + * * * *
Protein diffusion
GL / DIF HET + * * * *
4. Special condition of the proximal tubules
No specific changes found.
Summary: the number of points of positive answers is 6.75,
the presence of a process is highly suspicious.

Diagnostic complex "Tuberculosis of the kidney"
1. Diagnostic algorithm for kidney tuberculosis
No specific changes found.
2. Special condition of the renal glomeruli
No specific changes found.
3. Changes in interstitium in kidney tuberculosis
No specific changes found.
4. Features of excretion of elements in kidney tuberculosis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Pyelonephritis"
1. Diagnostic algorithm for chronic pyelonephritis
No specific changes found.
2. Diagnostic algorithm for xanthogranulomatous pyelonephritis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Malignant neoplasms"
1. Features of excretion of elements in renal cell carcinoma
No specific changes found.
2. Features of excretion of elements in papillary tumor of the pelvis
No specific changes found.
3. Features of the excretion of elements during extranatural localization
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Diabetic angionephropathy"
1. Diagnostic algorithm for diabetic angionephropathy
No specific changes found.
2. Features of the excretion of elements in diabetic angionephropathy
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Nephron state and proteinuria mechanisms"
1. Algorithms for some changes in the glomeruli and blood vessels of the kidneys
No specific changes found.
2. Algorithms for the defeat of the renal tubules
The defeat of the proximal tubules
TUBUL / PR DA + + + + + + + +
The defeat of the distal tubules
TUBUL / D DA + + + + + * * * *
3. Algorithms for renal interstitium
Mild to moderate sclerosis
SCL / + DA + * * *
4. The algorithm of hyperuricemia or hyperuricuria
No specific changes found.
5. Algorithms of some mechanisms of proteinuria
No specific changes found.
B-naya St. (urological clinic MMA) 02/23/92 (150s.nef / 69s.uro)
Computer urinodiagnosis of kidney disease
Functional load test system "AnSh" to the Spectrum autoanalyzer, f.Abbott
Version 0001
Initial data of the functional stress test Urine dose 1st 2nd 3rd 3rd 4th 5th 6th 7th Diuresis / ml / h 22.2 13.0 700.0 25.0 19.0 18, 9 14.0 Protein / g / l 0.66 2.70 0.11 1.68 1.67 1.03 0.84 Urea nitrogen / g / l 8.83 9.47 0.99 7.62 9, 31 10.76 11.81 Creatinine / g / L 1.59 2.91 0.20 2.38 2.81 2.60 3.00 Phosphorus / g / L 1.25 1.20 0.04 1.19 1.58 1.54 1.20 Potassium / g / L 1.04 1.98 0.81 1.77 1.63 1.40 1.41 Urea protein determined * b. * By biuret method
* s. * breakdown with sulfosalicylic acid Results of examination of arrays of derivative test indicators:
Diagnostic complex "Amyloidosis of the kidneys"
1. Diagnostic algorithm for renal amyloidosis
No specific changes found.
2. Special proteinuria in renal amyloidosis
No specific changes found.
3. Features of excretion of elements in renal amyloidosis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Glomerulonephritis"
1. Diagnostic algorithm for glomerulonephritis
Features of the load period
01 YES + *
Features of the polyuric period
02 YES +
2. Morphological forms of glomerulonephritis
No specific changes found.
3. Anatomical and functional changes in the renal glomeruli
Protein diffusion
GL / DIF HET + + * * * *
Enhanced Protein Filtration and Diffusion
GL / FIL + DIF HET + * * *
4. Special condition of the proximal tubules
No specific changes found.
Summary: the number of points of positive answers 4.75,
suspicious process presence.

Diagnostic complex "Tuberculosis of the kidney"
1. Diagnostic algorithm for kidney tuberculosis
No specific changes found.
2. Special condition of the renal glomeruli
GL / TUB HET + * * * *
3. Changes in interstitium in kidney tuberculosis
No specific changes found.
4. Features of excretion of elements in kidney tuberculosis
No specific changes found.
Summary: the number of points of positive answers 0.25, a negative result.

Diagnostic complex "Pyelonephritis"
1. Diagnostic algorithm for chronic pyelonephritis
No specific changes found.
2. Diagnostic algorithm for xanthogranulomatous pyelonephritis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Malignant neoplasms"
1. Features of excretion of elements in renal cell carcinoma
No specific changes found.
2. Features of excretion of elements in papillary tumor of the pelvis
No specific changes found.
3. Features of the excretion of elements during extranatural localization
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Diabetic angionephropathy"
1. Diagnostic algorithm for diabetic angionephropathy
No specific changes found.
2. Features of the excretion of elements in diabetic angionephropathy
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Nephron state and proteinuria mechanisms"
1. Algorithms for some changes in the glomeruli and blood vessels of the kidneys
No specific changes found.
2. Algorithms for the defeat of the renal tubules
The defeat of the proximal tubules
TUBUL / PR YES + + + + + + + +
The defeat of the distal tubules
TUBUL / D YES + + + + + * * *
3. Algorithms for renal interstitium
Mild to moderate sclerosis
SCL / + YES + * * *
4. The algorithm of hyperuricemia or hyperuricuria
No specific changes found.
5. Algorithms of some mechanisms of proteinuria
No specific changes found.
Computer urinodiagnosis of kidney disease
Functional load test system "AnSh" to the "Spectrum" autoanalyzer, f.Abbott Version 0001
B-naya S-va M.F. 36 years. I.b. 1869/92.

 MMA named after I.M.Sechenov, urological clinic.

Date of the survey (code N in the database):
02/23/92 (150.nef / 69.uro).

Conclusion
The results of the analysis of the derived indicators of the test carried out by the test system when determining the protein concentration in the urine using the biuret method (option * b. *) And the breakdown with sulfosalicylic acid (option * s. *) Are almost the same.

A comparison of both answers allows us to draw the following conclusion:
1) the presence of mesangioproliferative glomerulonephritis is very likely (++ +),
2) established the defeat of the tubular apparatus and small sclerosis of interstitium.

Leading Researcher
MMA named after I.M.Sechenov, MD

 Shapiro S.B.

Verte!
The principle of forming a conclusion on the results of the functional load test system "AnSh"
For the diagnostic complexes Amyloidosis of the kidneys, Glomerulonephritis and Tuberculosis of the kidney, a 4-degree gradation of the significance of the volume of positive answers is provided:
"Negative result" (less than 2 points -),
"Doubtful result" (from 2 to 4 points + -),
"Suspiciously the presence of a process" (from 4 to 6 points +),
"The presence of a process is extremely suspicious" (6 or more points ++).

For the diagnostic complexes "Pyelonephritis", "Malignant neoplasms" and "Diabetic angionephropathy" there is a 2-degree gradation of the significance of the volume of positive answers:
"Negative result" (less than 2 points -),
"Suspiciously the presence of a process" (from 2 points and above +),
The test system allows you to get 2 answers: when determining the protein concentration using the biuret method (b) and a breakdown with sulfosalicylic acid (s), which gives additional guarantees of the objectivity of the information received. The final conclusion is formulated in accordance with the Summary of both responses:
“It is highly likely that there is a process” if ++ ++ or ++ +
"It is very likely that there is a process" if ++ + - or + + or + + -
"Probably the presence of a process" if + - + - or ++ or +
"It is unlikely that there is a process" if + -
"No process data available" if -.

 PRI me R 4. B-naya A-on V.U.

 Computer urinodiagnosis of kidney diseases.

Date of examination 05/12/91
B-naya A-on (urological clinic MMA) 12.05.91 (14b.obm)
Computer urinodiagnosis of kidney disease
Functional load test system "AnSh" to the Spectrum autoanalyzer, f.Abbott
Version 0001
Initial data of the functional stress test Urine dose 1st 2nd 3rd 3rd 4th 5th 6th 7th Diuresis / ml / h 52.2 65.0 700.0 51.0 52.0 35, 5 34.0 Protein / g / l 0.40 0.33 0.02 0.49 0.80 0.63 0.78 Urea nitrogen / g / l 8.49 6.36 0.75 7.06 11, 83 15.44 15.06 Creatinine / g / L 0.92 0.74 0.08 1.32 2.01 1.43 1.73 Phosphorus / g / L 0.64 0.35 0.06 0.53 0.84 1.00 0.92 Potassium / g / L 1.23 1.66 0.49 1.85 2.01 1.17 1.87 Urea protein determined * b. * By biuret method
* s. * breakdown with sulfosalicylic acid Results of examination of arrays of derivative test indicators:
Diagnostic complex "Amyloidosis of the kidneys"
1. Diagnostic algorithm for renal amyloidosis
No specific changes found.
2. Special proteinuria in renal amyloidosis
No specific changes found.
3. Features of excretion of elements in renal amyloidosis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Glomerulonephritis"
1. Diagnostic algorithm for glomerulonephritis
No specific changes found.
2. Morphological forms of glomerulonephritis
No specific changes found.
3. Anatomical and functional changes in the renal glomeruli
Enhanced Protein Filtration
GL / FIL HET + * * * *
4. Special condition of the proximal tubules
No specific changes found.
Summary: the number of points of positive answers 0.25, a negative result.

Diagnostic complex "Tuberculosis of the kidney"
1. Diagnostic algorithm for kidney tuberculosis
No specific changes found.
2. Special condition of the renal glomeruli
No specific changes found.
3. Changes in interstitium in kidney tuberculosis
No specific changes found.
4. Features of excretion of elements in kidney tuberculosis
No specific changes found.
Summary: the number of points of positive answers is 0,
negative result.

Diagnostic complex "Pyelonephritis"
1. Diagnostic algorithm for chronic pyelonephritis
No specific changes found.
2. Diagnostic algorithm for xanthogranulomatous pyelonephritis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Malignant neoplasms"
1. Features of excretion of elements in renal cell carcinoma
BL.R./EXC YES +
2. Features of excretion of elements in papillary tumor of the pelvis
No specific changes found.
3. Features of the excretion of elements during extranatural localization
No specific changes found.
Summary: the number of points of positive answers is 2, the presence of a process is suspicious.

Diagnostic complex "Diabetic angionephropathy"
1. Diagnostic algorithm for diabetic angionephropathy
No specific changes found.
2. Features of the excretion of elements in diabetic angionephropathy
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Nephron state and proteinuria mechanisms"
1. Algorithms for some changes in the glomeruli and blood vessels of the kidneys
No specific changes found.
2. Algorithms for the defeat of the renal tubules
The defeat of the proximal tubules
TUBUL / PR YES + + + + + + + +
The defeat of the distal tubules
TUBUL / D YES + + + + + * * *
3. Algorithms for renal interstitium
Mild to moderate sclerosis
SCL / + YES + * * *
Severe sclerosis
SCL / ++ YES + * *
4. The algorithm of hyperuricemia or hyperuricuria
No special changes found
5. Algorithms of some mechanisms of proteinuria
No specific changes found.
B-naya A-on (urological clinic MMA) 05/12/91 (14s.obm)
Computer urinodiagnosis of kidney disease
Functional load test system "AnSh" to the Spectrum autoanalyzer, f.Abbott
Version 0001 Copy ****
Initial data of the functional stress test Urine dose 1st 2nd 3rd 3rd 4th 5th 6th 7th Diuresis / ml / h 52.2 65.0 700.0 51.0 52.0 35, 5 34.0 Protein / g / l 0.01 0.12 0.02 0.19 0.19 0.15 0.18 Urea nitrogen / g / l 8.49 6.36 0.75 7.06 11, 83 15.44 15.06 Creatinine / g / L 0.92 0.74 0.08 1.32 2.01 1.43 1.73 Phosphorus / g / L 0.64 0.35 0.06 0.53 0.84 1.00 0.92 Potassium / g / L 1.23 1.66 0.49 1.85 2.01 1.17 1.87 Urea protein determined * b. * By biuret method
* s. * breakdown with sulfosalicylic acid Results of examination of arrays of derivative test indicators:
Diagnostic complex "Amyloidosis of the kidneys"
1. Diagnostic algorithm for renal amyloidosis
No specific changes found.
2. Special proteinuria in renal amyloidosis
No specific changes found.
3. Features of excretion of elements in renal amyloidosis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Glomerulonephritis"
1. Diagnostic algorithm for glomerulonephritis
No specific changes found.
2. Morphological forms of glomerulonephritis
No specific changes found.
3. Anatomical and functional changes in the renal glomeruli
Enhanced Protein Filtration
GL / FIL HET + * * * *
Enhanced Protein Filtration and Diffusion
GL / FIL + DIF HET + * * *
4. Special condition of the proximal tubules
No specific changes found.
Summary: the number of points of positive answers is 0.5, a negative result.

Diagnostic complex "Tuberculosis of the kidney"
1. Diagnostic algorithm for kidney tuberculosis
No specific changes found.
2. Special condition of the renal glomeruli
GL / TUB HET + * * * *
3. Changes in interstitium in kidney tuberculosis
No specific changes found.
4. Features of excretion of elements in kidney tuberculosis
No specific changes found.
Summary: the number of points of positive answers 0.25, a negative result.

Diagnostic complex "Pyelonephritis"
1, Diagnostic algorithm of chronic pyelonephritis
No specific changes found.
2. Diagnostic algorithm for xanthogranulomatous pyelonephritis
No specific changes found.
Summary: the number of points positive answers 0, a negative result.

Diagnostic complex "Malignant neoplasms"
1. Features of excretion of elements in renal cell carcinoma
BL.R./EXC YES + +
2. Features of excretion of elements in papillary tumor of the pelvis
No specific changes found.
3. Features of the excretion of elements during extranatural localization
No specific changes found.
Summary: the number of points of positive answers 4,
suspicious process presence.

Diagnostic complex "Diabetic angionephropathy"
1. Diagnostic algorithm for diabetic angionephropathy
No specific changes found.
2. Features of the excretion of elements in diabetic angionephropathy
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Nephron state and proteinuria mechanisms"
1. Algorithm for some changes in the glomeruli and blood vessels of the kidneys
No specific changes found.
2. Algorithms for the defeat of the renal tubules
The defeat of the proximal tubules
TUBUL / PR HET + + + + + +
The defeat of the distal tubules
TUBUL / D YES + + + + + * * *
3. Algorithms for renal interstitium
Mild to moderate sclerosis
SCL / + YES + * * *
Severe sclerosis
SCL / ++ YES + * *
4. The algorithm of hyperuricemia or hyperuricuria
No specific changes found.
5. Algorithms of some mechanisms of proteinuria
No specific changes found.

Computer urinodiagnosis of kidney disease
Functional load test system "AnSh" to the "Spectrum" autoanalyzer, f. Abbott
Version 0001
B-naya A-on V.U. 46 years old. I.b. 10131/91.

 MMA named after I.M.Sechenov, urological clinic.

Date of the survey (code N in the database):
05/12/91 (14.obm).

Conclusion
The results of the analysis of the derived indicators of the test carried out by the test system when determining the protein concentration in the urine using the biuret method (option * b. *) And the breakdown with sulfosalicylic acid (option * s. *) Are almost the same.

A comparison of both answers allows us to draw the following conclusion:
1) the presence of renal cell cancer is very likely (+ +),
2) established lesion of the tubular apparatus and severe sclerosis of interstitium.

Leading Researcher
MMA named after I.M.Sechenov, MD

 Shapiro S.B.

Verte!
The principle of forming a conclusion on the results of the functional load test system "AnSh"
For the diagnostic complexes Amyloidosis of the kidneys, Glomerulonephritis and Tuberculosis of the kidney, a 4-degree gradation of the significance of the volume of positive answers is provided:
"Negative result" (less than 2 points -),
"Doubtful result" (from 2 to 4 points + -),
"Suspiciously the presence of a process" (from 4 to 6 points +),
"The presence of a process is extremely suspicious" (6 or more points ++).

For the diagnostic complexes "Pyelonephritis", "Malignant neoplasms" and "Diabetic angionephropathy" there is a 2-degree gradation of the significance of the volume of positive answers:
"Negative result" (less than 2 points -),
"Suspiciously the presence of a process" (from 2 points and above +),
The test system allows you to get 2 answers: when determining the protein concentration using the biuret method (b) and a breakdown with sulfosalicylic acid (s), which gives additional guarantees of the objectivity of the information received. The final conclusion is formulated in accordance with the Summary of both responses:
“It is highly likely that there is a process” if ++ ++ or ++ +
"It is very likely that there is a process" if ++ + - or + + or + + -
"Probably the presence of a process" if + - + - or ++ or +
"It is unlikely that there is a process" if + -
"No process data available" if -.

 PRI me R 5. B-Naya T-va N.I.

 Computer urinodiagnosis of kidney diseases.

Date of examination 06.24.91
B-naya T-va (urological clinic MMA) 06/24/91 (30b.uro)
Computer urinodiagnosis of kidney disease
Functional load test system "AnSh" to the Spectrum autoanalyzer, f.Abbott
Version 0001
Initial data of the functional stress test Urine dose 1st 2nd 3rd 3rd 4th 5th 6th 7th Diuresis / ml / h 48.4 40.0 416.0 64.0 31.0 28, 0 26.0 Protein / g / l 0.72 1.02 0.25 0.92 1.35 1.34 2.02 Urea nitrogen / g / l 6.57 5.35 0.92 9.77 10, 02 9.38 8.54 Creatinine / g / L 0.67 0.69 0.15 0.85 1.14 1.32 1.45 Phosphorus / g / L 0.45 0.18 0.03 0.87 1.07 1.03 0.35 Potassium / g / L 0.79 1.85 0.73 1.33 1.22 0.85 1.53 Urea protein determined * b. * By biuret method
* s. * breakdown with sulfosalicylic acid Results of examination of arrays of derivative test indicators:
Diagnostic complex "Amyloidosis of the kidneys"
1. Diagnostic algorithm for renal amyloidosis
No specific changes found.
2. Special proteinuria in renal amyloidosis
No specific changes found.
3. Features of excretion of elements in renal amyloidosis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Glomerulonephritis"
1. Diagnostic algorithm for glomerulonephritis
No specific changes found.
2. Morphological forms of glomerulonephritis
No specific changes found.
3. Anatomical and functional changes in the renal glomeruli
Enhanced Protein Filtration
GL / FIL HET + * * * *
Enhanced Protein Filtration and Diffusion
GL / FIL + DIF HET + * * *
4. Special condition of the proximal tubules
No specific changes found.
Summary; the number of points of positive answers is 0.5, a negative result.

Diagnostic complex "Tuberculosis of the kidney"
1. Diagnostic algorithm for kidney tuberculosis
No specific changes found.
2. Special condition of the renal glomeruli
No specific changes found.
3. Changes in interstitium in kidney tuberculosis
No specific changes found.
4. Features of excretion of elements in kidney tuberculosis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Pyelonephritis"
1. Diagnostic algorithm of chronic pyelonephritis "False" proteinuria
02 YES + * * * * * *
Features of the post-polyuric period
04 YES + * *
2. Diagnostic algorithm for xanthogranulomatous pyelonephritis
No specific changes found.
Summary: the number of points of positive answers is 4, the presence of a process is suspicious.

Diagnostic complex "Malignant neoplasms"
1. Features of excretion of elements in renal cell carcinoma
No specific changes found.
2. Features of excretion of elements in papillary tumor of the pelvis
No specific changes found.
3. Features of the excretion of elements during extranatural localization
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Diabetic angionephropathy"
1. Diagnostic algorithm for diabetic angionephropathy
No specific changes found.
2. Features of the excretion of elements in diabetic angionephropathy
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Nephron state and proteinuria mechanisms"
1. Algorithms for some changes in the glomeruli and blood vessels of the kidneys
No specific changes found.
2. Algorithms for the defeat of the renal tubules
The defeat of the proximal tubules
TUBUL / PR HET + + + + + + +
The defeat of the distal tubules
TUBUL / D YES + + + + + * * *
3. Algorithms for renal interstitium
Inflammatory infiltration
LGI YES +
Mild to moderate sclerosis
SCL / + YES + * * *
Severe sclerosis
SCL / ++ YES + * *
4. The algorithm of hyperuricemia or hyperuricuria
No specific changes found.
5. Algorithms of some mechanisms of proteinuria
No specific changes found.

B-naya T-va (urological clinic MMA) 06/24/91 (30s.uro)
Computer urinodiagnosis of kidney disease
Functional load test system "AnSh" to the "Spectrum" autoanalyzer, f. Abbott
Version 0001 Copy ****
Initial data of the functional stress test Urine dose 1st 2nd 3rd 3rd 4th 5th 6th 7th Diuresis / ml / h 48.4 40.0 416.0 64.0 31.0 28, 0 26.0 Protein / g / l 0.43 0.85 0.03 0.05 0.78 1.08 2.62 Urea nitrogen / g / l 6.57 5.35 0.92 9.77 10, 02 9.38 8.54 Creatinine / g / L 0.67 0.69 0.15 0.85 1.14 1.32 1.45 Phosphorus / g / L 0.45 0.18 0.03 0.87 1.07 1.03 0.35 Potassium / g / L 0.79 1.85 0.73 1.33 1.22 0.85 1.53 Urea protein determined * b. * By biuret method
* s. * breakdown with sulfosalicylic acid Results of examination of arrays of derivative test indicators:
Diagnostic complex "Amyloidosis of the kidneys"
1. Diagnostic algorithm for renal amyloidosis
No specific changes found.
2. Special proteinuria in renal amyloidosis
No specific changes found.
3. Features of excretion of elements in renal amyloidosis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Glomerulonephritis"
1. Diagnostic algorithm for glomerulonephritis
No specific changes found.
2. Morphological forms of glomerulonephritis
No specific changes found.
3. Anatomical and functional changes in the renal glomeruli
Enhanced Protein Filtration and Diffusion
GL / FIL + DIF HET + * * *
4. Special condition of the proximal tubules
No specific changes found.
Summary: the number of points of positive answers 0.25, a negative result.

Diagnostic complex "Tuberculosis of the kidney"
1. Diagnostic algorithm for kidney tuberculosis
No specific changes found.
2. Special condition of the renal glomeruli
GL / TUB HET + + + * * * *
3. Changes in interstitium in kidney tuberculosis
No specific changes found.
4. Features of excretion of elements in kidney tuberculosis
No specific changes found.
Summary: the number of points of positive answers is 0.75, a negative result.

Diagnostic complex "Pyelonephritis"
1. Diagnostic algorithm of chronic pyelonephritis "False" proteinuria
02 YES + * * * * * *
Features of the post-polyuric period
04 YES + * *
2. Diagnostic algorithm for xanthogranulomatous pyelonephritis
Summary: the number of points of positive answers 4,
suspicious process presence.

Diagnostic complex "Malignant neoplasms"
1. Features of excretion of elements in renal cell carcinoma
No specific changes found.
2. Features of excretion of elements in papillary tumor of the pelvis
No specific changes found.
3. Features of the excretion of elements during extranatural localization
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Diabetic angionephropathy"
1. Diagnostic algorithm for diabetic angionephropathy
No specific changes found.
2. Features of the excretion of elements in diabetic angionephropathy
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Nephron state and proteinuria mechanisms"
1. Algorithms for some changes in the glomeruli and blood vessels of the kidneys
Plethora of capillary loops
SANGV YES + * *
Glomerular sclerosis
SCL / MIN YES + * * *
2. Algorithms for the defeat of the renal tubules
The defeat of the proximal tubules
TUBUL / PR YES + + + + + + + +
The defeat of the distal tubules
TUBUL / D YES + + + + + * * *
3. Algorithms for renal interstitium
Inflammatory infiltration
LGI YES +++
Mild to moderate sclerosis
SCL / + YES + + * * *
Severe sclerosis
SCL / ++ YES + * *
4. The algorithm of hyperuricemia or hyperuricuria
No specific changes found.
5. Algorithms of some mechanisms of proteinuria
Postrenal proteinuria
POST / REN YES +
Computer urinodiagnosis of kidney disease
Functional load test system "AnSh"
to the Spectrum autoanalyzer, f.Abbott
Version 0001
B-naya T-va N.I. 32 years old. I.b. 13265/91.

 MMA named after I.M.Sechenov, urological clinic.

Date of the survey (code N in the database):
06.24.91 (30.uro).

Conclusion
The results of the analysis of the derived indicators of the test carried out by the test system when determining the protein concentration in the urine using the biuret method (option * b. *) And the breakdown with sulfosalicylic acid (option * s. *) Are almost the same.

A comparison of both answers allows us to draw the following conclusion:
1) the presence of chronic pyelonephritis is very likely (+ +),
2) established the defeat of the tubular apparatus, inflammation and severe sclerosis of interstitium,
3) revealed patterns that are determined in sclerosis of part of the glomeruli, as well as their plethora,
4) regularities are revealed that testify to the “false” (extranatural) mechanisms) of proteinuria due to a significant admixture in the urine of blood and pus.

Leading Researcher
MMA named after I.M.Sechenov, MD

 Shapiro S.Yu.

Verte!
The principle of forming a conclusion on the results of the functional load test system "AnSh"
For the diagnostic complexes Amyloidosis of the kidneys, Glomerulonephritis and Tuberculosis of the kidney, a 4-degree gradation of the significance of the volume of positive answers is provided:
"Negative result" (less than 2 points -),
"Doubtful result" (from 2 to 4 points + -),
"Suspiciously the presence of a process" (from 4 to 6 points +),
"The presence of a process is extremely suspicious" (6 or more points ++).

For the diagnostic complexes "Pyelonephritis", "Malignant neoplasms" and "Diabetic angionephropathy" there is a 2-degree gradation of the significance of the volume of positive answers:
"Negative result" (less than 2 points -),
"Suspiciously the presence of a process" (from 2 points and above +),
The test system allows you to get 2 answers: when determining the protein concentration using the biuret method (b) and a breakdown with sulfosalicylic acid (s), which gives additional guarantees of the objectivity of the information received. The final conclusion is formed in accordance with the "Summary" of both answers:
“It is highly likely that there is a process” if ++ ++ or ++ +
"It is very likely that there is a process" if ++ + - or + + or + + -
"Probably the presence of a process" if + - + - or ++ or +
"It is unlikely that there is a process" if + -
"No process data available" if -.

 PRI me R 6. B-naya R-va Z.A.

 Computer urinodiagnosis of kidney diseases.

Date of examination 02.27.92
B-naya R-va (urological clinic MMA) 02.27.92 (79b.tub / 74b.uro)
Computer urinodiagnosis of kidney disease
Functional load test system "AnSh" to the Spectrum autoanalyzer, f.Abbott
Version 0001
Initial data of the functional stress test Urine dose 1st 2nd 3rd 3rd 4th 5th 6th 7th Diuresis / ml / h 66.9 43.0 490.0 35.0 32.0 31, 1 17.0 Protein / g / l 0.54 0.73 0.34 0.54 0.62 0.66 1.90 Urea nitrogen / g / l 5.56 5.61 0.83 7.00 9, 41 8.44 8.91 Creatinine / g / L 0.71 0.96 0.16 1.28 1.08 0.97 1.81 Phosphorus / g / L 0.69 0.41 0.01 1.01 1.32 1.09 0.64 Potassium / g / L 0.91 1.62 0.57 2.02 1.49 1.03 1.78 Urea protein determined * b. * By biuret method
* s. * breakdown with sulfosalicylic acid Results of examination of arrays of derivative test indicators:
Diagnostic complex "Amyloidosis of the kidneys"
1. Diagnostic algorithm for renal amyloidosis
No specific changes found.
2. Special proteinuria in renal amyloidosis
No specific changes found.
3. Features of excretion of elements in renal amyloidosis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Glomerulonephritis"
1. Diagnostic algorithm for glomerulonephritis
No specific changes found.
2. Morphological forms of glomerulonephritis
No specific changes found.
3. Anatomical and functional changes in the renal glomeruli
Enhanced Protein Filtration
GL / FIL HET + * * * *
Protein diffusion
GL / DIF HET + * * * *
Enhanced Protein Filtration and Diffusion
GL / FIL + DIF HET + * * *
4. Special condition of the proximal tubules
No specific changes found.
Summary: the number of points of positive answers is 0.75, a negative result.

Diagnostic complex "Tuberculosis of the kidney"
1. Diagnostic algorithm for kidney tuberculosis
Features of the post-polyuric period
03 YES +
2. Special condition of the renal glomeruli
GL / TUB HET + * * * *
3. Changes in interstitium in kidney tuberculosis
No specific changes found.
4. Features of excretion of elements in kidney tuberculosis
No specific changes found.
Summary: the number of points of positive answers is 2.25, the dubious result.

Diagnostic complex "Pyelonephritis"
1. Diagnostic algorithm for chronic pyelonephritis
No specific changes found.
2. Diagnostic algorithm for xanthogranulomatous pyelonephritis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Malignant neoplasms"
1. Features of excretion of elements in renal cell carcinoma
No specific changes found.
2. Features of excretion of elements in papillary tumor of the pelvis
No specific changes found.
3. Features of the excretion of elements during extranatural localization
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Diabetic angionephropathy"
1. Diagnostic algorithm for diabetic angionephropathy
No specific changes found.
2. Features of the excretion of elements in diabetic angionephropathy
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Nephron state and proteinuria mechanisms"
1. Algorithms for some changes in the glomeruli and blood vessels of the kidneys
No specific changes found.
2. Algorithms for the defeat of the renal tubules
The defeat of the proximal tubules
TUBUL / PR YES + + + + + + + +
The defeat of the distal tubules
TUBUL / D YES + + + + + * * *
3. Algorithms for renal interstitium
Severe sclerosis
SCL / ++ YES + * *
4.Algorithm of hyperuricemia or hyperuricuria
No specific changes found.
5. Algorithms of some mechanisms of proteinuria
No specific changes found.

B-naya R-va (urological clinic MMA) 02.27.92 (79s.tub / 74s.uro)
Computer urinodiagnosis of kidney disease
Functional load test system "AnSh"
to the Spectrum autoanalyzer, f.Abbott
Version 0001
Initial data of the functional stress test Urine dose 1st 2nd 3rd 3rd 4th 5th 6th 7th Diuresis / ml / h 66.9 43.0 490.0 35.0 32.0 31, 1 17.0 Protein / g / l 0.20 0.21 0.10 0.21 0.23 0.21 0.51 Urea nitrogen / g / l 5.56 5.61 0.83 7.00 9, 41 8.44 8.91 Creatinine / g / L 0.71 0.96 0.16 1.28 1.08 0.97 1.81 Phosphorus / g / L 0.69 0.41 0.01 1.01 1.32 1.09 0.64 Potassium / g / L 0.91 1.62 0.57 2.02 1.49 1.03 1.78 Urea protein determined * b. * By biuret method
* s. * breakdown with sulfosalicylic acid Results of examination of arrays of derivative test indicators:
Diagnostic complex "Amyloidosis of the kidneys"
1. Diagnostic algorithm for renal amyloidosis
No specific changes found.
2. Special proteinuria in renal amyloidosis
No specific changes found.
3. Features of excretion of elements in renal amyloidosis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Glomerulonephritis"
1. Diagnostic algorithm for glomerulonephritis
No specific changes found.
2. Morphological forms of glomerulonephritis
No specific changes found.
3. Anatomical and functional changes in the renal glomeruli
Enhanced Protein Filtration
GL / FIL HET + * * * *
Protein diffusion
GL / DIF HET + * * * *
Enhanced Protein Filtration and Diffusion
GL / FIL + DIF HET + * * *
4. Special condition of the proximal tubules
No specific changes found.
Summary: the number of points of positive answers is 0.75, a negative result.

Diagnostic complex "Tuberculosis of the kidney"
1. Diagnostic algorithm for kidney tuberculosis
Features of the post-polyuric period
03 YES +
2. Special condition of the renal glomeruli
GL / TUB HET + + * * * *
3. Changes in interstitium in kidney tuberculosis
No specific changes found.
4. Features of excretion of elements in kidney tuberculosis
No specific changes found.
Summary: the number of points of positive answers is 2.5, the dubious result.

Diagnostic complex "Pyelonephritis"
1. Diagnostic algorithm for chronic pyelonephritis
No specific changes found.
2. Diagnostic algorithm for xanthogranulomatous pyelonephritis
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Malignant neoplasms"
1. Features of excretion of elements in renal cell carcinoma
No specific changes found.
2. Features of excretion of elements in papillary tumor of the pelvis
No specific changes found.
3. Features of the excretion of elements during extranatural localization
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Diabetic angionephropathy"
1. Diagnostic algorithm for diabetic angionephropathy
No specific changes found.
2. Features of the excretion of elements in diabetic angionephropathy
No specific changes found.
Summary: the number of points of positive answers is 0, a negative result.

Diagnostic complex "Nephron state and proteinuria mechanisms"
1. Algorithms for some changes in the glomeruli and blood vessels of the kidneys
No specific changes found.
2. Algorithms for the defeat of the renal tubules
The defeat of the proximal tubules
TUBUL / PR YES + + + + + + + +
The defeat of the distal tubules
TUBUL / D YES + + + + + * * *
3. Algorithms for renal interstitium
Severe sclerosis
SCL / ++ YES + * *
4. The algorithm of hyperuricemia and hyperuricuria
No specific changes found.
5. Algorithms of some mechanisms of proteinuria
No specific changes found.

Computer urinodiagnosis of kidney disease
Functional load test system "AnSh"
to the Spectrum autoanalyzer, f. Abbott
Version 0001
B-naya R-va Z.A. 55 years. I.b. 4374/92.

 MMA them. I.M.Sechenova, urological clinic.

Date of the survey (code N in the database):
02/27/92. (79.tub / 74.uro).

Conclusion
The results of the analysis of the derived indicators of the test carried out by the test system when determining the protein concentration in the urine by the biuret method (option * b. *) And the breakdown with sulfosalicylic acid (option * s. *) Are of the same type.

A comparison of both answers allows us to draw the following conclusion:
1) probably (+ - + -) the presence of tuberculosis of the kidney,
2) established lesion of the tubular apparatus and severe sclerosis of interstitium.

Leading Researcher
MMA named after I.M.Sechenov, MD

 Shapiro S.B.

Verte!
The principle of forming a conclusion on the results of the functional load test system "AnSh"
For the diagnostic complexes Amyloidosis of the kidneys, Glomerulonephritis and Tuberculosis of the kidney, a 4-degree gradation of the significance of the volume of positive answers is provided:
"Negative result" (less than 2 points -),
"Doubtful result" (from 2 to 4 points + -),
"Suspiciously the presence of a process" (from 4 to 6 points +),
"The presence of a process is extremely suspicious" (6 or more points ++).

For the diagnostic complexes "Pyelonephritis", "Malignant neoplasms" and "Diabetic angionephropathy" there is a 2-degree gradation of the significance of the volume of positive answers:
"Negative result" (less than 2 points -),
"Suspiciously the presence of a process" (from 2 points and above +),
The test system allows you to get 2 answers:
when determining the protein concentration by the biuret method (b) and the breakdown with sulfosalicylic acid (s), which gives additional guarantees of the objectivity of the information received. The final conclusion is formulated in accordance with the Summary of both responses:
“It is highly likely that there is a process” if ++ ++ or ++ +
"It is very likely that there is a process" if ++ + - or + + or + + -
"Probably the presence of a process" if + - + - or ++ or +
"It is unlikely that there is a process" if + -
"No process data available" if -.

Claims (1)

 METHOD FOR URINO-DIAGNOSIS OF KIDNEY DISEASES, including collection of urine at rest, after physical and saluretic loads at fixed intervals with subsequent determination of protein concentration in each portion of urine by a sample with sulfasalicylic acid, characterized in that the protein concentration is additionally determined in each sample using the biuret method, as well as the nitrogen content of urea, creatinine, phosphorus and potassium, then the obtained data are subjected to computer program analysis, according to the results of which a disease is diagnosed kidneys.

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