American endocrinologist Hirsch Wolf Sulkovich proposed to determine the level of calcium in urine using a reagent containing oxalic acid. Since 1937 this method has been used all over the world. Sulkovich's test is used as a screening test for early diagnosis of endocrine pathologies and disorders of calcium metabolism.
Preparing to collect urine for the Sulkovich screening test
The screening test is performed on a single portion of morning urine. Before collecting the analysis, you must carefully take a hygienic shower. The urine should be collected in a sterile container, which is currently not difficult to buy at any pharmacy.
Before collecting urine, do not eat for 8 hours, smoke, drink tea or coffee. If a baby is being tested, the baby should not be fed for 6 hours.
Under laboratory conditions, the Sulkovich reagent will be added to the urine portion to be examined. The level of calcium salts will be determined visually by the degree of turbidity of the sample and by the amount of undissolved precipitate of calcium oxalate crystals. Depending on this, the laboratory assistant will put a sample of the degree of turbidity from one to 4 crosses. In the absence of turbidity in the screening assay, a minus is set. This is the basis for suspecting a lack of calcium levels. The patient is prescribed an additional differential diagnosis for hypoparathyroidism. The results of a biochemical blood test will help to confirm or deny the suspicion.
Daily collection of urine for diagnostics according to the Sulkovich method
If the screening test shows two to four crosses, the opacity is considered high. The patient is prescribed a daily urine collection. This means that during the day, as a rule, from 8 to 8 in the morning, all portions of urine should be collected in one sterile container, which should be stored in the refrigerator during the entire period of collection of the analysis.
A week before the collection of daily urine according to Sulkovich, the patient needs to cancel diuretics. During the day during the collection of the analysis, the diet of the subject should consist of cereals, boiled in water. You can not use dairy products, tea, coffee, meat, semi-finished products, fruits, vegetables.
After completing the collection of the 24-hour urine test, the entire portion should be thoroughly mixed and poured into a sterile container. The laboratory will record the daily urine volume, height and weight of the patient.
For reliable results, on the basis of which an accurate diagnosis will be made, the doctor must prescribe an analysis to determine the level of calcium in the blood to the patient being examined.
In pediatrics, urine analysis according to Sulkovich is carried out for children with rickets in order to adjust the treatment. In particular, the amount of vitamin D required for additional intake is determined in accordance with the indicators of screening testing of the morning portion of urine according to the Sulkovich method.