What does urinalysis mean. General urine analysis in adults: norm and interpretation. Erythrocytes in the analysis of urine in children

Urine is the product of the final filtration by the kidneys, which get into them from the blood of the waste products of the body. With the help of urine, the body is cleansed not only of the decay products of obsolete cells, but also of toxins formed by their decay or introduced from outside. Therefore, the analysis of the composition of urine has a very high information content on the subject of the general condition of the body and its individual systems.

Deciphering the analysis

Like any other, a general urinalysis begins with the preparation of a sample for research. A few simple rules common to children, women and men to consider:

• It is best to take a sample of morning urine - its middle portion;
• Before collecting the sample, the toilet of the genital organs should be carried out;
• Limit physical activity - relevant for active men;
• 2 - 3 days before a general analysis is planned, it is advisable to limit the consumption of fatty, salty and spicy foods, proteins, animal origin, legumes, asparagus, beets, blackberries and other foods with coloring pigments;
• If possible, do not take drugs on the eve of the analysis;
• Collect urine in a sterile container. The best option is a pharmacy plastic container;
• For infants, it is worth buying a special bag - a urinal;
• A urine sample for its general analysis must be in the laboratory no later than 2 hours from the moment it was collected.

It is especially important to follow these rules when conducting a urinalysis in children and pregnant women, since failure to comply with one or more of these conditions is likely to result in false readings. You will have to conduct the study again, which is extremely unpleasant for a woman in position, and in the case of small children, it is completely difficult.

What is examined in the general analysis and what are the normal indicators?

A general study of urine considers a large number of indicators - from color and smell to its chemical and bacteriological composition. More on this below.

Color.

The color norm is determined visually. Urine is colored by the enzymes urochrome and uroerythin, both of which are yellow, so varying shades of yellow are considered normal. It can vary depending on the time of day, diet and, in the case of children, on their age - in infants, urine is almost transparent, and darkens somewhat with age.

With a healthy diet and lifestyle, urine is light yellow. Darkening, in the absence of pathologies, can be caused by its high concentration during dehydration, exposure to dyes contained in foods, medicines (antibiotics, vitamins) or an excess of phenols and bilirubin in the urine. The latter are indicators of toxicosis of a different nature, including alcohol.

A very dark, almost black color may indicate the presence of melanin, hemoglobin or homogentized acid in the urine, and a red tint is observed when blackberries and beets are used on the eve of the analysis.

The degree of transparency.

Urine excreted by a healthy body is absolutely transparent. Sometimes there may be small opacities that are not considered a pathology. This is often observed in men whose work is associated with high physical exertion in rooms with high temperatures, for example, in metallurgical shops.

Highly cloudy urine is a sure sign of unhealthy processes taking place in the ureteral system. The cause of cloudy urine is the excessive penetration of blood cells into it - leukocytes and erythrocytes, the reproduction of pathogenic microflora and salts of various origins dissolved in urine. This condition is especially dangerous for children.

Smell.

Healthy, fresh urine has a faint smell of ammonia. If there is an increase in the sharpness of the smell, the cause of its appearance should be established. These can be both quite normal processes, for example, the consumption of fatty protein and other heavy foods, and pathological processes that require the intervention of a doctor. For example, urine, clearly reeking of acetone, is a faithful companion of diabetes mellitus, and a putrid odor can occur both with excessive consumption of horseradish, garlic and beans, as well as with inflammatory foci of an infectious nature in the ureteral system.

Density or specific gravity.

The density of urine describes the ratio of water in it and organic compounds of salts and acids - electrolytes.

This indicator of the general analysis of urine, unlike the previous ones, is quite clearly expressed in numbers. Normal numbers are 1019 - 1035 grams per liter of liquid. A significant excess of urine density occurs with an increase in the concentration of protein compounds, glucose and metabolites in it, which is characteristic of chronic renal failure.

The density of urine is not a constant value. It changes during the day depending on the composition of the diet and the water balance of the body.

Increased urine density is possible with:

• Diabetes;
• Various toxicoses, including toxicosis of pregnant women;
• Proteinuria and glomerulonephritis;
• nephrosis;
• Intravenous administration of the drug - mannitol;
• Diarrhea, vomiting;
• Insufficient moisture intake;
• With colds in children;
• Large fluid loss due to heavy sweating in hot weather.

Decreased urine density - causes:

• Acute pathology of the tubules of the kidneys;
• Plentiful drink;
• The use of diuretics;
• Central, nephrogenic or idiopathic diabetes;
• Renal failure in the chronic form of the course.

Acidity (pH).

This indicator has 5 main gradations of the studied medium (urine) - acidic, slightly acidic, neutral, slightly alkaline and alkaline. A general analysis of healthy urine should show a slightly acidic reaction - pH = 6. Acidic is urine with a pH of less than 6. This reaction is typical with a predominance of protein products of animal origin in the diet.

An alkaline reaction - a pH above 6 is often observed in lovers of dairy products - in children and vegetarians. Often, such a urine reaction is accompanied by an increased content of potassium in it, which may indicate hyperparathyroidism or renal failure.

The state of dehydration is characterized by a pH value of less than 5. The same indicators are detected with fever.

This indicator of the general analysis of urine is especially important for the predisposition to the formation of urolithiasis. Urine pH less than 5.5 provokes the formation of stones from uric acid salts, pH -5.5 - 6 stones from oxalates, and if the pH is more than 7, it is likely to grow phosphate stones in the kidneys.

Urobilinogen.

The norm of this substance per liter of urine is from 5 to 10 mg.

epithelial cells.

In the urine of a healthy person, there should not be more than 10 such cells in the field of view. The + sign in the analysis says that everything is fine, but if you see +++, be prepared to hear the diagnosis during the examination - jaundice. But the complete absence of epithelium in the urine is often observed in women bearing children with cholestasis.

Ketones.

This term is called - acetoneacetic, beta-hydroxymalar acid and acetone. Normally, these substances should not be in the urine, but if they are detected, they are often diagnosed:

• Fever condition;
• Diabetes;
• Hyperglycemic coma;
• Eclampsia;
• Glycogenoses 1, 2 and 4 types;
• hyperinsulinism;
• Toxicosis, including alcohol.

The last, some men often sin, are excessively fond of drinking. In addition, ketones appear in the urine with prolonged fasting and even with insufficient intake of food rich in carbohydrates.

Cylinders.

These are products of the renal tubules, which are protein structures with a characteristic cylindrical shape. They are distinguished by seven types - waxy, granular, erythrocyte, epithelial, pigment, hyaline and leukocyte.

In the urine, the presence of only hyaline cylinders in small quantities is considered normal, but if a general urinalysis reveals a significant number of cylinders of other types, there is a pathology - cylindruria. This pathology is typical for stagnant processes in the kidneys, nephritis and nephrosis, as well as for infectious inflammation.

Hemoglobin.

It is normal if this substance is not present in the urine.

Indicators requiring special attention

Protein.

Normally, protein in the urine is not detected - its quantitative indicators in it are scanty. A sharp increase in the level of protein in urine is called proteinuria. Causes may be natural - an unbalanced diet, high physical activity, or the influence of drugs, such as:

• Griselfulvin;
• Acetazolamide;
• Amphoteric;
• Aminoglycoside;
• Methicillin;
• Nafcillin;
• Colistin;

Also, serious diseases can also lead to the detection of protein in the urine, therefore, for an accurate diagnosis of the problem, a general analysis is insufficient, additional studies are required. This is especially true for small children.

Glucose.

The norm is its complete absence or no more than 0.8 mmol per liter of liquid. Exceeding this level - glycosuria, carries alarm bells for the development of diabetes mellitus. And if a patient with elevated levels of sugar in the urine also has unquenchable thirst, this only confirms the diagnosis - diabetes.

Bilirubin.

The norm is its complete absence in the urine, and its appearance is often associated with the course of viral hepatitis, cirrhosis of the liver, and even metastatic tumors.

Sediment.

If the sediment is expressed by a small amount of erythrocytes, leukocytes, epithelium and minerals, this does not indicate pathology, but a sediment from pathogenic microorganisms or cylinders is already a problem that requires diagnosis and treatment.

Leukocytes.

The urine of a healthy body should contain no more than 5 pieces of these cells in the field of view in women, 3 or less in men. The condition in which these norms are exceeded is called leukuria, but if the number of leukocytes is 60 or more, they speak of pyuria.

Fungi Candida.

Fungi of this variety in the microflora of a woman's vagina are the norm, but in the urine they should not be at all. If they are nevertheless detected, the most likely reason is a decrease in the overall immunity of the body associated with rehabilitation after suffering serious illnesses. The active use of antibacterial drugs can also cause this phenomenon. Violation of the balance of microflora often provokes the rapid growth of the most tenacious group of microorganisms.

The risk group for a positive urinalysis for the Candida fungus includes patients suffering from chronic forms:

• Urethritis;
• cystitis;
• prostatitis;
• Venereal infectious diseases;
• Vulvovaginitis;
• Balanoposthitis, etc.

bacteria.

Bacteria in the urine, in one form or another, are constantly present in both sick and completely healthy people. However, their normal amount is absolutely scanty - no more than 10,000 per 1 ml of liquid. If there is a significant increase in their number, one can assume a bacterial infection of the urogenital area or a false positive result associated with insufficiently careful hygiene in the preparation of the analysis sample. Therefore, when receiving such indicators of a general urinalysis, the doctor, to be sure of its result, prescribes a separate study - a seeding tank.

Everyone had to give. This is done both in the order of a routine examination of the body, a medical examination, and to check for various diseases of the genitourinary system.

This is one of the few analyzes where the collection of material is completely dependent on the patient. Violations in the rules of urine collection can lead to errors in the results and misdiagnosis. The doctor or nurse will usually give advice on how to collect urine for analysis.

You need to give urine with any diagnosis to check the general condition of the body and work. This allows for a laboratory assessment of urine, microscopic analysis of the sediment, to identify various possible inflammatory diseases of the kidneys and bladder.

If a disease of the urinary system has already been detected, urine is taken several times during and after treatment to check the course of the disease and the effectiveness of the treatment.Even if there are no symptoms of kidney disease, it will help to identify them at an early, asymptomatic stage, which will allow timely treatment. Therefore, it is necessary to take this analysis for preventive purposes.

A general urinalysis can reveal not only diseases of the kidneys and urinary tract, but also such a serious disease as (urinary glucose and protein are assessed).

Urine collection for general analysis is carried out at home, so it is important to collect it correctly and deliver it to the laboratory on time so that the results are as accurate and reliable as possible.

CAM (complete urinalysis) is an inexpensive and fast examination method. The result will be ready within a day. If all the rules for collecting material are observed, the accuracy is quite high.

OAM includes the following items:

• Urine volume. This indicator has no diagnostic value, however, doctors ask to collect an average portion of urine, that is, about a third or half of the container.
• Color. Urine can be any shade of yellow, from very light to dark. However, brown color is considered a deviation from the norm.
• Transparency. The presence of clots, grains, turbidity of the material is assessed.
• pH and specific gravity. These indicators are important for determining various pathologies.
• Urine sediment. It is examined under a microscope for various inclusions, such as epithelium, cylinders and various microorganisms, which should not normally be present.

Be aware of errors. If the analysis showed a pathological deviation from the norm, you should pass urine again for additional verification. Only the attending physician can decipher the analysis and make a diagnosis. Some deviations from the norm are caused by physiological causes, and not by diseases.

Preparation, collection and storage

Proper collection of material - a reliable result

For the reliability of the analysis, it is important to collect urine correctly. This seems like a fairly simple procedure, but to reduce the likelihood of an erroneous result, you need to approach this process responsibly.

Moreover, preparation does not begin at the time of collection, but a day or two before urine collection:

• It is not necessary to observe any special before analysis, but it should be remembered that the color of urine is included in the parameters being examined. For this purpose, it is not recommended to eat any coloring foods such as carrots, citrus fruits, blueberries, beets, black currants, etc.
• One day before collecting urine, you need to stop taking any medications, including vitamins. If it is impossible to cancel the drug even for a day, you need to tell your doctor what you are taking.
• Mineral medicinal water affects the acidity of urine. Therefore, you can drink only ordinary teas and plain water.
• Eating mushrooms and raw eggs the day before can lead to detection.
• You need to give urine in the morning after sleep. If you have problems with your bladder or kidneys and can't stand it all night, set an alarm for 1 a.m. to go to the toilet and drink a glass of water.

Special containers are sold in pharmacies to collect urine, they are sterile and do not need additional processing. If you are using your own container, prepare it ahead of time. Wash thoroughly, avoiding detergent residues on the walls of the container, sterilize and dry.

Before you start urinating, be sure to wash well with baby soap. Women are advised to insert a swab into the vagina before collecting the material so that the secretions do not fall into the container.You need to start urinating in the toilet, after a couple of seconds you can collect urine in a container, and finish also in the toilet. This will be the average portion of urine. On average, half a container or a little less should be filled.

Useful video - Correct collection of urine for analysis.

Urine cannot be collected in advance. It must be delivered to the laboratory within an hour of collection. This material is not kept. Urine tends to ferment and becomes unsuitable for analysis. In extreme cases, you can put a tightly closed container in the refrigerator (but not in the freezer) for no more than one and a half to two hours.

Decryption

Only a doctor can make the correct decoding. Even in the presence of deviations, one should not immediately draw conclusions about the presence of any disease. First, the doctor will make sure that you collected urine correctly, ask about what you ate the day before and what medications you took.

Deviation from the norm can be on any parameter, starting with the color and transparency of urine. Urine is yellow (from light to deep yellow, orange), pH 4.8-7.5. An increase in pH indicates that the urine has an acidic environment, which means that the salt content in the body is increased.

The specific gravity should be between 1010 and 1025 g/l for an adult. However, this indicator is indirect. It shows the relative density of urine. It can change even during the day, depending on the fluid you drink and physical activity. An increased specific gravity may indicate diabetes mellitus or impaired kidney function.

Ideally, urine does not contain protein at all, but even its presence does not indicate that there is a pathological process. Small amounts of proteins may be present in the urine. The analysis takes into account most often two specific proteins: and globulin. They can signal the onset of kidney disease. However, proteins can also appear after eating certain foods or strenuous exercise.

In the urine, it can indicate both diabetes mellitus and a violation of the kidneys.

Normally, it should not be present in the urine at all, or be present in a very small amount. If it is, it indicates a change in blood glucose levels. If it was found once, it does not count. Perhaps this phenomenon is caused by the use of a large amount of carbohydrate foods.

Urine should also not be normal. If it is, this indicates an increased content in the blood. Similar disorders occur in liver diseases, bile stasis, cholelithiasis.

If there is a lot of bilirubin in the urine, further examination should be carried out, an ultrasound of the liver and gallbladder should be done.When in the urine, it can appear, which in a healthy person is not detected when passing a general urine test.

Deciphering urine sediment

With the help of a microscope, the content in the urine, other cells, as well as microorganisms is evaluated.

Bacteria can be contained in the urine of a healthy person in a certain amount. It cannot be considered a pathology. However, if there are too many of them, we can talk about a bacterial infection of the urinary system.

Bacteria can signal various inflammatory diseases:

• Cystitis. With inflammation of the bladder, burning and pain appear during urination, it becomes problematic to go to the toilet, urine is excreted in small portions, blood impurities are possible. The cause is bacteria that in one way or another enter the bladder and cause it to become inflamed.
• . This is an inflammation of the urethra that occurs in both men and women. Urethritis is often infectious. The main symptoms: burning and pain during urination, discharge of a different nature.
• Prostatitis. Inflammation is not always caused by an infection, sometimes it is a violation of blood flow. But if bacteria are found in the urine, we can talk about the infectious nature of prostatitis.
• Pyelonephritis. This inflammatory kidney disease is more common in preschool children. The causative agents of this disease are always bacteria. Signs: high fever, chills, headaches, pain in the lumbar region.
• Vulvovaginitis. This is an inflammation of the mucous membrane and vulva, which is quite rare in women of reproductive age and more common in older women and young girls. This disease can be caused by various infections, fungi and bacteria.
• Among fungi, Candida fungus is most often found in the urine, which constantly lives in the body, but with a decrease in immunity, it begins to actively multiply and disrupt the body. This disease is called candidiasis. It can occur on almost any mucous membrane: in, in the bladder, in the vagina and on the external genitalia.

Update: December 2018

Urine is a product of human life. Its formation occurs in the kidneys, it is a complex and lengthy process. Excess water, toxins (uric acid, urea), ions (sodium, potassium, chlorine), vitamins and hormones are excreted from the body with this liquid.

The study of the general analysis of urine plays a big role for the doctor, it helps to determine the function of the kidneys, and also allows you to judge the state of the gastrointestinal tract, cardiovascular system and others.

Rules for collecting urine

Human urine is normally sterile; bacteria can enter it only when passing through the urinary tract or from dirty dishes. The collection of this biological fluid is a very intimate process that is carried out independently; children or seriously ill people usually need help. How to collect urine?

• the material is collected in the morning, immediately after sleep, on an empty stomach;
• it is recommended that the previous urination was at least 5-6 hours ago;
• before urination, the patient must wash the toilet of the external genitalia (women wash the perineal area with soapy water, and men wash the glans penis and the external opening of the urethra);
• sampling is prohibited during menstruation;
• an average portion of urine is collected, its volume is approximately 50-100 ml;
• the first drops merge into the toilet, as they contain the epithelium that is exfoliated from the mucosa;
• the material is taken into a dry, clean, transparent container with a wide neck and a tight lid;
• it is forbidden to take urine from a duck, a urinal, a chamber pot, and so on;
• the sampling dishes must be thoroughly washed and rinsed from detergents, as they may affect the results of the analysis;
• the collected liquid must be immediately delivered to the laboratory, its shelf life is no more than one and a half hours;
• on the eve of the examination, it is undesirable to eat vegetables and fruits containing pigments (carrots, beets), as well as alcohol and chocolate.

Indications for the appointment of the study

• inflammatory processes in the genitourinary system (glomerulonephritis, interstitial nephritis, cystitis,);
• sharp and
• some neoplasms (multiple myeloma, melanoma, pituitary tumor);
• obstructive jaundice (, acute cholangitis);
• sugar and;
• acute pancreatitis.

Usually, ultrasound of the kidneys is also prescribed at the same time (see).

Table of norms for general urinalysis

Deciphering the general analysis of urine

Daily diuresis

This is the amount of urine excreted per day. It depends on the amount of liquid drunk and the loss of moisture through the lungs, skin and intestines. Normal indicators of the daily volume of urine at different ages:

Violations of daily diuresis:

An important role is also played by how many times a person urinates per day. Normally, this number is 4-5 times a day.

A change in the frequency of urination occurs in such cases:

• pollakiuria (more than 5 times a day) - it happens if you drink a lot of water, as well as with inflammation of the genitourinary system;
• olakiuria (less than 3 times a day) - this condition is possible with insufficient water intake or neuro-reflex disorders;
• dysuria (see) - occurs with cystitis, urethritis, pyelonephritis, etc. (see,).

Transparency

Urine should be clear, if it is cloudy, then it is possible:

• The presence of protein in the urine - amyloidosis, pyelonephritis, glomerulonephritis
• The presence of red blood cells - kidney cancer, urolithiasis, prostatitis, pyelonephritis, glomerulonephritis
• Bacteria in the urine - cystitis, pyelonephritis
• The presence of leukocytes - pyelonephritis, cystitis
• Epithelium in the urine - pyelonephritis
• Precipitation of salts (phosphates, urates, oxalates)

Color

The color of the liquid we secrete is provided by the pigment urochrome (a product of bilirubin metabolism). A change in the color of the material may indicate various pathologies, it is also observed when certain foods and medicines are consumed:

• reddish, red, the color of "meat slops"- indicates the presence of red blood cells (hematuria), that is, blood in the urine (urolithiasis, cystitis, glomerulonephritis), as well as with hereditary porphyrinuria, lead intoxication, with severe toxicosis, taking anti-tuberculosis drugs (rifampicin), phenacetin, iron preparations, sulfazol, red streptocide, amidopyrine.
• dark yellow with a brownish or greenish tint- release and bile pigments with mechanical (bile stagnates and does not flow from the gallbladder to the intestines), hemolytic anemia.
• dark yellow - concentrated urine, usually occurs with low fluid intake, increased sweating, and also with the use of carrots. With (vomiting, diarrhea, high fever), as well as with starvation, in children with a lack of breast milk, with heart and liver diseases.
• greenish yellow- an abundance of pus (pyuria);
• dirty brown- pyuria with an alkaline reaction;
• black and brown-black- release of hemoglobin in hemolytic anemia (hemoglobinuria), melanin in melanoma, melanosarcoma, Marchiafava-Micheli disease, naphthol poisoning
• white, whitish- a large amount of phosphates (phosphaturia), fats (lipuria) or lymph (tumors of the urinary system or kidney tuberculosis).
• clear, pale urine- harmless reasons: taking diuretics and products (see), drinking plenty of water. Pathological causes - diabetes insipidus, violation of the concentrating function of the kidneys;
• pink - the presence of phenolphthalein in an alkaline reaction;
• dark brown - the use of sulfonamides (biseptol), metronidazole, preparations based on bearberry;
• greenish brown- taking indomethacin, amitriptyline;
• orange-yellow - after the introduction of vitamins B, C, multivitamin complexes, as well as eating with beta-carotene - persimmons, apricots, carrots, bright orange fruits and vegetables.

Smell

Usually the material has a special specific smell. A change in it indicates some diseases. For example, an ammonia smell means an inflammatory process of the genitourinary system (urethritis, pyelonephritis) or a decaying tumor. And with diabetes, there is a smell of “soaked apples” or acetone.

Urine Specific Gravity (sg)

The determination of relative density is of great clinical importance, since this value reflects the ability of the human kidney to concentrate and dilute. The specific gravity of urine is measured by the substances in it (various salts, sugar,).

Urine pH reaction

The urine of a healthy person has a neutral or slightly acidic reaction. Its change is connected, first of all, with the nature of nutrition (meat or vegetables), as well as with a number of diseases. It should be remembered that if urine stays at room temperature for a long time, this leads to its alkalization and destruction of formed elements, thereby changing the results of the analysis.

What diseases can change the pH of the material?

total protein

The presence of a small amount of protein in the material is possible with psycho-emotional stress, physical overstrain, sports competitions, taking a cold shower or bath (orthostatic proteinuria). An increase in total protein in the urine over 0.14 g / day (proteinuria) is a formidable sign of the presence of certain diseases (see).

In the test fluid, special types of proteins can be determined:

• Bence-Jones protein - for multiple myeloma, Waldenström's microglobulinemia;
• β2-microglobulin - with damage to the renal tubules.

The degree of increase in total protein in the urine:

Glucose

The presence of glucose in the urine (glucosuria) is directly related to blood sugar levels: the more glucose in the blood, the more it will be excreted from the body. Glucosuria is the first sign of DIABETES! Also, sugar in the urine can increase with:

• acute pancreatitis;
• thyrotoxicosis;
• renal diabetes;
• steroid diabetes, Itsenko-Cushing's disease;
• sepsis;
• brain tumors;
• pheochromocytoma;
• the action of toxic substances (morphine, strychnine, phosphorus, chloroform).

But not in all cases, glucosuria indicates a disease. Normally, this condition occurs when overeating sweets, with constant stress and in pregnant women.

Ketone bodies

Ketone bodies are products of fat metabolism. Normally, they are produced in very small amounts in the body. Ketones include: acetone, β-hydroxybutyric acid and acetoacetic acid.

The detection of ketones in the urine (ketonuria or) indicates the following:

• uncompensated diabetes mellitus;
• carbohydrate-free diet, starvation, cachexia;
• excessive production of steroid hormones in tumors of the brain and adrenal cortex;
• acetonemic vomiting in children;
• dysentery;
• thyrotoxicosis;
• acromegaly;
• eclampsia in pregnant women;
• intoxication.

Leukocytes in urine

The detection of a large number of these cells in the urine always indicates an inflammatory process in the urinary system, whether it is cystitis or pyelonephritis. If the number of white blood cells is more than 60 per field of view, this is called pyuria (pus in the urine). Both neutrophils and lymphocytes can be found in the analysis. In chronic inflammation, leukocytes are a more reliable indicator than bacteria, which are not always detected.

erythrocytes in urine

In the urine of a healthy person, erythrocytes are absent or are determined in the form of single cells (0-1-2-3 in the field of view). Normally, their appearance is associated with hard physical labor, sports. In women, red blood cells can be analyzed during menstruation or pregnancy.

Depending on the number of red blood cells in the urine, there are:

• mild erythrocyturia - up to 20 cells under a microscope;
• moderate - from 20 to 200 cells;
• severe erythrocyturia (hematuria) - more than 200 cells in the field of view.

Depending on which part of the urinary system, erythrocytes enter the urine, they are found leached or unchanged. Reasons for the presence of red blood cells in the urine:

• kidney injury - tear, bruise, rupture
• urolithiasis disease
• kidney infarction
• urethritis, cystitis, acute glomerulonephritis
• bladder cancer, kidney cancer, prostate cancer

Why does blood appear in the urine?

• glomerulo- and pyelonephritis (acute and chronic);
• urolithiasis disease;
• acute cystitis;
• kidney infarction;
• kidney and bladder cancer;
• prostate adenoma;
• trauma of the genitourinary system;
• hemorrhagic diathesis;
• systemic lupus erythematosus;
• hemorrhagic fever (Ebola, Crimean, Congo);
• amyloidosis of the kidney;
• poisoning with benzene, aniline, snake venom;
• kidney tuberculosis;
• lipoid nephrosis.

Epithelium

Epithelial cells are always found in the analysis. They get there, exfoliating from the mucous membrane of the urinary tract. Depending on the origin, there are transitional vtc (bladder), squamous (lower urinary tract) and renal (kidney) epithelium. An increase in epithelial cells in the urinary sediment indicates inflammatory diseases and poisoning with salts of heavy metals.

cylinders

Cylinders are the so-called "protein casts" from the urinary tract. Depending on the appearance and origin, there are:

bilirubin in urine

Bilirubin normally cannot be found in the urine, since it is excreted into the intestinal lumen as part of bile. When the level of bilirubin in the blood is increased, the kidneys take over the function of removing it. Causes of bilirubin in the urine:

• hepatitis
• destruction of red blood cells in malaria, hemolytic disease, toxic hemolysis, sickle cell anemia
• cholelithiasis

Urobilinogen in urine

Urobilinogen is a substance formed from bilirubin released with bile in the intestinal lumen. From the intestines, it partially returns to the blood and enters the liver with the blood flow, where it is excreted again with bile. If the liver is not able to bind all the incoming urobilinogen, part of it enters the general circulation, then this urobilinogen is excreted from the body by the kidneys. The reasons for the release of urobilinogen in the urine:

• liver failure
• intestinal inflammation - colitis, enterocolitis
• massive destruction of red blood cells

hemoglobin in urine

Hemoglobin is a protein involved in the transport of oxygen to cells, it is contained inside the erythrocyte. When there is a strong destruction of red blood cells, a large amount of hemoglobin is released into the blood, and the spleens and liver do not have time to break it down. In this case, free hemoglobin is excreted in the urine. Also, in myocardial infarction, when squeezing muscle tissue, myoglobin (similar in structure to hemoglobin) can be released into the blood, which is also partially excreted by the kidneys. The causes of hemoglobin in the urine are:

• malaria
• burns
• blood transfusion
• hemolytic disease
• damage to muscle tissue - contusion with hematoma, crush syndrome
• poisoning with sulfanilamide drugs, phenol, mushrooms

salt crystals

Many ions and salts are dissolved in urine. Their excess leads to the formation of sediment and stones that cause urolithiasis. In the sediment of the material most often found:

bacteria and fungi

The detection of more than 50,000 bacteria in 1 ml of the material indicates inflammation of the urinary tract. Then the patient is recommended to take a urine culture to determine the specific type of microorganisms and their sensitivity to antibiotics. The presence of fungal mycelium in the analysis indicates candidiasis or a decrease in local immunity after taking antibiotics.

Slime

Mucus should normally not be in the urine. Its presence indicates an acute or chronic inflammatory process of the genitourinary system.

In the end, I would like to add that a general urinalysis is an important diagnostic indicator. A person can independently pay attention to changes in urine and consult a doctor. Even healthy people are advised to take this analysis at least once a year. It should also be remembered that a single result is not an indicator of pathology. It is very important to take tests in dynamics in order to make a final conclusion about the presence of the disease.

The value of a general urinalysis is difficult to overestimate. Deciphering the designations of urine analysis reveals dysfunctions of the kidneys, liver, lymphatic, digestive and excretory systems of the body. Deciphering the analysis of urine consists of many parameters that can be divided into physical and chemical.

The interpretation of the clinical analysis of urine for men and women is different. The same is true for the analysis of secretions from pregnant women. Also, the state of urine is reflected in the diet and lifestyle of the patient.

Deciphering the results of a general urine test by physical indicators

Before deciphering the general analysis of urine, physical indicators are examined, such as quantity, color, density, smell, and so on. Laboratory assistants evaluate them by eye, which means a general urine test. The interpretation of the results of a general urine test provides only approximate data.

The first parameter is the urine color value. The normal color of urine is light, straw-yellow. This indicator is affected by nutrition and the intake of certain drugs. Urine lighter than normal means hyperhydration - excess fluid in the body. More saturation yellow, orange indicates dehydration. Red shades of varying degrees of saturation indicate the presence of blood.

The second parameter is the smell of selections. A mild smell of discharge is considered normal. A more intense, sweet smell of secretions is characteristic of patients with diabetes. A sharp ammonia smell indicates infectious processes occurring in the patient's excretory system. A fecal or putrid odor indicates the presence of decay processes or an enterovesical fistula.

The third parameter is the transparency index. Normal urine is clear. Turbidity is caused by the presence of blood cells or other inclusions in the secretions, depending on how the urinalysis is interpreted. A cloudy color may indicate the presence of an infectious disease.

The interpretation of s g in the analysis of urine (density) depends on the amount of substances dissolved in the secretions. The norm sg in the analysis of urine is 1.012 grams per liter - 1.022 grams per liter. A lower density indicates an excess of liquid, and a higher density indicates a large number of various substances.

Deciphering the indicators of the general analysis of urine by chemical and cytological composition

Deciphering the microscopy of a urine test provides information about the chemical composition of the secretions. Deciphering the chemical analysis of urine, in turn, gives an idea of ​​the processes occurring in the body. Further in the article on how to read a urine test even without special education.

In another way, the decoding of indicators of a general urine test is called a hardware analysis, therefore, the decoding of a hardware urinalysis is the same as the previous names.

The acidity of normal secretions should be between 4 and 7. A decrease in acidity indicates:

• fasting;
• a large amount of meat in the diet;
• diabetes
• dehydration.

Deciphering ph in a urine test with an increased indicator indicates kidney ailments. Cancer of the kidneys or bladder also leads to similar consequences.

The pro rate in the urine test should not exceed 0.033 grams per liter. At the same time, deciphering a protein in a urine test in excess of the norm does not always indicate malaise.

Deciphering pro in a high protein urine test occurs after:

• physical activity;
• profuse sweating;
• cold shower.

Protein enters women's urine from vaginal secretions.

The sediment of any sample contains epithelial cells of several configurations. No more than 10 pieces are considered normal. The cells that make up the epithelium can enter the urine from the kidneys, bladder or ureters, which indicates their defeat.

Interpretation of urine analysis in women can reveal squamous epithelium, but this is not a sign of damage.

Glucose (sugar) in the sample

In the normal state, glucose should not be detected, however, its content in a concentration of not more than 0.8 mmol per liter is acceptable and does not indicate deviations. The most common cause of high blood sugar levels is diabetes mellitus.

Also, decoding a urine test in Latin with a large amount of glucose may indicate:

• pancreatitis;
• Cushing's syndrome;
• pregnancy;
• abuse of sweet foods.

To confirm any diagnosis, in addition to a urinalysis, a complete blood count is usually prescribed. What will he show? Read more. If a woman's urine test contains elements that should not be, the doctor will prescribe women's examinations. This is covered in this article.

In a healthy body, these components do not enter the urine. Bilirubin is part of bile, but with some disorders, its concentration in the blood increases. In such cases, the excretion of the substance is carried out by the kidneys.

Bilirubin, which enters the intestinal lumen, is transformed into urobilinogen. The norm of ubg in urinalysis is its absence. With its increased content, the excretory function also falls on the kidneys.

Deciphering urobilinogen in a urine test indicates:

• hepatitis;
• cirrhosis of the liver;
• colitis.

Hemoglobin is not present in the analysis of a healthy person. In the normal state, this protein is part of the erythrocytes. With the defeat of a large number of blood cells, part of the protein is excreted in the urine. Most often this is due to malaria, burns, myocardial infarction or mushroom poisoning.

Deciphering z in the analysis of urine

Leukocytes are cytological elements of the immune system in the blood. A urinalysis for men should show no more than 3 pieces, a general urinalysis for women and children - no more than six. Lead to their increased content: pyelonephritis, cystitis, prostatitis.

Deciphering z in the analysis of urine is not possible. Because the letter Z does not actually exist in the analysis, in most cases it is a misread or spelled L, which means the number of leukocytes.

Decoding of erythrocytes in the analysis of urine

Deciphering of erythrocytes in the analysis of urine should not detect more than three in the test sample. Deciphering bld in a general urine test with an increased content indicates a serious lesion of the kidneys or excretory system.

Most often it is:

• acute glomerulonephritis;
• cancer of the kidney, prostate, bladder, kidney infarction.

Cylinders are called formations from the tubules of the kidney. In the normal state, single hyaline are allowed.

There are several types of these formations:

• granular;
• epithelial;
• waxy or erythrocyte.

The detection of any number of these formations in the urine indicates pathology.

Salts in the sample

Salts in the analysis of a healthy person should not be. The interpretation of a new urine test with a high salt content indicates, first of all, an improper diet.

An excess of minerals in the blood causes the formation of kidney stones. Urates, calcium oxalates, and hippuric acid crystals are found in the urine.

After detecting one of these elements in the urine, it is necessary to change the diet, in accordance with the advice of a specialist.

A normal discharge sample should not contain any bacteria or fungi. Mushrooms in the urine test indicate the presence of a fungal infection, bacteria - a bacterial one. In this case, you need to go with the doctors of the appropriate profile.

Deciphering cre in urine analysis

Creatinine (CRE) should be 0.64-1.6 g / l in men, and for women the norm is slightly less - 0.48-1.44 g / l. Deciphering cre in the analysis of urine with a low content in the urine and a high content in the blood occurs with ailments of the endocrine system, dystrophy and pregnancy.

With the above information, anyone can find out what the urinalysis results mean.

Deciphering the indicators of a general urine test

General urine analysis refers to mandatory diagnostic procedures that are assigned to all patients who apply to a healthcare institution.

Here we will tell you what indicators of urine are measured in a general urine test, and what diseases are indicated by certain deviations of these indicators from the norm. And also about how to properly collect urine for general analysis, analysis of daily urine and for urine analysis according to Nechiporenko.

In the general analysis of urine, parameters such as specific gravity (relative density), color, transparency, odor, pH (acidity), protein content, glucose content, content of ketone bodies and bile pigments and some other indicators are examined.

The results of the urine test are given to the patient in the form of a table with incomprehensible letters, which can only be read by a specialist. Below is a transcript of those same "incomprehensible letters", as well as the norms and possible deviations for individual indicators.

Deciphering the indicators of a general urine test

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.

The table shows the main indicators of the general analysis of urine in the norm. Some of them will be discussed in more detail below:

The norm of a general urine test (table)

Interpretation of urinalysis indicators

The rate of urine analysis in adults and children (table)

Normal values ​​(in the field of view)

Acid-base reaction of urine is normal

The urine reaction (pH) of urine in a healthy person on a mixed diet is acidic or slightly acidic.

Table: Urine acidity in children and adults is normal

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The specific gravity of urine (g / l) is normal

The specific gravity of the urine of a healthy person during the day can fluctuate in a fairly wide range, which is associated with periodic food intake and loss of fluid through sweat and exhaled air.

Table: The specific gravity of urine in adults and children is normal

The specific gravity of urine depends on the amount of substances dissolved in it: urea, uric acid, creatinine, salts.

• A decrease in the specific gravity of urine (hypostenuria) to 1005-1010 g / l indicates a decrease in the concentration ability of the kidneys, an increase in the amount of urine excreted, and drinking plenty of water.
• An increase in the specific gravity of urine (hyperstenuria) more than 1030 g / l is observed with a decrease in the amount of urine excreted, in patients with acute glomerulonephritis, systemic diseases, cardiovascular insufficiency, may be associated with the appearance or increase edema, large fluid loss (vomiting, diarrhea), toxicosis of pregnant women.

Protein in the urine, protein in the urine

Fine protein in urine absent. Appearance protein in urine is one of the most important symptoms of kidney and urinary tract disease. The appearance of protein in the urine is called proteinuria. Proteinuria is possible in healthy people after taking a large amount of food rich in proteins, after strong physical stress, emotional experiences.

Pathological proteinuria divided into renal (prerenal) and extrarenal (postrenal):

• Extrarenal proteinuriadue to the admixture of protein excreted by the urinary tract and genital organs; they are observed at cystitis, pyelitis, prostatitis, urethritis, vulvovaginitis. Such proteinuria rarely exceeds 1 g / l (except in cases of severe pyuria - the detection of a large number of leukocytes in the urine).
• Renal proteinuriamost often associated with acute and chronic glomerulonephritis and pyelonephritis, nephropathy of pregnancy, febrile conditions, severe chronic heart failure, kidney amyloidosis, lipoid nephrosis, kidney tuberculosis, hemorrhagic fevers, hemorrhagic vasculitis, hypertension.
  

Glucose (sugar) in urine (normal)

Carbohydrates (glucose) in urine a healthy person are contained in insignificant concentrations, their presence is almost always a sign diabetes. So, normally, urine contains glucose in the form of traces not exceeding 0.02%, which, like protein, is not detected by ordinary quality tests.

Urinalysis for red blood cells (normal)Source: http://med..php/%D0%B0%D0%BD%D0%B0%D0%BB%D0%B8%D0%B7%D1%8B/193-%D0%B0%D0%BD %D0%B0%D0%BB%D0%B8%D0%B7-%D0%BC%D0%BE%D1%87%D0%B8.html

Erythrocytes (red blood cells)normally, there are no urine sediments or single ones are found in the preparation. A general urine test in a healthy person should show no more than 2 erythrocytes in the microscope field of view, and no more than 3 leukocytes in men and 5 in women.

An increased number of red blood cells is characteristic of many diseases: pyelonephritis, urolithiasis, glomerulonephritis, urinary tract infections, systemic lupus erythematosus or poisoning(especially poisonous mushrooms, snake venom, benzene and aniline derivatives).

Urinalysis for leukocytes (normal)

Fine leukocytes in the urine are absent, or single ones are detected in the preparation and in the field of view. An increased content of leukocytes indicates possible pathologies of the kidneys or urinary tract: glomerulonephritis, pyelonephritis, urethritis, cystitis, prostatitis.

Leukocyturia (more than 5 leukocytes per field of view) can be infectious (bacterial inflammation of the urinary tract) and aseptic (with glomerulonephritis, amyloidosis, chronic renal transplant rejection, chronic interstitial nephritis). pyuria consider the detection in the sediment during microscopy of 10 or more leukocytes in the field of view.

Urinalysis for epithelium (normal)

squamous epithelium: in men, only single cells are normally detected, their number increases with urethritis and prostatitis. In the urine of women, squamous cells are present in greater numbers.

Transitional epithelial cells may be present in significant amounts acute inflammatory processes in the bladder and renal pelvis, intoxication, urolithiasis and neoplasms of the urinary tract.