Addis-Kakowski test

The Addis-Kakovsky test is a very old but effective method of counting the number of red blood cells – erythrocytes, as well as leukocytes, cylinders (“glued together” by protein formed elements) in urine.

What is the purpose of a study such as the Addis-Kakovsky test?

Many diseases have a latent form, and a person often does not notice threatening symptoms, experiencing only a slight malaise. Any latent ailments related to the kidneys and urinary tract require careful diagnostics, which usually include methods for counting protein compounds, formed elements in the urine. The Addis-Kakovsky test is very similar to another analysis - the Nechiporenko test, but the indicators are calculated based on material collected over a day. During this period, you can see the dynamics and more accurately determine what is more in the urine sediment - erythrocytes or leukocytes.

The history of the development of the method is interesting because back in 1910, the famous doctor of that time, Anton Fomich Kakovsky, proposed an effective method for diagnosing nephritis.

Kakovsky, throughout his entire professional career, sought to find truly effective methods for treating nephropathologies. As an experienced clinician, he suggested that it was necessary to count the number of formed elements in the collected urine throughout the day, starting early in the morning.

Such fractional counting did indeed provide more detailed and accurate information about cell sedimentation. As often happens, at about the same time, on the other side of the planet, the American Addis was also experimenting with urine analysis. And in 1925, taking Kakovsky's method as a basis, he improved it somewhat. Since then, the laboratory began to study material collected not during the daytime, but during the day. Colleagues did not start a battle for the palm, because they were talking about an effective diagnostic measure. And since then, the method has been called by a double name, namely, the Addis-Kakovsky test. Apparently, Addis was placed first according to the alphabet, and not following the chronology of the development of the method.

How is the Addis-Kakovsky test performed?

Urine should be collected over a period of 24 hours, less often over a period of ten hours. Heavy drinking is not recommended, fluid intake remains normal. The only condition that is set for the patient is to avoid urinating at night if possible. The Addis-Kakovsky test involves fractional examination of the material, i.e. urine excreted over a period of 10-15 minutes is taken. Normally, about 4 million white protective blood cells - leukocytes, no more than 2 million red blood cells - erythrocytes and about 20,000 compounds - cylinders should be excreted along with urine per day. If the normal limits are exceeded for one of the categories of formed cells, this signals kidney diseases or infectious diseases of the urinary system.

The Addis-Kakovsky test also helps to identify the predominance of erythrocytes or leukocytes in the sediment. If the white cells exceed normal limits, then most likely this is evidence of pyelonephritis. Leukocytes sometimes reach six million, and this is already a severe form of bacterial infection. Erythrocytes that "go beyond" the normal limits indicate glomerulonephritis, in such cases the red blood cells can reach 5 million.

The Addis-Kakovsky test is a method that has been tested for a century and has never let doctors down. This method has helped in the past and continues to help in making an accurate diagnosis.