Urinalysis e. What does a urinalysis show? Mixed connective tissue disease

Urine is a metabolic product formed in the kidneys as a result of filtration of the liquid part of the blood, as well as the processes of reabsorption and secretion of various analytes. It consists of 96% water, the remaining 4% are nitrogenous products of protein metabolism dissolved in it (urea, uric acid, creatinine, etc.), mineral salts, and other substances.

A general urine test in children and adults includes an assessment of the physicochemical characteristics of urine and sediment microscopy. This study allows you to evaluate the function of the kidneys and other internal organs, as well as to identify the inflammatory process in the urinary tract

Physical and chemical studies of urine include an assessment of the following indicators:

• color;
• transparency of urine;
• specific gravity (relative density);
• protein concentration;
• glucose concentration;
• bilirubin concentration;
• urobilinogen concentration;
• concentration of ketone bodies;
• nitrite concentration;
• hemoglobin concentration.

Microscopy of the urinary sediment includes the evaluation of the following objects:

Assessment of the physical properties of urine, such as odor, color, turbidity, is carried out by an organoleptic method. The specific gravity of urine is measured using a urometer, refractometer, or evaluated by the methods of "dry chemistry" (test strips) - visually or on automatic urine analyzers.

urine color

In an adult, urine is yellow. Its shade can range from light (almost colorless) to amber. The saturation of the yellow color of urine depends on the concentration of substances dissolved in it. With polyuria, urine has a lighter color, with a decrease in diuresis, it acquires a rich yellow hue. The color changes when taking medications (salicylates, etc.) or eating certain foods (beets, blueberries).

Pathologically changed color of urine occurs when:

• hematuria - a type of "meat slop";
• bilirubinemia (beer color);
• hemoglobinuria or myoglobinuria (black color);
• leukocyturia (milky white).

Urine clarity

Normally, freshly collected urine is completely transparent. Turbidity of urine is due to the presence in it of a large number of cell formations, salts, mucus, bacteria, and fat.

The smell of urine

Normally, the smell of urine is mild. When urine is decomposed by bacteria in the air or inside the bladder, for example in the case of cystitis, an ammonia smell appears. As a result of putrefaction of urine containing protein, blood or pus, for example, with bladder cancer, the urine acquires the smell of rotten meat. If there are ketone bodies in the urine, the urine has a fruity odor, reminiscent of the smell of rotting apples.

Urine reaction

The kidneys excrete “unnecessary” substances from the body and retain the necessary substances to ensure the exchange of water, electrolytes, glucose, amino acids and maintain acid-base balance. The reaction of urine - pH - largely determines the effectiveness and specificity of these mechanisms. Normally, the reaction of urine is slightly acidic (pH 5.0–7.0). It depends on many factors: age, diet, body temperature, physical activity, kidney condition, etc. The lowest pH values ​​​​are in the morning on an empty stomach, the highest - after eating. When eating predominantly meat food, the reaction is more acidic, when eating vegetable food, it is alkaline. With prolonged standing, urine decomposes, ammonia is released and the pH shifts to the alkaline side.

An alkaline urine reaction is characteristic of chronic urinary tract infections, and is also noted with diarrhea and vomiting.

The acidity of urine increases with fever, diabetes, tuberculosis of the kidneys or bladder, kidney failure.

Specific gravity (relative density) of urine

Relative density reflects the functional ability of the kidneys to concentrate and dilute urine. Normally functioning kidneys are characterized by wide fluctuations in the specific gravity of urine during the day, which is associated with the periodic intake of food, water and fluid loss by the body. The kidneys under various conditions can excrete urine with a relative density of 1.001 to 1.040 g/ml.

Distinguish:

• hypostenuria (fluctuations in the specific gravity of urine less than 1.010 g / ml);
• isostenuria (the appearance of a monotonous nature of the specific gravity of urine corresponding to that of primary urine (1.010 g / ml);
• hyperstenuria (high values ​​of specific gravity).

The maximum upper limit of the specific gravity of urine in healthy people is 1.028 g / ml, in children - 1.025 g / ml. The minimum lower limit of the specific gravity of urine is 1.003–1.004 g/ml.

To assess the chemical composition of urine, as a rule, diagnostic test strips (the "dry chemistry" method) produced by different manufacturers are currently used. The chemical methods used in the test strips are based on color reactions that give a change in color of the test area of ​​the strip at different concentrations of the analyte. Color change is determined visually or by reflectance photometry using semi-automatic or fully automated urine analyzers, the results are evaluated qualitatively or semi-quantitatively. If a pathological result is found, the study can be repeated using chemical methods.

Protein

The protein is normally absent in the urine or present in a concentration undetectable by conventional methods (traces). There are several types of proteinuria (the appearance of protein in the urine):

• physiological (orthostatic, after increased physical activity, hypothermia);
• glomerular (glomerulonephritis, the action of infectious and allergic factors, hypertension, decompensation of cardiac activity);
• tubular (amyloidosis, acute tubular necrosis, interstitial nephritis, Fanconi syndrome).
• prerenal (multiple myeloma, necrosis of muscle tissue, hemolysis of red blood cells);
• postrenal (with cystitis, urethritis, colpitis).

Glucose

Normally, there is no glucose in the urine. The appearance of glucose in the urine can have several reasons:

• physiological (stress, intake of an increased amount of carbohydrates);
• extrarenal (diabetes mellitus, pancreatitis, diffuse liver damage, pancreatic cancer, hyperthyroidism, Itsenko-Cushing's disease, traumatic brain injury, strokes);
• renal (renal diabetes, chronic nephritis, acute renal failure, pregnancy, phosphorus poisoning, certain drugs).

Bilirubin

Bilirubin is normally absent in the urine. Bilirubinuria is detected in parenchymal lesions of the liver (hepatitis), obstructive jaundice, cirrhosis, cholestasis, as a result of the action of toxic substances.

Urobilingen

Normal urine contains a low concentration (traces) of urobilinogen. Its level increases sharply with hemolytic jaundice, as well as with toxic and inflammatory lesions of the liver, intestinal diseases (enteritis, constipation).

Ketone bodies

Ketone bodies include acetone, acetoacetic and beta-hydroxybutyric acids. An increase in the excretion of ketones in the urine (ketonuria) appears when there is a violation of carbohydrate, lipid or protein metabolism.

Nitrites

Nitrites are absent in normal urine. In the urine, they are formed from nitrates of food origin under the influence of bacteria, if the urine has been in the bladder for at least 4 hours. The detection of nitrites in properly stored urine specimens is indicative of urinary tract infection.

Hemoglobin

Normally absent in urine. Hemoglobinuria - the result of intravascular hemolysis of red blood cells with the release of hemoglobin - is characterized by red or dark brown urine, dysuria, and often back pain. With hemoglobinuria, there are no erythrocytes in the urine sediment.

Microscopy of urine sediment

The urine sediment is divided into organized (elements of organic origin - erythrocytes, leukocytes, epithelial cells, cylinders, etc.) and unorganized (crystals and amorphous salts).

Research methods

The study is carried out visually in a native preparation using a microscope. In addition to visual microscopic examination, research is used with the help of automatic and semi-automatic analyzers.

red blood cells

During the day, 2 million erythrocytes are excreted in the urine, which, when examining the urine sediment, is normally 0-3 erythrocytes in the field of view for women and 0-1 erythrocytes in the field of view for men. Hematuria is an increase in red blood cells in the urine above the specified values. Macrohematuria is distinguished (urine color is changed) and microhematuria (urine color is not changed, erythrocytes are detected only with microscopy).

In the urinary sediment, erythrocytes can be unchanged (containing hemoglobin) and altered (devoid of hemoglobin, leached). Fresh, unchanged erythrocytes are characteristic of urinary tract lesions (cystitis, urethritis, stone passage).

The appearance of leached erythrocytes in the urine is of great diagnostic value, because they are most often of renal origin and occur in glomerulonephritis, tuberculosis, and other kidney diseases. To determine the source of hematuria, a three-cup sample is used. When bleeding from the urethra, hematuria is greatest in the first portion (unchanged erythrocytes), from the bladder - in the last portion (unchanged erythrocytes). With other sources of bleeding, erythrocytes are distributed evenly in all three portions (leached erythrocytes).

Leukocytes

Leukocytes in the urine of a healthy person are contained in a small amount. The norm for men is 0-3, for women and children 0-6 leukocytes per field of view.

An increase in the number of leukocytes in the urine (leukocyturia, pyuria) in combination with bacteriuria and the presence of clinical symptoms indicates an inflammation of an infectious nature in the kidneys or urinary tract.

epithelial cells

Epithelial cells are almost always found in the urinary sediment. Normally, in the analysis of urine, no more than 10 epithelial cells in the field of view.

Epithelial cells have different origins:

• squamous epithelial cells enter the urine from the vagina, urethra, their presence has no special diagnostic value;
• transitional epithelial cells line the mucous membrane of the bladder, ureters, pelvis, large ducts of the prostate gland. The appearance in the urine of a large number of cells of such an epithelium can be observed with urolithiasis, neoplasms of the urinary tract and inflammation of the bladder, ureters, pelvis, large ducts of the prostate gland;
• cells of the renal epithelium are detected with damage to the parenchyma of the kidneys, intoxication, febrile, infectious diseases, circulatory disorders.

cylinders

A cylinder is a protein coiled in the lumen of the renal tubules and includes any contents of the lumen of the tubules in its matrix. The cylinders take the shape of the tubules themselves (cylindrical impression). Normally, there are no cylinders in the urine sample taken for general analysis. The appearance of cylinders (cylindruria) is a symptom of kidney damage.

There are cylinders:

• hyaline (with the imposition of erythrocytes, leukocytes, renal epithelial cells, amorphous granular masses);
• granular;
• waxy;
• pigment;
• epithelial;
• erythrocyte;
• leukocyte;
• fat.

unorganized sediment

The main component of unorganized urine sediment are salts in the form of crystals or amorphous masses. The nature of the salts depends on the pH of the urine and other properties of the urine. For example, with an acidic reaction of urine, uric acid, urates, oxalates are detected, with an alkaline reaction of urine - calcium, phosphates, ammonium urate. The unorganized sediment has no special diagnostic value; indirectly, one can judge the patient's tendency to urolithiasis. In a number of pathological conditions, crystals of amino acids, fatty acids, cholesterol, bilirubin, hematoidin, hemosiderin, etc. may appear in the urine.

The appearance of leucine and tyrosine in the urine indicates a pronounced metabolic disorder, phosphorus poisoning, destructive liver disease, pernicious anemia, leukemia.

Cystine - a congenital disorder of cystine metabolism - cystinosis, cirrhosis of the liver, viral hepatitis, hepatic coma, Wilson's disease (congenital defect of copper metabolism).

Xanthine - xanthinuria is due to the absence of xanthine oxidase.

bacteria

Normally, the urine in the bladder is sterile. When urinating, microbes from the lower urethra enter it.

The appearance of bacteria and leukocytes in the general analysis of urine against the background of symptoms (dysuria or fever) indicates a clinically manifest urinary infection.

The presence of bacteria in the urine (even in combination with leukocytes) in the absence of complaints is regarded as asymptomatic bacteriuria. Asymptomatic bacteriuria increases the risk of urinary tract infection, especially during pregnancy.

yeast mushrooms

The detection of fungi of the genus Candida indicates candidiasis, which occurs most often as a result of irrational antibiotic therapy, the use of immunosuppressants, and cytostatics.

In the urine sediment, eggs of the blood schistosome (Schistosoma hematobium), elements of the echinococcal bladder (hooks, scolexes, brood capsules, fragments of the membrane of the bladder), migrating larvae of the intestinal acne (strongylides), washed with urine from the perineum of the oncosphere teniid, pinworm eggs (Enterobius vermiсularis ) and pathogenic protozoa - Trichomonas urogenitalis, amoeba (Entamoeba histolitika - vegetative forms).

Sample collection and storage conditions

For general analysis, a morning portion of urine is collected. Urine collection is carried out after a thorough toilet of the external genital organs without the use of antiseptics. For the study, freshly collected urine is used, which was stored for no more than four hours before analysis. The samples are stable at a temperature of 2–8 °C for no more than 2 days. The use of preservatives is not recommended. Before the study, urine is thoroughly mixed.

The results of a general urine test (OAM) can tell a lot about the state of the internal organs, especially the excretory system. What elements should be present in the urine, and the presence of which leads to diseases?

To learn about the state of internal organs, processes inside the body, various tests are prescribed.

A general urine test helps to understand why a person has certain problems in the functioning of the urinary system. It shows how the disease progresses. With its help, the specialist evaluates the development of the pathological process, whether there are complications, and whether the prescribed treatment is suitable.

The subject of this article will be what is oam in medicine, deciphering the results of a general urine test in adults in the form of a table, as well as normal indicators.

What is OAM?

Key points:

1. A urinalysis is not the same as drug testing or pregnancy tests.
2. A complete urinalysis (CUA) is often used as a preventative screening during pregnancy, before a patient has surgery, or as part of a routine medical or physical examination.
3. The test is carried out in a laboratory in a doctor's office, in a hospital, or at a specialized testing facility.

Urinalysis is a laboratory test. Helping your doctor find problems with your body.

Many diseases and disorders affect how your body removes waste and toxins. The excretory system includes your lungs, kidneys, urinary tract, skin, and bladder.

Problems with any of these body parts can affect the appearance, concentration, and content of your urine.

The UAM is not a drug or pregnancy test, although all three tests include a urine sample.

Norm and interpretation of the results: table

The table shows the indicators of the general analysis of urine in the norm in adults, in the presence of any deviations, it is necessary to decipher.

Any urinalysis result should be discussed with the attending physician to make decisions about further treatment. The final conclusions about the state of health are made only by a specialist.

Parameters by which urine is deciphered (OAM)

In adults, urine is examined in several ways. The norm and pathology will be considered below.

Urine color index

With the breakdown of hemoglobin, after several transformations, the substance urochrome (a derivative of bile pigments) is obtained, which gives color to the urine. This pigment normally gives the liquid a yellow color with different shades.

Most often, this indicator is in men. But sometimes a precipitate forms when salts, phosphates, oxalates are detected.

If the urine is light, then the person does not have a lack of fluid. In the case of a dark yellow hue, a sharp loss of fluid from the body is possible, as a result

• edema;
• vomiting
• diarrhea.

The color of urine changes as a result of the use of coloring foods and medicines.

Transparency score

The norm in adult patients is completely transparent urine. If it is cloudy, this is due to several reasons:

• various microorganisms accumulate in the urine, cells that normally should not be in it: leukocytes, pus, epithelial particles, bacteria;
• the ingress of a large amount of salts into the biological fluid;
• if the urine becomes cloudy after a certain time, when it stands for a while, this indicates that there are actively multiplying bacteria in it.

Density index

Specific gravity, also called urine density, depends on how much liquid a person consumed during the day. If there are chronic diseases of the excretory system, the density will decrease significantly.

This indicator depends on the release of electrolytes (calcium, sodium and potassium), as well as processed substances. It is they who show whether all the organs of the excretory system are working correctly.

The norm for adults is the density of urine: 1003 - 1035 g / l. If the OAM results differ from the norm, this indicates the following pathologies:

• High values observed with nephrotic syndrome or (then there will be protein in the field of view), sudden loss of fluid in the body, intravenous injections of certain drugs, increased blood sugar without the use of hypoglycemic drugs, toxicosis during the period of bearing a child, minimal fluid intake during the day.
• Low values are detected with the development of diabetes mellitus, pathological processes of the kidney tubules, heavy drinking during the day or taking diuretic medications, kidney failure in a chronic form.

Urine pH

Deciphering the analysis of urine contains a pH indicator. What does it mean for an adult? This is the reaction or acidity of the biological fluid. It fluctuates significantly throughout the day, depending on the food consumed.

An indicator of the acidity of urine is important when examining it for the likelihood of stone formation. The doctor determines the nature of salt formation, which stones are formed: uric acid, oxalate or phosphate.

Normally, this indicator has the following range of values: from 4.5 to 8. The ideal option is 5-6.

The pH rises when:

• constant consumption of vegetables and fruits (containing acids and fiber);
• with constant vomiting;
• infections that break down urea;
• neoplasms on the organs of the genitourinary system;
• decrease in the functionality of the parathyroid gland;

The values ​​of this indicator decrease when:

• frequent liquid bowel movements;
• hypoglycemia;
• intentional prolonged refusal of food;
• protein diet;
• lack of fluid in the body;
• elevated body temperature;
• diabetes mellitus and;
• use in the treatment of ascorbic acid and methionine.

The presence of protein in the urine

Useful information for a doctor about the capabilities of the kidneys is provided by a urinalysis, the norm of this indicator is up to 0.14 g / l.

Detection of protein in the urine of healthy people is possible if a person experienced severe stress or froze the day before. Traces of protein are noticed during the study if the person did not wash the dishes enough to collect the analysis or with poor personal hygiene.

It is important that this indicator does not exceed the reference value.

If the protein is detected and the value is above the norm, this indicates that pathological processes are occurring in the body associated with the development of such diseases:

• glomerulonephritis;
• causing kidney failure;
• malignant neoplasms of the urinary tract;
• impaired absorption in the tubules of the kidneys;
• nephrosclerosis;
• hypertension (high blood pressure);
• sickle cell

Parameters of glucose (sugar) in the urine

This value indicates how much glucose is excreted in the body fluid. Moderately glucose in the urine is detected with excessive consumption of sugary foods before taking the test.

This indicator is important in determining diabetes mellitus, inflammation of the pancreas, various types of tumors, diseases of the thyroid gland, adrenal glands.

For an accurate result on suspicion of diabetes mellitus, a urinalysis is best done along with blood tests.

In the results of the study - from 0.1 to 0.8 mmol / l.

With a high value, additional diagnostics are carried out to determine diseases such as dumping syndrome, acute, chemical poisoning, diabetes mellitus, and some other diseases.

Medications can also increase the amount of glucose in the body.

Urinalysis also helps to determine the norm of the liver indicator - - its absence in the urine.

If it is determined, this indicates problems with the outflow of bile or liver tissue damage. In addition, bilirubin in the biological fluid can be detected when:

• hemolytic anemia;
• resorption of bruises (hematomas);
• exposure to toxins in the form of alcohol;
• infectious pathologies of the liver.

Detection of ketone bodies in urine

As a result of the breakdown of fatty acids entering the body, acetone and acids are released. This indicator shows the work of the endocrine system, the implementation of the functions of the digestive tract. Norm in adult patients: 0-0.5 mmol / l.

The number of ketone bodies is of decisive importance in the therapy prescribed for diabetes mellitus. This value indicates the extent to which sugar affects the internal organs.

In the extreme case, an increased concentration of ketone bodies leads to disruption of the central nervous system and coma against the background of a sharp increase in sugar in the body.

These elements can occur in the urine due to:

• alcohol intoxication;
• impaired perception of insulin by the body or its overdose;
• prolonged refusal of any food;
• lack of carbohydrates;
• severe fever and eclampsia.

Presence of hemoglobin

Deciphering a urine test is important for examining a biological fluid for the presence of hemoglobin. Normally, this substance is absent. In the results of the analysis should be written: "not detected."

In the presence of this substance in the urine, only a doctor should draw conclusions about the patient's state of health. This result appears in complex diseases accompanied by the release of hemoglobin or muscle necrosis.

If hemoglobin or myoglobin is still found in the biological fluid, the following diseases are suspected in a person:

• burn;
• severe hemolytic anemia;
• chemical poisoning;
• myopathy;
• damage to muscle tissue;
• excessive physical activity and training (the last 4 occur when myoglobin is detected).

Should there be nitrites?

The norm for this indicator is the complete absence of this substance. Due to the content of urine in the bladder for a period of 4 hours, bacteria act on the fluid.

Microscopy of residual urine

To examine the biological fluid for the content of body cells, the method of analyzing urine sediment under a microscope is used. Ten ml of urine is run through a centrifuge and the content below the following components is determined.

• red blood cells . These are the cells that color the blood. Normally, there should be up to 2 cells per µl. To exclude the mechanical entry of blood cells into the urine, it is better for women to refrain from this analysis during menstruation.
• Leukocytes . At elevated values, an inflammatory pathological process is observed in the organs of the excretory system. When collecting biological fluid for analysis, leukocytes can enter their external genitalia if they are inflamed. The norm in men is less than 3 in the field of view, in women: less than 5.
• epithelium (squamous) - a large number indicates the presence of infection. Its normal content is less than 5 in women and less than 3 in men.
• cylinders – casts of the renal tubules, show insufficient functioning of the kidneys due to some disease conditions. Normally, they are not found.
• crystals normally not found. These are compounds of salts that are formed due to the increased content of ampicillin and sulfonamides.

After urinalysis

Abnormal urine results usually require additional screening methods to adequately determine the cause. They may include:

• imaging studies, such as computed tomography or MRI;
• comprehensive metabolic panel (CMP);
• urine culture;
• complete blood count (CBC);

How to prepare for the analysis?

Urine in humans is sterile, but before it gets into the dishes for laboratory research, it can be contaminated by the person himself. Therefore, it is important to observe the rules of personal hygiene as much as possible so as not to affect the results of the analysis.

To collect biological fluid, you must:

• properly clean the external genital organs, women need a sterile piece of cotton wool (tampon) dipped in soapy water, treat the vagina from top to bottom, men need to wash the end of the urethra with soap;
• wait for morning urine with a break of 6 hours from the previous trip to the toilet;
• when urinating, the first thing that comes out is the dead cells of the channel through which urine flows, so you need to flush the first portion of the liquid into the toilet;
• in order to prevent changes in the result of the analysis, sterile dishes should be taken; it is impossible to take liquid for research from an intermediate container, for example, a pot;
• it is better to send the collected liquid to the laboratory immediately, try not to expose it to sunlight;
• before collecting biological fluid, it is not recommended to eat foods that change the color of urine, such as beets.

Also, tell your doctor about any medications or supplements you are taking. Medications or dietary supplements that may interfere with urinalysis results:

• vitamin C;
• metronidazole;
• riboflavin;
• anthraquinone laxatives;
• methocarbamol;
• nitrofurantoin.

Video about OAM indicators

Interesting

Deciphering the general analysis of urine, with the advent of more advanced medical devices, has become difficult, without special skills and knowledge. Take your analysis in hand, what do you see? Personally, I see a lot of English letters. Everyone who reads this article will be able to understand what they mean, we will give explanations of "incomprehensible abbreviations", as well as the norms and deviations of each of the indicators.

Abbreviations used in the general analysis of urine:

• BLd - erythrocytes;
• Bil - bilirubin;
• Uro - urea;
• KET - ketones;
• PRO - protein;
• NIT - nitrites (in the usual sense - bacteriuria);
• GLU - glucose;
• pH - acidity;
• S.G - density;
• LEU - leukocytes;
• UBG - urobilinogen.

1. Erythrocytes - in the urine should be absent. If available, re-analysis, observation is required. The urine of women may contain blood that has entered there during the menstrual period, which gives the presence of red blood cells in the urine. Permissible no more than 1-2 erythrocytes in the field of view. An increase in the number of red blood cells in the urine is called hematuria. Its causes are as follows: bleeding into the urinary tract, tumors, stones in the kidneys and ureters.
2. Bilirubin is normally absent in urine. It is detected in parenchymal lesions of the liver (viral hepatitis), mechanical (subhepatic) jaundice, cirrhosis, cholestasis. In hemolytic jaundice, urine usually does not contain bilirubin. It should be noted that only direct (bound) bilirubin is excreted in the urine.
3. Ketones - the presence of ketone bodies in the urine (acetone) - are normally absent, if ketone bodies are detected, diabetes mellitus, starvation, lack of carbohydrates, hyperinsulism can be assumed. Occurs with the intensive consumption of body fat reserves. To the attention of those who are losing weight and starving! - can lead to hyperglycemic coma. In fact, 20-50 mg of ketone bodies (acetone, acetoacetic acid, beta-hydroxybutyric acid) are excreted in the urine per day, but they are not detected in single portions. Therefore, it is believed that normally in the general analysis of urine there should be no ketone bodies.
4. Protein - its presence in the urine (normally there is no protein), a sign of kidney pathology. Protein enters the urine with pyelonephritis, nephrotic syndrome, amyloidosis of the kidneys. Protein in the urine can appear from the urinary tract and genital organs during inflammation, with cystitis, vulvovaginitis, prostate adenoma - in these cases it is usually not more than 1 g / l. If the urine of a woman during pregnancy contains protein, then this may be a sign of nephropathy in pregnant women. Normally, the protein content in the urine is so low that it can only be determined by ultrasensitive methods. Sometimes traces of protein are determined, however, this is a borderline condition and requires detailed study. The fact is that traces of protein are acceptable, but only in single analyzes.
5. Nitrites (bacteriuria) - bacteria in the urine are normally absent or determined in small quantities. In a healthy person, the urine in the kidneys and bladder is sterile. When urinating, microbes from the lower urethra enter it, but their number is not more than 10,000 in 1 ml. Therefore, it is considered that bacteria are normal in the general analysis of urine are absent. A large number of bacteria may be evidence of a urinary tract infection. The presence of bacteria indicates infection of the genitourinary system, cystitis, nephritis.
6. Glucose - normally should be absent, in the presence of glucose in the urine, manifestations of diabetes mellitus, receiving a large amount of carbohydrates from food, acute pancreatitis can be suspected.
7. Acidity - the kidneys maintain a blood pH of 5.0-6.0 - a slightly acidic reaction. At a pH greater than 7, hyperkalemia, a deviation in thyroid function, an infection of the urinary system can be assumed, at a pH less than 5, hypokalemia, diabetes mellitus, urolithiasis, and renal failure.
8. Density - with a density of more than 1030, one can assume the presence of glucose (diabetes mellitus), protein (glomerulonephritis), with a density of less than 1010 - renal failure, damage to the renal tubules. Since the density of urine depends on the amount of water drunk, this indicator is not of significant value in the diagnosis.
9. Leukocytes - an increased content of leukocytes in the urine is called leukocyturia, it is also an indicator of nephritis and urethritis. This condition is observed in various inflammatory diseases of the urinary system. Too pronounced leukocyturia, when the number of these cells exceeds 60 in the field of view, is called pyuria. Almost all diseases of the kidneys and urinary system increase the content of leukocytes in the urine.
10. Urobilinogen - Normal urine contains traces of urobilinogen. Its level increases sharply with hemolytic jaundice (intravascular destruction of red blood cells), as well as with toxic and inflammatory liver damage, intestinal diseases (enteritis, constipation). With subhepatic (mechanical) jaundice, when there is a complete blockage of the bile duct, there is no urobilinogen in the urine. Urobilinogen is formed from direct bilirubin excreted in the bile in the small intestine. Therefore, the complete absence of urobilinogen is a reliable sign of the cessation of bile flow into the intestine.

Below is also a table of normal urinalysis values:

A person often has to take tests to diagnose his body, but he often does not understand what is hidden under the medical concepts of BLD in a urine test. What information can erythrocytes provide, and why are they dangerous to humans? What is it - physiology or pathology? All details are below.

What does a urine test include?

Extrarenal - its appearance is possible with inflammatory processes in the urogenital area, is a consequence of diseases such as urethritis, prostatitis and cystitis.

When erythrocytes are detected in a urine test (BLD trace), the attending physician usually prescribes an additional examination to the patient. With a positive result of the secondary analysis, there will no longer be any doubts about the pathological transformations of the urinary tract and kidneys. The most common disease is hematuria, which is particularly common. The most dangerous form of all of the above is gross hematuria, which is accompanied by pathologies such as:

Malignant tumors of the renal pelvis;

kidney cancer;

Malignant formations in the bladder and ureter;

Renal tuberculosis.

If a person is healthy, then there are no red blood cells in his urine. If they are detected in the urine, it is necessary to conduct repeated tests to refute or confirm the diagnosis.

Deciphering BLD in urine analysis

A person comes to the clinic when something in his condition causes concern. The doctor should immediately write him a referral for tests. The most informative and common is a general urine test, which immediately reflects all the malfunctions in the body. However, an ignorant person is unlikely to be able to understand the terms.

Each indicator has its own norms, BLD in urinalysis is no exception, and if they are all within these limits, then the patient does not need to worry, since there are no pathologies. But if any value is exceeded, we can talk about this or that inflammation.

So, BLD in urine should not be, and in the case of a positive nature of the results with repeated analyzes, the alarm should be sounded and treatment should be started immediately.

What is the reason for the increase in erythrocytes?

If, after a general analysis of urine for red blood cells, a positive result was obtained, then this indicates a number of factors. In this case, pathological transformations in the genitourinary system and in the kidneys can be observed. In addition, the result may be false positive, which is due to the physiological specifics of the human body.

Often, red blood cells are found as a result of dehydration, a lack of fluid in the body. Water deficiency is caused by vomiting, stomach upset.

During physical exertion, athletes lose fluid in large quantities, which can also provoke the appearance of BLD in the urine. After the restoration of water balance in the body, erythrocytes disappear.

The physiological factors that cause BLD CA to appear in the urine test (we considered the norm) are:

The temporary nature of the manifestation of red blood cells in urine, for example, after a person is in a hot shop or in a hot bath, which caused the body to overheat;

Increased physical and mental stress;

Due to the increased content of glucocorticosteroids in the blood, which can often be associated with stress experienced by a person;

When you are in a mountainous area where there is a lack of oxygen;

Poisons and toxins that a person often encounters;

The use of alcoholic products, which causes the risk of vascular spasm, which causes the appearance of red blood cells in the urine after drinking alcohol;

A large number of spices in food.

In addition, urine can turn red not because it contains an excess amount of red blood cells, but because the concentration of hemoglobin in its composition is increased. When hemolysis develops, the erythrocytes contained in the blood are destroyed, and this is typical for defects in the filtration of urine in the kidneys, and everything ends with acute renal failure.

It is worth noting that the human body is unique in the sense that it can adapt to the influence of various factors, and in a number of situations, the detected red blood cells can become a normal indicator for a particular person. Pathologies that cause BLD include the following diseases:

Kidney failure: ten cells;

Vulvitis, inflammation processes in the genital area, in the uterus: up to ten cells;

Cystitis, urolithiasis: 50 r b c / u l;

Diseases of the bladder and kidneys of an oncological nature: 250 r b c / u l. BLD trace-lysed in urinalysis means traces of red blood cells. Normally, they shouldn't be.

If red blood cells rise to two hundred and fifty cells, then this is a serious danger to human life. The patient is urgently hospitalized, additional diagnostics are carried out: biopsy, ultrasound, blood biochemistry, after which a therapeutic course is prescribed.

What else does BLD show in a urinalysis.

Renal type of redness of urine

In this case, urination simultaneously with blood is recorded in the patient against the background of such pathologies of the kidneys as:

Autoimmune disease of the channels and glomeruli of the kidneys with acute or chronic glomerulonephritis;

kidney cancer;

Urolithiasis disease;

Infection with pyelonephritis;

Hydronephrosis;

A stab wound to the renal surface or a significant bruise - in such a situation, blood clots in the urine can take the form of gross hematuria.

Postrenal type

To determine that the symptoms of hematuria in a patient are due precisely to postrenal causes, it is necessary to conduct an examination, as a result of which inflammation in the urethra or in the bladder can be detected:

Due to damage to the mucous membrane of these organs with sand or stones;

Against the background of cystitis, both in women and men;

With neoplasms of an oncological nature;

With hard sexual intercourse, which damages the mucous membrane of the urethra;

Injuries to the urethra or bladder with simultaneous bleeding and damage to blood vessels, which are accompanied by symptoms of gross hematuria.

Erythrocytes in the analysis of urine in children

The norm for children in terms of the number of red blood cells should be no higher than six in the field of view in girls and four in boys. If their content is increased, this is called erythrocyturia. If the urine turns red due to too many red blood cells, then in this case we are talking about hematuria.

Since urine travels a long path during its formation, starting in the kidneys and ending in the urethra, each of the departments along the way can become a source of red blood cells. What does BLD CA 25 ery/ul mean in urinalysis? More on that below.

If there are significant defects in the formation of thrombi and the coagulation system, then the erythrocytes in urine have an extrarenal genesis. They are detected with anemia of the hemolytic type, a low content of platelets or a violation of their activity, hemolytic-uremic syndrome and coagulopathy.

Renal erythrocytes occur in glomerulonephritis, hereditary nephritis, and IgA nephropathy.

If the calyces and pelvis are damaged in case of vascular defects, carcinoma, kidney injuries, in urolithiasis and cystic diseases, then the shape of erythrocytes during microscopy is unchanged, but their number is increased.

Since stones move from the kidneys along with the flow of urine, the urinary tract and its components are damaged: the bladder, ureters, urethra, as a result of which red blood cells appear in the urine.

With acute or chronic rhinitis, after catheterization of the bladder and with urethritis, erythrocytes in the urine may also be elevated. In a urinalysis, BLD CA 25 means there are 25 RBCs per field of view.

Elevated red blood cells in urine in men

In some situations, men (especially the elderly) may need complex therapy for hematuria in the presence of prostate pathologies.

Blood under such circumstances means:

Cancer in the prostate that can cause bleeding.

Inflammatory processes in the prostate, as a result of which red blood cells are mixed with urine. BLD - trace intact - what is it in a urinalysis? This means that there are no red blood cells in the urine, which is good.

Increased red blood cells in women

Women especially often suffer from an excessive concentration of red blood cells in urine if they have problems caused by the pathological processes of the genitourinary system:

If blood is found during urination, one can judge the uterine diseases that provoked bleeding;

Cervical erosion lesions can also cause blood clots in the urine.

In addition, the doctor in the tests may find that not only erythrocytes are elevated, but also leukocytes. This indicates the presence of inflammatory processes in the kidneys.

We reviewed the interpretation of BLD in the general analysis of urine.

When passing a medical examination or the occurrence of any disease, the doctor directs the patient to take a general urine test. This is necessary to establish an accurate diagnosis or early detection of various pathologies. Indeed, despite the fact that urine is produced by the kidneys, it is an indicator of diseases of all organs and systems. And the correct interpretation of the analysis in adults allows you to identify even minor failures, not to mention the most serious diseases.

What urine should be normal

During a general urine test, a laboratory assistant examines the liquid visually, uses various test strips, and carefully examines it under a microscope. After all, the following characteristics have diagnostic value:

• color;
• transparency;
• reaction;
• smell;
• relative density (specific gravity);
• the presence of salts, glucose, protein, etc.

Normal urine is straw yellow and clear. It does not have a pronounced unpleasant odor, but if it stands, it acquires an ammonia smell (it is formed as a result of alkaline fermentation).

The relative density depends on the amount of liquid consumed, the quality of the food, but normally in an adult it is 1010–1030.

The reaction of urine is neutral or slightly acidic. This setting is power dependent. When eating a large amount of meat products, urine becomes alkaline, but plant foods increase its acidity.

Be sure to study whether there are substances in the urine that should not normally be there (glucose, etc.)

The deviation of each of these parameters from the norm signals various pathologies. But it is not enough just to know what kind of urine should be normal. For accurate diagnosis, it is necessary to correctly decipher, as evidenced by the obtained indicators.

Deciphering the physical parameters of urine

The color depends on the relative density: the higher it is, the urine will have a more intense yellow color. This parameter is affected by the presence of red blood cells, pus, bacteria, bile pigments.

A change in the color of urine indicates various diseases:

1. Dark yellow. It happens with severe dehydration (vomiting), accompanied by congestion in the kidneys, edema.
2. Pale yellow color is typical for and.
3. Urine acquires a greenish-yellow, brown hue due to the presence of bile pigments, with pathology of the liver and gallbladder. If the liquid has the color of beer, the doctor will suspect parenchymal jaundice, and a greenish tint indicates medication.
4. The red color occurs due to the presence of blood, with a kidney infarction, renal colic. Often in women, urine acquires this color during menstruation due to mechanical ingress of blood from the perineum during urination. The color of meat slops means that the patient has nephritis. Blood can get into the urine for other reasons.
5. Dark, almost black urine occurs with.

Color is influenced by foods and medicines:

• If the urine has acquired a purple hue, before you go to the doctor, you need to remember if you did not eat beets the day before.
• The pink color is due to aspirin.
• Greenish-blue - when taking methylene blue.
• The use of a decoction on bear ears (bearberry) will give a brown tint.

Therefore, when deciphering the analysis, be sure to pay attention to other indicators.

Often, urine is transparent, and turbidity occurs if it contains salts, mucus, and epithelial cells. Normally, the appearance of a cloudy cloud is acceptable. With a pronounced change in transparency, the precipitate must be examined, it may contain:

• blood cells;
• epithelium;
• bacteria;
• slime;
• salt.

To identify from which part of the urinary tract a cloudy sediment appears, a three-glass sample is prescribed.

The unpleasant smell of urine is an indicator of various pathological processes:

• If it smells, most likely, the metabolism is disturbed, and it is desirable to further examine the pancreas.
• A putrid odor indicates gangrenous changes in the bladder or purulent-inflammatory diseases of the excretory system.
• Just an unpleasant smell occurs if the patient used horseradish, garlic the day before.

The relative density of urine depends on the ratio of the content of liquid, urea and sodium chloride in it. That is why it is less than the norm in violation of the filtration function of the kidneys, renal failure. It increases due to severe dehydration, edema, or in the urine they find:

• glucose;
• protein;
• salt;
• elevated levels of urea and creatinine.

Specific gravity is an indicator of the concentration function of the kidneys. And if it does not meet the norm, the doctor may recommend additional studies (Zimnitsky's test, Folgart's test).

Deciphering chemical indicators

For the timely detection of various pathologies, urine is examined for the presence of elements that normally should not be in it or they are contained in a small amount:

Normally, protein is absent or it is detected in an amount of less than 0.002 g / l (traces). It increases with:

• kidney disease;
• urinary tract pathology.

For diagnosis, it matters which protein was detected. For example, the Bens-Jones protein appears due to Waldenström's macroglobulinemia, and β 2 -microglobulin occurs when the renal tubules are damaged.

Glucose in the urine appears if its concentration in the blood is above 6.5 mmol/L. And this happens when:

• diabetes mellitus;
• brain tumors;
• sepsis.

In healthy people, glucosuria can also occur, but this is due to the abuse of foods containing a lot of sugar, after the administration of adrenaline, or as a result of stress.

Ketone bodies (acetoacetic and β-hydroxybutyric acid, acetone) appear when:

• feverish conditions;
• hypothermia;
• physical activity;
• diabetes.

Massive ketonuria indicates hyperglycemic coma, decompensated severe diabetes mellitus.

In healthy people, ketone bodies are found with malnutrition, if the ratio of consumed fats and carbohydrates does not match.

Bile pigments (bilirubin and urobilinogen) are normally found in small amounts in the urine. Bilirubin is detected when:

• obstructive jaundice;
• cirrhosis of the liver;
• cholestasis.

Normally, it is not detected by conducting a general analysis. But urobilinogen is excreted from the body with urine, and therefore traces of it are found in the liquid. This pigment is absent when the bile duct is blocked. The rise indicates:

• hemolytic jaundice;
• toxic and inflammatory diseases of the liver;
• extensive;
• intestinal diseases (enteritis,).

Conducting a general analysis, determine the presence of red blood cells. Normally they are absent or they are single. Appear due to excessive physical activity, in women during menstruation or due to gynecological diseases. The presence of red blood cells indicates:

• diseases of the kidneys and urinary tract;
• blood clotting disorders;
• heart failure;
• tumors of the intestine;
• malaria;
• smallpox;
• hemorrhagic fever;

Taking medications (sulfonamides, urotropin) leads to the appearance of red blood cells in the urine.

When deciphering the analysis, attention should be paid to other indicators. For example, if an increased number of erythrocytes and erythrocyte cylinders are detected, this indicates intrarenal hematuria. The absence of protein and cylinders indicates an extrarenal cause of the appearance of red blood cells.

Leukocytes are found in normal urine, but their content is not more than 3 (in men) and 6 (in women). High concentration is a consequence of acute inflammatory processes, infectious diseases of the urinary system. The localization of the pathological focus will help to determine a three-cup test. Often, an increase in leukocytes is accompanied by bacteriuria. But if the bacteria are not detected (clean culture), then the patient probably has tuberculosis or lupus nephritis. An increase in leukocytes, protein and cylinders indicates renal pathology.

Leukocytes may increase due to the use of medications:

• aspirin;
• ampicillin.

And also after taking heroin.

Epithelial cells are present in the urine constantly, but in small quantities. An increase occurs when the bladder, pelvis and kidney parenchyma are affected.

Cylinders are cellular or protein casts of the renal tubules. They are of various types and their appearance is associated with certain diseases:

1. Hyaline. Characteristic for organic kidney disease (nephritis, urolithiasis), arterial hypertension, heart failure, heavy metal poisoning, fever. In healthy people appear due to hypothermia, physical stress.
2. Grainy. They indicate damage to the parenchyma of the kidneys, congestive kidney, viral diseases, lead poisoning.
3. Waxy. Found at .
4. Leukocyte. Their appearance is associated with pyelonephritis, lupus nephritis.
5. Erythrocyte. They indicate acute progressive glomerulonephritis, kidney infarction, renal vein thrombosis, polyarthritis, severe arterial hypertension.
6. Epithelial. Appear with necrosis of the kidney. After allotransplantation, their presence indicates rejection.

A small amount of mucus is normal, especially in women. But if there is a lot of it, then you should suspect:

• urethritis;
• urolithiasis.

Salts found in the study of urinary sediment testify to various diseases:

1. Uric acid. Its excessive amount occurs with gout, leukemia, viral hepatitis, chronic nephritis, dehydration, eating meat food.
2. Phosphates. They are found after gastric lavage, overeating, in patients with cystitis,.
3. Oxalates. They are detected if the patient consumes mainly plant foods, with diabetes mellitus, ethylene glycol poisoning, pyelonephritis.

Salts contribute to the development of urolithiasis, so be sure to establish the cause of their appearance, if necessary, adjust the diet.