Kakovsky-Addis Urine Test.
Kakovsky-Addis urine test is a quantitative method aimed at determining the total number of formed elements (leukocytes, erythrocytes, and casts) in the 24-hour urine volume. The method allows assessment of the degree of inflammation and the nature of urinary system involvement, which is important for differential diagnosis of diseases such as pyelonephritis and glomerulonephritis.
Method overview:
- Urine is collected over 10–12 hours (typically from evening to morning). Before starting, the patient empties the bladder (this portion is not counted), then all urine during the set period is collected into one container.
- The collected urine volume is measured, thoroughly mixed, and a portion is taken for analysis.
- In the laboratory, using a counting chamber (Goryaev, Fuchs-Rosenthal or Bürker), the number of leukocytes, erythrocytes, and casts in the sediment is counted, then recalculated for the entire urine volume collected.
Approximate normal values:
- Erythrocytes — up to 1,000,000 (some sources indicate up to 2–3 million)
- Leukocytes — up to 2,000,000 (other sources up to 4 million)
- Casts — up to 20,000 (other sources up to 100,000)
Indications for the test:
- Detection of hidden leukocyturia and hematuria.
- Differential diagnosis of inflammatory kidney diseases (pyelonephritis, glomerulonephritis).
- Dynamic monitoring of urinary system disease progression.
Preparation and sample collection:
- One day before the test, fluid intake is limited and a meat diet is prescribed to standardize urine density and pH (usually density 1020–1025, pH about 5.5).
- The patient urinates before sleep (this portion is not collected), notes the time, then collects all urine for 10–12 hours, including all intermittent portions.
- Urine is collected in a clean container, stored in a cool place, and delivered to the laboratory no later than 2 hours after collection ends.
- If collection at once is impossible, multiple collections are allowed with mandatory time recording.
Method features:
- The method is labor-intensive and requires strict adherence to urine collection and storage rules.
- Results may be distorted by improper preparation or prolonged urine storage due to degradation of formed elements.
- Primarily used in inpatient settings and when precise quantitative evaluation of cellular elements is needed.
Thus, the Kakovsky-Addis urine test is an important tool for quantitative assessment of cellular elements in urine, helping to clarify diagnosis and monitor the course of kidney and urinary tract diseases.