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Evaluation of the results of the Zimnitsky

Alexey Portnov, medical expert
Last reviewed: 23.04.2024

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For various diseases in the sample according to Zimnitsky, the following deviations can be detected:

When comparing daily diuresis with the amount of fluid drunk, it may turn out that during the day, not 3/4 (65-80%) of the drunk liquid is discharged with the urine, but much larger or, conversely, less. An increase in diuresis in comparison with the volume of the fluid consumed is observed with the convergence of edemas, a decrease in the swelling of the edemas (regardless of their cause) and due to increased sweating.
Day diuresis and nocturnal diuresis are the same, or even nocturnal diuresis is more than daytime (nocturia). The increase in nocturnal diuresis caused by the intake of liquids at night can occur as an adaptive reaction when the concentration function of the kidneys is limited, as well as in case of heart failure.
The density of urine in all portions may be low, and its fluctuations in individual portions during the day will be less than 0.012-0.016, that is, isostenuria may be detected.

Isostenuria is the most important sign of renal failure and may be in patients with chronic glomerulonephritis, chronic pyelonephritis, sometimes in patients with essential hypertension. In amyloid (or amyloid-lipoid) nephroses, the concentration function of the kidneys can remain undisturbed for a long time, isostenuria appears when the amyloid-wrinkled kidney develops. Isostenuria can occur with hydronephrosis and expressed polycystosis. This is an earlier sign of kidney failure, rather than an increase in creatinine and urea blood, it is possible with their normal content in the blood. It should be remembered that the low density of urine and its small fluctuations during the day can depend on extrarenal factors. So, in the presence of edema, density fluctuations can be reduced. The density of urine in these cases (in the absence of renal failure) is high; hypostenuria is observed only during the period of convergence of edemas (in particular, when using diuretics). With prolonged compliance with protein-free and salt-free diets, the density of urine can also remain low throughout the day.

Low density of urine with small fluctuations (1,000-1,001) with rare up to 1,003-1,004 is observed only in diabetes insipidus, it does not occur in any other diseases, including those with kidney diseases that are deficient in their concentration function. Nicturia can sometimes be due to prostatic hypertrophy of various etiologies.

An increase in the density of urine in all portions causes hypovolemic conditions, uric acid diathesis.

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