Diagnosis of latent forms of renal pathology by the structure of the solid phase of urine

• Published in: Vestnik medit͡s︡inskogo instituta Reaviz no. 5; pp. 6 - 12
• Main Authors: Shatokhina, I. S., Shatokhina, S. N., Shabalin, V. N.
• Format: Journal Article
• Language: English; Russian
• Published: Private institution educational organization of higher education "Medical University "ReaViz 01-11-2022
• Subjects: bacterial and fungal infection; markers of urolithiasis; microaggregates; urine facies
• ISSN: 2226-762X; 2782-1579
• DOI: 10.20340/vmi-rvz.2022.5.MORPH.1

Introduction
. Currently, chronic kidney disease is called a "silent killer", since patients with the development of a pathological process do not experience pain for a long time, modern functional and laboratory diagnostic methods also do not allow to determine the early signs of this disease, which contributes to the chronicity of the disease.
Purpose
: to reveal the hidden signs of the pathology of the urinary system according to the structures of the solid phase of the patient's urine.
Materials and methods
. The urine of 359 patients without signs of renal pathology was studied. The method of analysis of solid-phase structures of dehydrated urine (facies) was applied by microscopy in ordinary and polarized light. Processing the structures of the solid phase of urine with a stream of steam of boiling water caused their recrystallization, which made it possible to reveal hidden markers of renal pathology.
Results
. Analysis of the structure of native urine facies (N-facies) showed that in all examined patients they were completely covered with salt crystals, which corresponded to the physiological state of the body. Steam jet treatment of urine N-facies revealed organic (non-mineralized) inclusions in 23 patients, and a marker of bacteriuria was detected in 9 patients. The study of urine facies with the Lithos protein reagent (LR-facies) showed that the Lithos-reagent protein dissolves organic inclusions and they cease to appear in LR-facies. In 15 patients, organo-mineral microaggregates were detected in the marginal zone of the LR-facies of urine. After exposure to steam, these microaggregates disappeared in 7 patients, and remained in 8. In 9 patients, in whose N-facies, after steaming, a marker of bacteriuria was manifested, in the LR-facies of urine of 7 patients, a marker of candidiasis was detected.
Conclusion
. The study of the structure of urine facies before and after their treatment with boiling water steam makes it possible to identify hidden forms of renal pathology: insufficient filtration capacity of the kidneys, the risk of nephrolithiasis, bacterial and fungal infection. The data obtained make it possible to ensure timely prevention and treatment in the early stages of the disease.