Urinalysis with microscopy of sediment - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Laboratory

General analdiz urine - routine method of investigation, which is used in the diagnosis and monitoring for a number of diseases, as well as screening examinations.Urine test is one of the most effective methods of diagnosis abnormalities in the kidneys.

Urinalysis includes evaluating the physical and chemical characteristics and urine sediment microscopy.The general analysis of urine in patients with kidney disease and urinary tract is performed repeatedly over time to assess and monitor therapy.Healthy Individuals are advised to carry out this analysis of 1 - 2 times a year.

Do not underestimate its value to identify other abnormalities in the body of modern man.This disease and inflammation of the urinary tract (study on a weakly acid, neutral or alkaline), urinary system (increased levels of white blood cells), urolithiasis (occurrence of red blood cells in the sample), diabetes (presence of glucose urine), stagnant processes (presence of mucus) and much more.

There is no doubt that such a serious

kind of urine analysis studies should be carried out with utmost precision, using modern equipment and a properly prepared material.

define the general properties of the urine (color, clarity, specific gravity, pH, protein, glucose, bilirubin, urobilinogen, ketones, nitrites, hemoglobin);Microscopy

urinary sediment (epithelium, erythrocytes, leukocytes, cylinders, bacteria, salt).

Rules urine collection

mayonnaise jars for analysis of urine and other "classic" packaging polyclinics and folklore irrevocably receding into the past.To gather the material necessary to use a special sterile containers and preservatives.Thus, minimizing the chances of getting the sample of foreign matter, as well as significantly increasing acceptable quality of urine analysis, the term transport of the sample from the patient to diagnostic equipment.

Next - Preparations for the collection of material.Rules of personal hygiene at this moment are not just desirable, but mandatory: in urine should not be there, either sweat or sebaceous glands.Antibacterial soap is not recommended in this case.Urine without additives - the result of the study with no errors.It is necessary to mention another form of impurities that can skew the results of the analysis of urine: food and medicines.The night before, should not be used in food beets, carrots and other natural dyes.Remember that one of the main parameters of the study - the color of urine.And, if it is different from the norm, which is considered to be yellow color and its shades, let him give information not only about what you had dinner.

note that the violation of the norms of pigments present can make the urine color is completely unexpected - blue, brown, red and even green.

dark urine may indicate violations of the liver, in particular with the disease hepatitis.The liver ceases to destroy one of the enzymes, which reacts with the air and gives a color change.If urine

flushed likely to present blood in it.If resembles watered milk - it has a surplus of body fat.Grayish hue gives it contained pus.Green or blue - one of the hallmarks of the processes of decay in the gut.Frothy urine occurs only in men.Nothing wrong there: it happens when it gets sperm.And, for example, wet dreams or sperm overabundance no one has learned not control.

Medicines.Even innocuous aspirin in large doses can paint the urine pink.Especially on the eve of receiving the undesirable delivery of the analysis of urine antibacterial drugs and uroseptikov.Consult your doctor about a pause in their application.Except when the main subject of study is just the concentration of drug in the urine.

Alcohol greatly distorts the results of a urine test.

Try to drink no more than on the eve of a urine test and not less liquid than usual.

12 hours before taking the sexual life analysis is not live.

Note also that undesirable to pass urine during menstruation and within a week after procedures such as cystoscopy.

Remember that the main role in diagnosis (eg, "inflammation in the genitourinary system") plays the very presence / absence of bacteria in the urine, and their increased amount of: a characteristic increase compared with the norm (2000 bacteria in 1 ml)50 times (up to 100 tysyach bacteria in 1 ml of urine).

urinalysis prescribed for:

- diseases of the urinary system;
- screening on prophylactic examinations;
- to assess the course of the disease, control over the development of complications and the effectiveness of the treatment.
- Persons who have suffered streptococcal infection (tonsillitis, scarlet fever) is recommended to give a urine sample within 1 - 2 weeks after recovery.Healthy people we recommend to pass urine 1-2 times a year.Remember, prevention is always more expensive treatment.

Collecting urine for general analysis training.

Before collecting the urine required hygienic procedures that have not been put in urine bacteria sebaceous and sweat glands.

Gather strictly morning portion of urine allocated immediately after sleep, preferably an average serving.The interval between the collection of urine and delivered to the laboratory material should be as small as possible.

urine collection using a special kit (sterile container and vial with a preservative), which, together with instructions for collection must be pre-purchased at any medical office invitro under the collateral value.

urine in a test tube with preservative taken throughout the day (according to the schedule of delivery of blood tests).

Indications

  • diseases of the urinary system.
  • Screening at prophylactic examinations.
  • Evaluation of the disease, control of complications, and the effectiveness of the treatment.
  • Persons who have suffered streptococcal infection (tonsillitis, scarlet fever) is recommended to give a urine sample within 1 - 2 weeks after recovery.

Decoding results urinalysis

urine color.

Normally urochrome urine pigment gives urine a yellow coloring of different shades, depending on the degree of saturation of urine.Sometimes only the color of the sediment may vary: for example, an excess of urate sediment has a brownish color, uric acid - yellow, phosphates - whitish.
Increase color intensity - a consequence of the loss of body fluids: edema, vomiting, diarrhea.
Change the color of urine may be the result of selection of coloring compounds formed during the organic changes, or under the influence of diet components, taking the medicine, contrast agents.

urine color condition Colorants
Straw yellow swelling, burns, vomiting, diarrhea, congestive edema in heart failure -
Dark yellow swelling, burns, vomiting, diarrhea, congestive edema in heart failure large concentration urochrome
pale, watery, colorless diabetes insipidus, a reduced concentration of kidney function,
receiving diuretics, hyperhydration
Low concentration urochrome
Yellow-orange Admission vitamins, furagin -
Reddish pink eating brightly colored fruit and vegetables, such as beets, carrots, blueberries;medicines - antipyrine, aspirin -
Red Renal colic, kidney, heart attack presence of red blood cells in urine - fresh hematuria, presence of hemoglobin, porphyrin, myoglobin
«meat slops" Color Acute glomerulonephritis hematuria (the changed blood)
Dark brown Hemolytic anemia urobilinuria
Maroon Admission metronidazole, sulfonamides, drugs based on bearberry.Poisoning by phenols -
Black disease Marchiafawa-Michelli (paroxysmal nocturnal hemoglobinuria)
homogentisuria.Melanoma
Hemoglobinuria
alcapton
Melanin (melanuriya)
beer color
(yellow-brown)
hepatocellular jaundice
(hepatitis)
bilirubinuria, urobilinogenuriya
Greenish-yellow
Mechanical(obstructive) jaundice - cholelithiasis,
cancer of the pancreatic head
bilirubinuria
whitish presence of phosphates or lipids in the urine -
Milk kidney limfostazom, infection of the urinary tract chyluria, Piura

Transparency urine

Reference Range: complete.
Turbidity incontinence can result from the presence in urine of erythrocytes, leukocytes, epithelial, bacteria, fat droplets falling into salts precipitate (urate, phosphates, oxalates) and depends on the salt concentration, pH, and urine storage temperature (low temperature favors salt precipitation of).Prolonged standing urine may become turbid as a result of the growth of bacteria.Normally, small turbidity may be caused by the epithelium and mucus.

Relative density (specific gravity) of the urine

Relative density (specific gravity) of the urine is dependent on the selected number of organic compounds (urea, uric acid, salts) and electrolyte - Cl, Na and K, and the number of released water.Diuresis higher, the smaller the relative density of urine.The presence of protein and especially of glucose causes an increase in urine specific gravity.Reducing the concentration of kidney function in patients with renal insufficiency leads to lower specific gravity (gipostenuriya).Complete loss of function of the concentration leads to the equalization of the osmotic pressure of plasma and urine, a condition called izostenuriey.

Reference Range (for all ages): 1003 - 1035 g / l.

Increasing the relative density (baruria):

  1. glucose in the urine with uncontrolled diabetes;
  2. protein in the urine (proteinuria), glomerulonephritis, nephrotic syndrome;
  3. drugs and (or) their metabolites in the urine;
  4. intravenous mannitol, dextran or radiopaque agents;
  5. low fluid intake;
  6. large fluid losses (vomiting, diarrhea);
  7. toxemia of pregnancy;
  8. oliguria.

Reduced relative density:

  1. diabetes insipidus (nephrogenic central or idiopathic);
  2. chronic renal failure;
  3. acute renal tubular damage;
  4. polyuria (as a result of receiving diuretics, plentiful drink).

urine pH.

Fresh urine of healthy people may have a different reaction (pH 4.5 to 8), urine is usually slightly acidic reaction (pH between 5 and 6).Fluctuations in the pH of the urine due to the composition of food: meat diet causes acidic urine, the predominance of plant and dairy food leads to alkalization of urine.Changes in urine pH corresponds to the pH of the blood;Acidosis when the urine is acidic, while alkalosis - alkaline.Sometimes there is a discrepancy between these figures.

In chronic lesions of the renal tubules (tubulopathy) giperhlorny acidosis observed in the blood and urine alkaline reaction, due to the violation of the synthesis of acid and ammonia in connection with damage to the tubules.Bacterial decomposition of urea in the ureters or storage of urine at room temperature leads to alkalization of urine.Urine reaction affects the nature of salt formation in urolithiasis: at pH below 5.5 often formed uric acid at pH 5.5 to 6.0 - oxalate at pH above 7.0 - phosphate stones.

Reference Range:

  • 0 - 1 month.- 5.0 - 7.0;
  • 1 month.- 120 years - 4,5 - 8,0

Increase:

  1. metabolic and respiratory alkalosis;
  2. chronic renal failure;
  3. renal tubular acidosis (Type I and II);
  4. hyperkalemia;
  5. primary and secondary hyperparathyroidism;
  6. inhibitors of carbonic anhydrase;
  7. diet rich in fruits and vegetables;
  8. prolonged vomiting;
  9. urinary tract infection caused by microorganisms that break down urea;
  10. administration of certain drugs (adrenaline, nicotinamide, bicarbonate);
  11. neoplasms of the genitourinary system.

Reduction:

  1. metabolic and respiratory acidosis;
  2. hypokalemia;
  3. dehydration;
  4. starvation;
  5. diabetes;
  6. tuberculosis;
  7. fever;
  8. severe diarrhea;
  9. receiving medications: ascorbic acid, corticotropin, methionine;
  10. a diet high in meat protein, cranberry.

protein in the urine (proteinuria).

Protein in urine - one of the most important diagnostic laboratory evidence of kidney pathology.A small amount of protein in the urine (proteinuria physiological) can be in healthy people, but the protein excretion in the urine is less than normally 0.080 g / day alone, and 0.250 g / day during intense physical exertion, after a long walk (march proteinuria).Protein in the urine can also be found in healthy people with strong emotional experiences, colds.Teenagers found orthostatic proteinuria (in the vertical position of the body).After

glomerular membrane normally most of the proteins do not pass because of the large size of the protein molecules, and their charge and structure.With minimal damage in the kidney glomeruli is observed above all the loss of low molecular weight proteins (mainly albumin), so when a large protein loss often develop hypoalbuminemia.In more severe pathological changes in the urine and get the larger protein molecules.The epithelium of the renal tubules physiologically secreted a protein (protein Tamm-Horsfall).Part of urine protein can come from the urinary tract (ureter, bladder, urethra) - the content of these proteins in the urine rises sharply in infections, inflammation or tumors of the urinary tract.Proteinuria (the appearance of protein in the urine in large amounts) can be pre-renal (related to enhanced dissolution of tissue or the appearance of abnormal proteins in the plasma), renal (caused by kidney disease) and postrenal (associated with urinary tract pathology).The appearance of protein in the urine is a common non-specific symptoms of kidney disease.When renal proteinuria Protein is found in both daytime and nocturnal urine.On the mechanism of renal glomerular proteinuria distinguish and tubular proteinuria.Glomerular proteinuria is associated with pathological changes in the barrier function of membranes of kidney glomeruli.The massive loss of protein in the urine (& gt; 3 g / l) is always associated with glomerular proteinuria.Tubular proteinuria is due to violation of the protein reabsorption in the pathology of the proximal tubule.

Reference Range: & lt;0.140 g / l.

presence of protein in the urine (proteinuria):

  1. nephrotic syndrome;
  2. diabetic nephropathy;
  3. glomerulonephritis;
  4. nephrosclerosis;
  5. impaired absorption in the renal tubules (Fanconi syndrome, heavy metal poisoning, sarcoidosis, sickle cell pathology);
  6. myeloma (Bence Jones protein in the urine) and other paraproteinemia;
  7. impairment of renal hemodynamics in patients with heart failure, fever;
  8. malignant tumors of the urinary tract;
  9. cystitis, urethritis and other urinary tract infections.

glucose in the urine.

Glucose in the urine is normal or not is detected in minor amounts, up to 0.8 mmol / m. K. In healthy persons blood glucose after all membrane filtration of renal glomeruli completely absorbed back into the tubules.