By the composition and quality of urine, one can judge the presence of pathological changes in the human body. Doctors consider the specific gravity to be one of the important indicators. Its deviation from the standard leads to the development of hypostenuria.
Hypostenuria – what is it
Chemical composition of urine is a substance (uric acid, sodium and potassium salts, creatinine, etc.) dissolved in water. It contains over 150 components, including hormones, enzymes, and white blood cells. They are decay products. The kidneys cleanse the body of harmful compounds. But, when the functioning of this organ is disrupted, hypostenuria occurs. It can be found in a single portion of urine or in the daily volume of urine output.
Hypostenuria is understood as a low density of a substance, at which the osmotic concentration of urine is less than the osmotic concentration of plasma. This condition is typical for renal pathologies. The inability of the kidneys to form and remove biological fluid with a normal specific gravity occurs at the terminal stage of organ failure. A nephrologist and an endocrinologist are involved in the treatment of hypostenuria.
The specific gravity of urine depends on the volume of biologically active fluid that the human body is able to excrete per day. If urine is excreted in large volumes, the density will be lower. With a small amount, the specific gravity increases. The optimal indicator for the density of urine is 1010-1020 g/l. But the value depends on the age of the patient. So, for:
- For children under 10 days from the moment of birth, the norm is 1008-1018 g/l.
- Babies 24-36 months – 1007-1017 g/l.
- Boys and girls from 6 months to a year – 1006-1016 g/l.
- Children from one to 4 years old – 1010-1020 g/l.
- Children 4-12 years old – 1012-1020 g/l.
- For persons over 12 years old, adolescents and adults, the standard varies between 1010-1020 g/l.
For any deviation, it is better to be examined. It should be borne in mind that the indicator of the specific gravity of urine is influenced by the time of collection of the biomaterial, the intake of certain food products, and physical activity.
The cause of hypostenuria can be any pathology that disrupts the filtration and excretory functions of the kidney system. A decrease in the density of urine below the normal limit can be caused by:
- A large amount of liquid drunk before testing.
- Long-term and misuse of diuretic drugs.
- Diabetes insipidus.
- Poisoning with nephrotoxic poisons.
- Development of nephrosclerosis.
- Chronic pyelonephritis.
- Polycystic kidney disease.
- The period after an acute inflammatory disease.
- Benign prostatic hyperplasia.
- Interstitial nephritis.
- Development of dystrophy.
- Toxicosis in pregnant women.
- Heart failure.
- Postoperative disorders in kidney function.
- Hormonal failure (more typical for the fairer sex of childbearing age and during menopause).
- Primary aldosteronism.
- Prolonged fasting, low-calorie diet.
- The last stage of kidney failure.
The clinical picture of hypostenuria is similar to that of renal failure. In appearance, it is impossible to suspect the onset of the disease. But all the changes are clearly visible in the results of the general study of urine.
As the density of urine decreases, the following symptoms occur:
To diagnose hypostenuria, the doctor assigns the patient a urine test according to Zimnitsky. This test is carried out as follows: urine is collected at 3-hour intervals and sent to the refrigerator. Then measure the density of each portion. If in all samples the value is less than 1010 g/l, the development of hypostenuria is assumed.
In case of doubtful indicators, it is recommended to carry out the Volhard test. This study assumes the exclusion of liquid from food: the patient does not take liquid food two hours before the examination. In a healthy person, in three portions, the specific gravity will be up to 1030-1045 g/l. If the result showed again 1010 g/l, the diagnosis is made of hypostenuria. Also, the patient is recommended to donate blood and urine for general and biochemical analyzes, to conduct the Nechiporenko test.
What to do
If the test result showed a reduced urine density, you need to retake the analysis. If re-delivery shows the same specific gravity, you will need to undergo a full diagnosis and treatment course. The principle of treatment is to find out what exactly provokes hypostenuria, which internal organs of a person are at risk. The patient must be constantly under the supervision of a nephrologist. Therefore, in such cases, hospitalization is indicated.
If the cause is type (type ) diabetes mellitus, then insulin therapy is selected. There is no specific treatment regimen. The patient needs to ensure that the sugar level does not go beyond the normal range. It is also worth regularly undergoing preventive examinations by an endocrinologist and nephrologist in order to avoid complications from the renal system.
If renal failure is diagnosed, then it is recommended to follow the diet (do not eat spicy, salty food). Your doctor may choose a combination of drugs to help maintain kidney function. For example, Furosemide, Renagel, Mannit, Epovitan. In case of severe organ failure, a person is transferred to hemodialysis, organ transplantation is performed.
If hypostenuria occurs frequently, blood and urine tests should be taken four times a year, and a specialist should be consulted.
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