Laboratory diagnostics is aimed at studying pathological conditions and contains several stages. - this is the taking of a part of the urinary fluid from the bottom of the flask after it has been allowed to stand for at least 2 hours. Sediment diagnostics is the most effective and accurate method that indicates the functioning of all vital systems, in particular, the functioning of the kidneys.

Many diseases of the genitourinary system at the primary stages proceed without pronounced symptoms, a microscopic examination will make it possible to accurately diagnose and begin timely treatment.

Examination of urine microscopy

Correctly collected urine is the basis for obtaining a reliable result; the correctness of the diagnosis depends on the preparatory stage and the time of delivery of the material for diagnosis. The collection of biomaterial for microscopy begins with a mandatory preparatory stage. Collect urine in a sterile container in the morning.

The result is a diagnostic marker:

• to count the number of erythrocytes - hematuria;
• counting the number of leukocytes - pyuria;
• determining the number of bacteria;
• detecting the presence of impurities, mucus.

Based on the results of the examination, doctors determine the quality of the functioning of the genitourinary system,renal failure... The diagnostic process takes place in several stages:

1. Urine settles for two hours, after which 10 milliliters of material is collected from the bottom of the flask.
2. The collected sample is placed in a centrifuge for 7 minutes.
3. The drop is placed under a microscope and study at different magnifications.

This diagnosis allows you to determine the foci of the inflammatory process and the presence of urinary tract infections. Microscopy reveals metabolic disorders, metabolic problems.

What is the study of urine microscopy for?

Urine is a final product that consists of many components and reflects the general state of the body's vital activity. The qualitative composition of the biomaterial excreted by the kidneys gives an exhaustive result on the functioning of internal organs. Decryption is carried out by a doctor after receiving a laboratory report.

Urine sediment research methodsappoint in such situations:

1. Diagnosis of kidney diseaseimpossible without microscopy. The doctor makes appointments if there are suspicions of the presence of pathologies of the genitourinary system.
2. A differential study is carried out on the basis of a general urine analysis.
3. To diagnose the presence of inflammatory processes, infectious diseases.
4. Therapy of any disease is impossible without regular laboratory examination of urine. With the help of a simple method, the doctor monitors the patient's condition, determines the correctness of the prescriptions, the result of the general treatment.
5. Monitoring the patient's condition using urine analysis, preventing complications.
6. Before and after surgery the patient gives urine daily for diagnosis, as prescribed by the doctor.
7. During a medical examination, urine analysis is a mandatory diagnostic minimum.

Indicators that pay attention to when diagnosing

Microscopic examination is prescribed to study urine sediment,general medical research identified the indicators to which doctors pay attention first of all. The sediment is the microcomponents of cells,crystals, mucus, amorphous deposits. There are several types of microscopy:

• the organized type studies the organic composition of urine;
• not organized type - diagnoses the presence of fungi, bacteria, mucus.

When carrying out the method, the following indicators are studied and calculated:

1. The number of red blood cells in the urine - an important indicator of health, a minimum number of them is allowed.
2. The presence of leukocytes is permissible in urine, but only if their number does not exceed the established standards.
3. Epithelial cells divided into types, each subspecies is counted during diagnosis. The flat cell type is allowed in urine sediment, other types indicate the development of the disease.
4. Hyaline casts in urine - allowed in small dose, other varietiesrenal cells epithelium is unacceptable.
5. Bacteria in urine a healthy person is absent, if such components have been diagnosed, then additional diagnostics and examination are prescribed.
6. Salt, mucus is diagnosed by type and deciphered by a doctor.

Urinary indicator rate, which is deciphered in the atlas of microscopy, this is the correct diagnostic minimum for making a diagnosis. The book contains important information about all indicators of the study, indicates additional methods when detecting specific components.

Urine precipitation

Urine has a sediment, which does not always indicate the development of pathology; with individual characteristics of the organism, a characteristic color of urine and impurities is possible.

A white precipitate may indicate a high protein level, which is considered an abnormality. During pregnancy, the sediment is studied according to separate standards. The development of the fetus increases the load on the kidneys, which leads to an increase in some indicators.

Causes of sediment appearance

The sediment appears when there are difficulties in the work of the genitourinary system, the reasons for the presence of sediment can be the following factors:

• drug therapy;
• non-compliance with the diet the day before the delivery of the material;
• the material was collected incorrectly.

If the urine has a cloudy color and sediment, then this factor indicates the presence of salt, epithelial particles, and is detected in many diseases. Changeurine color - this is the signal of the body, the beginning of the development of the disease. Staining urine in a characteristic color depends on a person's nutrition, taking medications.

Composition and components of urine

To get a reliable result,collection of urine spend in the morning. The collected material is sent to the laboratory, before sampling the urine is settled for 2 hours. During the study, the appearance of the material, the component composition of the biomaterial, chemical components are taken into account:

1. The color of the urine depends on the pigments and can vary. The indicator is influenced by various factors, medications, the amount of liquid drunk, alcohol, smoking, chronic diseases. A change in the color of urine also indicatespathology , therefore, only a comprehensive conclusion will indicate the true state of the body.
2. The structure of urine plays an important role; in a healthy person, there is no turbidity of urine. The altered structure indicates the presence of impurities. Microscopy is used to make an accurate diagnosis.
3. Offensive odor. A healthy body excretes odorless urine, but it does not have any pronounced indicators.
4. A test is carried out for chemical reactions, the norm for a person is established by general recommendations.
5. To determine the protein, a reagent is added to the material; with an unarmed eye, you can detect the protein - the urine becomes cloudy.
6. Under normal conditions, there is no sugar in the urine, such a result can be found out simply by passing a quick test strip.

The composition of urine is carefully studied by laboratory assistants and deciphered by doctors. Each patient receives a detailed analysis result.

Decoding

Survey , microscopy suggests further extensivedecryption that the doctor deals with. Before starting the decoding, the doctor is obliged to obtain complete information about the patient's lifestyle, the presence of bad habits, chronic diseases, adherence to the diet leads to a distortion of the usual standards. Excessive physical activity also affects the indicators.

Medicines, antibiotics affect the color and composition of urine. If you follow a diet or individual characteristics, you need to indicate this fact in the card or inform the doctor about it. High rates of components indicate such pathologies:

1. Increased content of red blood cells indicates kidney disease, infectious diseases.
2. An increased leukocyte count indicatespyelonephritis , inflammatory processes.
3. The presence of epithelial cells indicatespoisoning with heavy metals.
4. Hyaline cylinders are high blood pressure, heart disease, physical activity.
5. A high concentration of bacteria indicates infection.
6. Salt is a lack of fluid in the body, frequent diets, kidney disease.
7. Mucus is an inflammatory process, a disease associated with hypothermia.

The end result is affected by non-compliance with the rules for collecting and storing urine. Microscopy can re-appoint if mistakes were made.Deviations from the norm in an adult when decoding, it indicates various factors that are determined when studying the general clinical picture of the patient.

The presence of hemoglobin

General, detailed urinalysis with sediment microscopy prescribed when obtaining a quality result for each chemical component. Hemoglobin in urine indicates serious infectious foci. Hemoglobin is formed when the breakdown of erythrocytes occurs, the presence of a component is a deviation from the norm. The appearance of hemoglobin is provoked by various factors, both external and internal:

• flu, colds;
• pneumonia;
• injuries received;
• intoxication of the body.

Characteristic symptoms appear, pain in the lower back, urine changes color, becomes with a red tint.

The presence of red blood cells

A high level of erythrocytes is already evidence of the presence of pathology. To avoid possible false results, doctors do not recommend taking tests during the menstrual cycle. An increased level of red blood cells is hematuria, which has characteristic causes:

• pathological manifestations in the kidneys;
• bruises, injuries;
• malignant neoplasms of the urinary system;
• infectious diseases;
• intoxication.

Normally, in humans, erythrocytes in urine are in scanty amounts, when violations occur, erythrocytes appear, indicating pathology. Cause of blood in urine is the wrong collection of urine during menstruation.

The presence of leukocytes in the sediment

The presence of leukocytes causes clouding of urine, if the rates are increased, then pus particles are released along with the urine. This phenomenon always indicatesinflammatory process in the kidneys, glomerulonephritis... To accurately diagnose the focus of inflammation, additional examination methods are prescribed. The three-glass test will accurately determine the localization of the disease, the level of distribution of pyuria.

Epithelium in sediment

A single presence of epithelial cells is considered normal. There is an epithelium classifier, which divides them into subspecies according to the nature of their occurrence. If renal epithelium was found in the urine, then this indicates serious diseases of the genitourinary system. Polymorphic epithelium indicates infectionscysts, oncology.

Availability of cylinders

Hyaline casts in urine manifested in urine in many diseases of the urinary system. These components can be present only in small amounts in the urine of a healthy person. Excessive physical activity is the only reason for the appearance of cylinders. The reasons for the appearance of a substance in a significant amount are kidney pathologies, poor blood circulation, and infectious foci.

Salt on urine microscopy

Crystals of urine saltcannot exceed the established rate from 20 to 40 mg. When the excretory system malfunctions, the balance changes, and the amount of salts increases significantly. Salt is in different forms, therefore, pay attention to the presence of phosphates, urates, oxalates. The presence of each species indicates a disease.

Extra options

Bacteria are also considered an important indicator of human health. Diagnostics with a microscope allows you to determine the presence of mucus, bacteria. There can be no bacteria in the urine if the person is completely healthy. With the help of microscopy, only the presence of bacteria is determined, in order to determine the species, an additional analysis is prescribed. Bacteria are caused by infections,cystitis. Mucus in urineappears after hypothermia.

Deviations from the norm

After diagnosis, deviations from the norm are allowed, which indicates various pathological conditions. The main cause of deviations is diseases of the excretory system. Indicators fluctuate under various conditions of the body. The composition and structure of urine is affected by:

• pregnancy;
• chronic diseases;
• blood transfusion;
• neoplasms, infections, inflammations.

Significant changes can affect performancein organism and diet, wrong lifestyle. To correct deviations from the norm, refer todoctors for therapeutic appointments.

Inaccuracies in microscopy

Before decoding, the nuances of a person's life are taken into account, which can affect the result. Inaccuracies can arise for a number of understandable reasons:

• taking medications;
• non-compliance with the preparatory stage;
• improper collection of urine;
• adherence to a diet.

The structural composition of urine is influenced by the person's lifestyle, both external and internal factors are distinguished, which require competent correction by the doctor. Treatment of prostatitis start after a complete examination, delivery of laboratory analysis of urine for microscopy.

Indicators that are not normal

A deviation from the norm is allowed during pregnancy, when the kidneys are working in an enhanced mode. But each result requires special attention from the doctor, because the diagnostic marker indicates possible fetal pathologies.

Differences from the norm also appear in the case of individual characteristics, individual lifestyle. Vegetarians, when passing laboratory tests, indicate their diet in order to avoid distorting the result. For treatmentbladder diseasea urine test is required regularly.

Why are excellent indicators from the norm dangerous?

If, after decoding, deviations from the norm are recorded, then the patient turns to the doctor for prescriptions and treatment. Excellent indicators from the norm may indicate pathologies or non-compliance with urine collection standards. The doctor will be able to explain the result by prescribing a re-analysis or additional diagnostic methods. (1 estimates, average: 5,00 out of 5)

What is urine sediment microscopy? The attending physician will answer this question. A general urine test is a familiar analysis that almost each of us has taken at least once in our life. This analysis reveals the general properties of urine, as well as its chemical and physical characteristics. It is important to remember that urine in humans is the end product in the work of the kidneys, which is why it is a source that reflects the state of metabolism, blood and metabolism. The content of urine is very diverse, it contains water, metabolic substances, leukocytes, hormones, trace elements, tubule cells and urinary tract mucosa, salts, electrolytes, mucous components.

Knowledge of the properties of urine provides information not only about the kidneys and the state of the urinary tract in humans, but also helps to assess the metabolism and detect those pathologies that are in the internal organs.

However, a general urine analysis cannot fully reveal all these details, and here microscopic examination of urine sediment comes to the rescue.
What is it and why is this research needed? Urine microscopy is a qualitative and quantitative determinant of a number of compounds in the urine, which in turn help to determine and reveal whether a patient has infectious or inflammatory processes in the body. That is, we can say that microscopic examination makes it possible to investigate deeper indicators and, accordingly, obtain additional information.

Urinary sediment is divided into two types:

1. Organized - this composition includes elements of organic origin, such as electrolytes, erythrocytes, leukocytes, mucus, casts, epithelium.
2. Unorganized - this type is made up of elements of inorganic origin. Namely, crystalline and amorphous salts. To understand each component, you need to look at each of them separately.

Erythrocytes in urine (hematuria, blood). The human body excretes 2,000,000 red blood cells in urine per day. If a person has no abnormalities, then when studying the urine sediment, women should have 0-3 erythrocytes, men 0-1. An indicator above this already speaks of a problem, since this is a sure sign of hematuria.

In turn, hematuria is of 2 types:

1. Macrohematuria. If there is this type, then the patient's urine color changes.
2. Microhematuria. In this case, the color does not change. Microhematuria will be revealed only by microscopic examination.

Decoding analysis

How is the analysis results decrypted? In the urinary sediment, erythrocytes are unchanged and changed. Fresh unchanged erythrocytes are found in those who have urinary tract infections: for example, with cystitis, urethritis, or when stones pass.

And if the analysis reveals the presence of leached erythrocytes in the patient, then this is primarily due to the kidneys. This type of red blood cells occurs in people with tuberculosis, with glomerulonephritis and other renal ailments. To identify the source, the triple test method is used, where a person takes tests in three vessels.

Leukocytes. Another parameter that is shown by microscopic examination of urine is the number of leukocytes. Usually, in women and children, their number should be 0-6, and in men 0-3, everything that is more than this already speaks of pathology.

And violations are as follows. Infectious leukocyturia - with this type of disorder, a person must have symptoms. This can be fever, pain when urinating, or pain in the lumbar region. All this indicates the presence of infection and inflammation in the kidneys or in the urinary tract. To determine the source, the patient is again tested by the triple test method.

Sterile leukocyturia - the patient does not have dysuria and bacteriura. This happens in patients with chronic glomerulonephritis. Sterile leukocyturia in the sediment is due to dirt during the delivery of urine for examination, with pathology of the body after certain medications, bladder cancer, kidney disease and nephritis.

Urethral syndrome - with pain during urination and leukocytes in the urine. More common in women.

There are also epithelial cells in the urine, but their presence should not be more than 10. It all depends on which type of epithelium prevails in the sediment:

1. Squamous epithelial cells - can get into the urine from the genitals. They are not particularly dangerous.
2. Transitional epithelial cells - they cover the mucous membrane of the urethra, urethra, pelvis, large ducts of the prostate. If there are a lot of them in the analysis, then this is a manifestation of inflammation that occurs in these organs or during the formation of stones in the urinary tract.
3. In humans, renal epithelial cells are formed when the renal parenchyma is affected or intoxication, infectious diseases, and circulatory disorders are present.

In a healthy person, cylinders are not present in the urine, however, there are single cylinders during the day. But it doesn't really matter. Cylinders are proteins that coagulate in the renal tubules in the lumen. They include the contents of the tubules. And the cylinders themselves are found in the shape of the tubules (a cylindrical cast).

The presence of cylindruria signals renal damage, and, as a rule, always appears together with protein and renal epithelium in the urine.

Unorganized sediment. This component of urine consists of salt precipitated in the form of crystals and amorphous masses. The nature of the salts depends on the ph of the urine and not only. For example, if there is an acid reaction in the urine, then urates, oxalates can be found. If the reaction is alkaline, then calcium and phosphates will be present.

Material collection rules

It is important to remember simple rules when taking a urine test. Failure to follow these simple rules can distort the result and, at best, you will have to take tests again. Rules that must be followed when passing the analysis:

• only urine taken early in the morning is taken for analysis;
• before taking the analysis for 12 hours, you can not live a sexually active life;
• you need to take the analysis on an empty stomach;
• to collect analyzes, special forms are used today, that is, banks and the like are not suitable for collecting urine;
• it is important to maintain good hygiene, but do not use special gels, as this can change the result.

It is also important to remember that prevention is cheaper than treatment, so it is necessary to take an analysis 2 times a year as a prevention. After all, it is always easier to prevent diseases than to cure later.

Microscopy of urine sediment is part of the laboratory study of clinical (general) urine analysis. The essence of the process lies in identifying or refuting various pathologies.

Microscopy of urine sediment is part of a general clinical medical examination of the human body to identify and diagnose a variety of pathological and chronic processes. The essence of studying the sedimentary environment of biological material is to assess the concentration and quality of the identified substances, which helps to obtain reliable results of health status.

Microscopic examination of urine sediment is part of a general urinalysis (OAM). A general urine analysis is able to identify a number of pathologies, chronic diseases, and diagnose the result of latent diseases. Ailments without certain symptoms of manifestation pose a serious threat, affecting many systems of life over time.

General analysis of urine involves a laborious research process in laboratory conditions, part of which is reduced to studying the sediment of the biomaterial. The sediment is obtained by processing the liquid in a centrifuge, after which solid particles are detected at the bottom of the tube. From a glass container, substances (amorphous deposits, crystals and cells) suspended from urine are taken using a pipette onto a viewing glass under a microscope.

When examining the microscopy of a photo of sedimentary substances, it is permissible to see their display of schematic division. Micro sludge is divided into two types:

• Organized view.

The organized type of sediment contains organic matter, including epithelial cells, casts, erythrocytes and leukocytes.

• Unorganized type of connections.

This species includes inorganic elements: fungi, mucus, salts and bacteria.

The essence of the diagnostic technique, by studying the urine sediment, is to identify, review and collect information on the quantitative content of the following components:

• Leukocytes are cells circulating in the bloodstream, that's all the reasons for their presence in urine.
• Erythrocytes, the reasons for their presence in urine are similar - microorganisms enter the biomaterial from the blood.

The reasons for the increased rate of red blood cells in urine, which a woman takes for analysis, may lie in the incorrect sampling of material during menstruation. It is recommended to postpone the analysis to other days, since particles getting into the biomaterial give a false positive result.

• The epithelium, which can be detected by microscopic examination of urine sediment, is renal, polymorphic and flat. The epithelium is the cellular tissue lining the surfaces of all mucous membranes and organ cavities without exception.

The presence of squamous epithelium in the sediment is considered normal. If the examination revealed the renal epithelium and polymorphic, then it is worth looking for the reasons that will reveal pathologies and various diseases of the body.

• The cylinders are protein coagulated compounds or cellular tissue of the renal epithelium. Substances are epithelial, leukocytic, erythrocytic, hyaline, waxy and granular.

The presence of hyaline cells of the cylinders in a single amount in the sediment is the norm. If the study found other types of cylinders, then the specialist begins to look for the reasons for the failure of the body's systems and pathological processes.

• Salts are also an integral part of the human body, and have many varieties: oxalates, urates, phosphates and others.
• Mucus is also found in the sediment. The reasons for the content of mucus in urine are simple - the substance is secreted by the epithelium of the mucous membrane of all organs.
• Bacteria should not be found in the composition. The reasons for their presence can be different. Depending on what causes infectious inflammation, a specialist prescribes an additional examination (bacteriological culture of urine) and appropriate adequate treatment.

In a laboratory study of urine sediment, a laboratory assistant, in order to avoid erroneous statement of results, uses a special atlas, where microscopy of urine sediment is decomposed. After all, for each substance being searched for, there is a special generally accepted content norm.

Results of the study of urine sedimentary material: norms

Interpreting the results is the specialization of the attending physician, who focuses on the performance of each patient individually:

• age;
• gender (male \\\\ female);
• level of physical activity;
• field of activity;
• way of life;
• general health.

Decoding the analysis of urine sediment microscopy is a diagnosis of the general state of human health. In the process, they rely on generally accepted norms for the presence of certain substances in a certain concentration:

• Leukocytes: in women less than 5, in women during pregnancy the same indicator, in men less than 3 in the field of view.
• Erythrocytes for both sexes and during pregnancy should be found no more than 2.
• Epithelium (flat) for women and during pregnancy ≤5, for men - ≤3.
• The renal epithelium should not be found. The likelihood of renal epithelial sediment during pregnancy is high and requires special attention.
• The transitional epithelium can be in the urine in a minimal amount.
• Hyaline cylinders are acceptable for detection. Other types of cylinders should be absent.
• Fungi and bacteria - complete absence. Fungi can be detected during pregnancy and in patients who are taking antibiotics.
• Mucus is acceptable in small amounts.
• Salts, although an integral part of the activity of many systems, should be absent in the sediment.

If any deviations from the norms of any indicator are found, the specialist should appoint additional examinations so as not to make an erroneous diagnosis.

Sediment in urine during pregnancy is especially carefully studied, since the slightest deviations, bacteria and other substances in the body can negatively affect the overall development of the child in the womb. During pregnancy, it is correct to take a urine test within the walls of the laboratory with the help of specialists in order to avoid the ingress of foreign microorganisms into the biological material. This fact is especially true during late pregnancy.

General urine analysis among general clinical studies is prescribed by doctors more often than others. The fact is that it is very informative, simple and cheap, while reflecting fairly complete data on the state of human health.

Urinalysis with sediment microscopy

Urine, or urine, is a product of the kidneys, the final component of metabolic processes. There is water in urine, as well as hormones dissolved in it, electrolytes, dead cells of the urinary tract mucosa, salts, leukocytes, etc. General analysis of urine (OAM) gives a set of information about the physical, chemical parameters of urine, the presence of various metabolites in it.

A general analysis of urine allows you to assess the activity of the kidneys, bladder and other organs of the system; these are its most important, but not exhaustive purposes. Also, the study will help to identify violations in the activity of internal organs that are not related to the urinary system.

Microscopy of urine sediment is one of the routine diagnostic techniques that is used both for screening various diseases, and for monitoring the course of diseases and the results of therapy.

The data that will be obtained after completing the study are as follows:

• General analysis (urine analysis by dry chemistry) - urine specific gravity, shade, transparency, acid-base index, sugar, nitrites, hemoglobin, ketone bodies, bilirubin, urobilinogen.
• Sediment microscopy (qualitative and quantitative assessment of a number of insoluble components) - erythrocytes, epithelial cells, salts,.

Indications

For patients with various pathologies of the urinary and other systems, the analysis is prescribed according to the recommendations of the doctor, for healthy people, for preventive purposes, it should be done every 6-12 months. After suffering a streptococcal infection, OAM is taken 7-14 days after recovery. The results of the analysis should be interpreted only by a doctor in order to correctly diagnose or exclude it.

Other indications for the analysis:

• Screening studies, medical examinations.
• Monitoring the development of complications.
• Evaluation of the effectiveness of treatment.
• In a comprehensive examination of the body.
• For differential diagnosis purposes.
• To identify metabolic diseases, electrolyte imbalances.
• For the diagnosis of infections, inflammatory pathologies.
• In order to monitor the patient's clinical condition after surgery.
• To analyze the condition of the kidneys when taking nephrotoxic drugs.

Photo microscopy of urine sediments

How do they do it?

The container for collecting the analysis should be bought only at the pharmacy, home containers and previously used containers are absolutely not suitable! Disposable sterile jars exclude the ingress of foreign substances into the material and distortion of results.

The day before, you should not eat coloring products - beets, carrots, wine, blueberries and other natural dyes. Determining the correct color of urine is very important, because, for example, a dark shade of urine is sometimes a sign of liver inflammation. The day before the analysis with sediment microscopy, it is undesirable to take drugs - some of them distort the results, for example, Aspirin paints urine in a pinkish tint. If the patient takes antibiotics, antiseptics, uroseptics, it is imperative to inform the doctor about this.

Also, the day before sample collection, you should refuse:

• Drinking alcohol;
• Drinking a lot of fluids;
• Sexual conduct;
• Performing cystoscopy.

Before collecting urine, you should wash without using soap, disinfectants. After the toilet, you need to collect the morning portion of urine (the first after sleep) in a container. The container should be delivered to the laboratory within 24 hours, stored at a temperature of + 2 + 24 degrees.

The study of urine is carried out as follows:

1. By appearance and with the help of the necessary equipment, the physical indicators of urine are assessed.
2. A pipette is lowered to the bottom of the container, which has stood for 2 hours.
3. Collect 10 ml of urine, which is centrifuged for 5-7 minutes.
4. The composition of the sediment droplet is analyzed to obtain all basic data.

Decoding

OAM standards are given in the table:

Parameters	Norm	Units
Shade	Yellow, straw yellow	-
Transparency	Transparent	-
Specific gravity	1,010-1,025	-
pH	5,00-7,00	pH
Protein	No or traces	g / l
Ketone bodies	Not	Mmol / l
Glucose	Not	Mmol / l
Bilirubin	Not	Mmol / l
Hemoglobin	Not	Ery / uL
Nitrite	Not	-
Urobilinogen	Not	Mmol / l

Deciphering abnormalities in the general urine analysis with sediment microscopy:

Parameters	Standards	Units
Leukocytes	Up to 3 in men, up to 5 in women	In sight
Erythrocytes	Until 3	In sight
Epithelium	Less than 5 in women, less than 3 in men	In sight
Salt	Not	In sight
Cylinders	No or single hyaline	In sight
Bacteria	Not	In sight
Slime	No or insignificant amount	In sight

After receiving the results of the analysis, the doctor will be able to draw conclusions about the changes in the body:

1. Colour. Darkening of urine indicates the presence of large amounts of bilirubin or urobilinogen. A red tint can indicate the presence of blood, a whitish color - about inflammation, the presence of mucus, blue-green - about putrefaction in the intestines.
2. Reaction. The abundance of animal food leads to acidification of urine, dairy-vegetable food - to alkalization. Acidic urine is also observed in diabetes mellitus, gout, fever, a shift to the alkaline side is characteristic of kidney inflammation, massive loss of salts against the background of vomiting, diarrhea.
3. Specific gravity. The density of urine increases with heart and kidney diseases, loss of water from the body, accumulation of protein, sugar, drug metabolites, toxins. The specific gravity is reduced due to hormonal imbalance, with some kidney pathologies.
4. Transparency. If the urine is cloudy, this is due to the presence of fat, salts, epithelial cells, erythrocytes, leukocytes.
5. Protein. The presence of protein means the development of severe or long-term renal diseases, without kidney damage can be observed with fever, after hard sports, with congestive heart failure.
6. Bilirubin. Appears in urine with pathologies of the liver, biliary tract.
7. Urobilinogen makes urine more yellow, it is observed in liver diseases, enteritis, hemolytic anemia.
8. Nitrite in urine is associated with the presence of bacteria and inflammatory reaction products in it.
9. Glucose. Appears in diabetes mellitus, thyrotoxicosis, acromegaly, Fanconi syndrome.
10. Ketone bodies. They grow with diabetes mellitus, less often with starvation, a sharp decrease in carbohydrate foods, a prolonged increase in temperature.
11. Epithelium. Appears in large quantities in the inflammatory process in the urinary system.
12. Erythrocytes. Blood in the urine is found in severe cardiac pathologies, kidney and urethral injuries, cystitis, kidney infarction, bladder tuberculosis, vasculitis, polycystic kidney disease, infectious process, and oncological diseases.
13. Leukocytes. The growth of leukocytes in the urine means the development of various forms of the inflammatory process in the kidneys, urethra, bladder, and is also observed in general infections, fever.
14. Cylinders. They appear in case of impaired renal filtration, typical for serious diseases of the kidneys and heart, for dehydration, overheating, poisoning.
15. Slime. It increases with inflammation in the kidneys and the lower parts of the urinary system.
16. Bacteria. Indicates the presence of a bacterial infection.
17. Salts (crystals). Indicate violations of mineral metabolism, the presence of stones, sand.

The analysis can be adversely affected by improper collection of the sample, its long-term storage, poor hygiene, excessive consumption of liquids, drugs and dyes, as well as stress, pregnancy, and menstruation.
In the video about sediment microscopy:

General urine analysis is a routine research method used in the diagnosis and control of the course of a number of diseases, as well as screening examinations. Urinalysis is one of the most effective methods for diagnosing abnormalities in kidney function.

The general analysis of urine includes an assessment of the physicochemical characteristics of urine and microscopy of the sediment. General urine analysis of patients with kidney and urinary system diseases is performed repeatedly over time to assess the condition and control therapy. Healthy people are encouraged to perform this test 1 to 2 times a year.

Do not underestimate its importance for determining other pathologies in the body of a modern person. These are diseases and inflammatory processes of the urinary tract (study for a slightly acidic, neutral or alkaline reaction), the genitourinary system (an increased level of leukocytes), urolithiasis (the appearance of erythrocytes in the sample), diabetes mellitus (the presence of glucose in the urine), stagnant processes (the presence of mucus ) and much more.

There is no doubt that such a serious type of urine analysis must be carried out with maximum accuracy, on modern equipment and on properly prepared material.

The general properties of urine are determined: (color, transparency, specific gravity, pH, protein, glucose, bilirubin, urobilinogen, ketone bodies, nitrites, hemoglobin);

Microscopy of urinary sediment: (epithelium, erythrocytes, leukocytes, casts, bacteria, salts).

Urine collection rules

Mayonnaise jars for urine analysis and other "classic" containers of polyclinics and folklore are irrevocably a thing of the past. To collect material, it is worth using special sterile containers and preservatives. Thus, the chances of foreign substances entering the sample are minimized, and the period of transporting the sample from the patient to the diagnostic equipment, acceptable for high-quality urine analysis, is significantly increased.

Further - preparation for the collection of material. The rules of personal hygiene at this moment become not only desirable, but obligatory: neither sweat nor secretion of the sebaceous glands should get into the urine. Antibacterial soap is not recommended in this case. Uncontaminated urine is a test result without errors. It is necessary to mention another type of impurities that can distort the results of a urine test: food and drugs. Do not eat beets, carrots and other natural dyes the night before. Remember that one of the main parameters of the study is the color of the urine. And, if it already differs from the norm, which is considered to be yellow and its shades, then let it give information not only about what you had dinner with.

Note that a violation of the norm for the presence of pigments can make the color of urine completely unexpected - blue, brown, red, even green.

Dark urine may indicate abnormalities in the liver, in particular with hepatitis. The liver stops destroying one of the enzymes, which, by reacting with air, and gives such a color change.

If the urine turns red, it is most likely bleeding. If it resembles milk diluted with water, it has an excess of fat. The pus contained in it gives a grayish tint. Green or blue is one of the signs of putrefaction in the intestines. Foamy urine occurs only in men. There is nothing wrong: it happens when sperm gets into it. And, for example, no one has yet learned to control wet dreams or an excess of sperm.

Medicines. Even harmless aspirin in large doses can turn urine pink. It is especially undesirable to take antibacterial drugs and uroseptics on the eve of urine analysis. It is necessary to consult with your doctor about the pause in their use. Except when the main subject of research is just the concentration of drugs in the urine.

Alcohol greatly distorts the results of urinalysis.

Try to drink no more and no less fluids than usual the day before your urinalysis.

Do not live sexually 12 hours before taking the analysis.

We also note that it is undesirable to pass a urine test during menstruation and within a week after procedures such as cystoscopy.

Remember that the main role in the diagnosis (for example, "an inflammatory process in the genitourinary system") is played not by the presence / absence of bacteria in the urine, but by their increased number: the characteristic growth in comparison with the norm (2 thousand bacteria in 1 ml) is 50 times (up to 100 thousand bacteria in 1 ml of urine).

Urine analysis is prescribed for:

Diseases of the urinary system;
- screening examinations during medical examinations;
- to assess the course of the disease, control the development of complications and the effectiveness of the treatment.
- Persons who have had streptococcal infection (tonsillitis, scarlet fever) are recommended to have a urine test 1 to 2 weeks after recovery. We recommend that healthy people have a urine test 1-2 times a year. Remember, treatment is always more expensive than prevention.

Collection of urine for general analysis preparation.

Before collecting urine, hygiene procedures are mandatory so that bacteria of the sebaceous and sweat glands do not get into the urine.

Collect strictly the morning portion of urine, allocated immediately after sleep, preferably the middle portion. The interval between collection of urine and delivery of material to the laboratory should be as short as possible.

To collect urine, a special kit (a sterile container and a test tube with a preservative) is used, which, together with the collection instructions, must be purchased in advance at any INVITRO medical office at a security deposit.

Urine in a test tube with a preservative is taken throughout the day (according to the blood test schedule).

Indications

• Diseases of the urinary system.
• Screening examination during medical examinations.
• Assessment of the course of the disease, control of the development of complications and the effectiveness of the treatment.
• Persons who have had streptococcal infection (tonsillitis, scarlet fever) are advised to have a urine test 1 to 2 weeks after recovery.

Decoding the results of a general urine test

Urine color.

Normally, urine pigment urochrome gives urine a yellow color of various shades, depending on the degree of urine saturation with it. Sometimes only the color of the sediment can change: for example, with an excess of urate, the sediment has a brownish color, uric acid - yellow, phosphates - whitish.

Increased color intensity - a consequence of the loss of fluids by the body: edema, vomiting, diarrhea.
Discoloration of urinemay be the result of the release of coloring compounds formed during organic changes or under the influence of components of the diet, drugs taken, contrast agents.

Urine color	condition	Dyes
Straw yellow		-
Dark yellow	Edema, burns, vomiting, diarrhea, congestive edema with heart failure	High concentration of urochromes
Pale, watery, colorless	Diabetes insipidus, decreased concentration function of the kidneys, taking diuretics, overhydration	Low concentration of urochromes
Yellow-orange	Taking vitamins of the group, furagin	-
Reddish, pink	Eating brightly colored fruits and vegetables, such as beets, carrots, blueberries; drugs - antipyrine, aspirin	-
Red	Renal colic, kidney infarction	The presence of red blood cells in the urine - fresh hematuria, the presence of hemoglobin, porphyrin, myoglobin
Meat slop color	Acute glomerulonephritis	Hematuria (altered blood)
Dark brown	Hemolytic anemia	Urobilinuria
Red brown	Taking metronidazole, sulfonamides, bearberry-based drugs. Poisoning with phenols	-
The black	Markiafava-Micelli disease (paroxysmal nocturnal hemoglobinuria) Alcaptonuria. Melanoma	Hemoglobinuria Homogentisic acid Melanin (melanuria)
Beer color (yellow-brown)	Parenchymal jaundice (viral hepatitis)	Bilirubinuria, urobilinogenuria
Greenish yellow	Mechanical (obstructive) jaundice - gallstone disease, pancreatic head cancer	Bilirubinuria
Whitish	The presence of phosphates or lipids in the urine	-
Lactic	Kidney lymphostasis, urinary tract infection	Hiluria, pyuria

Clarity of urine

Reference values:complete.
Clouding of urine can be the result of the presence in the urine of erythrocytes, leukocytes, epithelium, bacteria, fat droplets, precipitation of salts (urates, phosphates, oxalates) and depends on the concentration of salts, pH and storage temperature of urine (low temperature promotes the precipitation of salts) ... If you stand for a long time, the urine can become cloudy as a result of bacteria growth. Normally, slight turbidity can be caused by epithelium and mucus.

Relative density (specific gravity) of urine

The relative density (specific gravity) of urine depends on the amount of released organic compounds (urea, uric acid, salts) and electrolytes - Cl, Na and K, as well as on the amount of excreted water. The higher the urine output, the lower the relative density of urine. The presence of protein and especially glucose causes an increase in the specific gravity of urine. A decrease in the concentration function of the kidneys in renal failure leads to a decrease in the specific gravity (hypostenuria). The complete loss of concentration function leads to equalization of the osmotic pressure of plasma and urine, this condition is called isostenuria.

Reference values \u200b\u200b(for all ages): 1003 - 1035 g / l.

Increased relative density (hypersthenuria):

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

Decrease in relative density:

1. diabetes insipidus (nephrogenic, central, or idiopathic);
2. acute damage to the renal tubules;
3. polyuria (as a result of taking diuretics, drinking plenty of fluids).

urine pH.

Fresh urine from healthy people can have a different reaction (pH 4.5 to 8), usually the urine reaction is slightly acidic (pH between 5 and 6). Fluctuations in urine pH are due to the composition of the diet: a meat diet causes an acidic reaction of urine, the predominance of plant and dairy foods leads to alkalization of urine. Changes in urine pH correspond to blood pH; with acidosis, urine has an acidic reaction, with alkalosis - alkaline. Sometimes there is a discrepancy between these indicators.

With chronic lesions of the kidney tubules (tubulopathies), hyperchloric acidosis is observed in the blood, and the urine reaction is alkaline, which is associated with a violation of the synthesis of acid and ammonia due to damage to the tubules. Bacterial decomposition of urea in the ureters or storage of urine at room temperature leads to alkalization of urine. The reaction of urine affects the nature of salt formation in urolithiasis: at a pH below 5.5, uric acid stones are more often formed, at a pH of 5.5 to 6.0 - oxalate stones, at a pH above 7.0 - phosphate stones.

Reference values:

• 0 - 1 month - 5.0 - 7.0;
• 1 month - 120 years old - 4.5 - 8.0

Increase:

1. metabolic and respiratory alkalosis;
2. chronic renal failure;
3. renal tubular acidosis (type I and II);
4. hyperkalemia;
5. primary and secondary hyperfunction of the parathyroid gland;
6. carbonic anhydrase inhibitors;
7. a diet high in fruits and vegetables;
8. prolonged vomiting;
9. infections of the urinary system caused by microorganisms that break down urea;
10. the introduction of certain drugs (adrenaline, nicotinamide, bicarbonates);
11. neoplasms of the genitourinary system.

Decrease:

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

Protein in the urine (proteinuria).

Protein in urine is one of the most diagnostically important laboratory signs of kidney disease. A small amount of protein in the urine (physiological proteinuria) may be present in healthy people, but the excretion of protein in the urine does not normally exceed 0.080 g / day at rest and 0.250 g / day during intense physical exertion, after a long walk (marching proteinuria). Protein in urine can also be found in healthy people with strong emotional distress, hypothermia. In adolescents, orthostatic proteinuria (in an upright position of the body) occurs.

Normally, most of the proteins do not pass through the membrane of the renal glomeruli, which is explained by the large size of protein molecules, as well as their charge and structure. With minimal damage in the glomeruli of the kidneys, there is primarily a loss of low molecular weight proteins (mainly albumin), therefore, with a large loss of protein, hypoalbuminemia often develops. With more pronounced pathological changes, larger protein molecules also enter the urine. The epithelium of the renal tubules physiologically secretes a certain amount of protein (Tamm-Horsfall protein). Some of the proteins in urine can come from the genitourinary tract (ureter, bladder, urethra) - the content of these proteins in the urine rises sharply during infections, inflammation or tumors of the genitourinary tract. Proteinuria (the appearance of protein in the urine in an increased amount) can be prerenal (associated with increased tissue breakdown or the appearance of abnormal proteins in the plasma), renal (caused by kidney pathology), and postrenal (associated with urinary tract pathology). The appearance of protein in the urine is a common nonspecific symptom of kidney disease. In renal proteinuria, protein is found in both daytime and nighttime urine. According to the mechanisms of the occurrence of renal proteinuria, glomerular and tubular proteinuria are distinguished. Glomerular proteinuria is associated with a pathological change in the barrier function of the membranes of the renal glomeruli. Massive urinary protein loss (\u003e 3 g / L) is always associated with glomerular proteinuria. Tubular proteinuria is caused by impaired protein reabsorption in the pathology of the proximal tubules.

Reference values: < 0,140 г/л.

The presence of protein in the urine (proteinuria):

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

Glucose in the urine.

Glucose in urine is normally absent or found in minimal amounts, up to 0.8 mmol / l, since in healthy people all blood glucose after filtration through the membrane of the renal glomeruli is completely absorbed back into the tubules. When the concentration of glucose in the blood is more than 10 mmol / L - exceeding the renal threshold (the maximum ability of the kidneys to reabsorb glucose) or when the renal threshold decreases (damage to the renal tubules), glucose appears in the urine - glucosuria is observed.

Detection of glucose in urine has implications for the diagnosis of diabetes mellitus as well as for monitoring (and self-monitoring) antidiabetic therapy.

Note: the most accurate method isstudies of general urine analysis using diagnostic strips Multistix (+ sediment microscopy). The result is read automatically using the analyzer (errors of visual determination are excluded). The principle of the method for determining glucose on them is glucose oxidase. The step of the test strip for the analysis of urine for glucose is as follows: first, there is a "negative" result, the next step is "5.5" (traces). If the true glucose value is between these values, then due to such a step of the test strip, the device issues it as the minimum positive value - 5.5.

Since the questions of doctors and patients about this threshold value of glucose concentration have recently become more frequent, the laboratory decided to give out a number, and write "traces" when obtaining such a result. With such a response for glucose in urine, we recommend additional studies, in particular, the determination of fasting blood glucose, a study of daily urine excretion (hexokinase method), or, if prescribed by a doctor, a glucose tolerance test.

Reference values:0 - 1,6.

"SEE COMM.":

• < 1,7 - отрицат;
• 1.7 - 2.8 - traces;
• \u003e 2.8 - a significant increase in the concentration of glucose in the urine.

Increased levels (glucosuria):

1. diabetes;
2. acute pancreatitis;
3. hyperthyroidism;
4. renal diabetes;
5. steroid diabetes (taking anabolic steroids in diabetics);
6. poisoning with morphine, strychnine, phosphorus;
7. dumping syndrome;
8. cushing's syndrome;
9. myocardial infarction;
10. pheochromocytoma;
11. big trauma;
12. burns;
13. renal tubulointerstitial lesions;
14. pregnancy;
15. taking a lot of carbohydrates.

Bilirubin in the urine.

Bilirubin is the main final metabolite of porphyrins excreted from the body. In the blood, free (unconjugated) bilirubin in the plasma is transported by albumin, in this form it is not filtered in the renal glomeruli. In the liver, bilirubin combines with glucuronic acid (a conjugated, water-soluble form of bilirubin is formed) and in this form it is excreted with bile into the gastrointestinal tract. With an increase in the concentration of conjugated bilirubin in the blood, it begins to be excreted by the kidneys and is found in the urine. Healthy urine contains minimal, undetectable amounts of bilirubin. Bilirubinuria is observed mainly with damage to the liver parenchyma or mechanical obstruction of the outflow of bile. In hemolytic jaundice, the urine reaction to bilirubin is negative.

Reference values:negatively.

Detection of bilirubin in urine:

1. obstructive jaundice;
2. viral hepatitis;
3. cirrhosis of the liver;
4. neoplasm metastases in the liver.

Urobilinogen in urine.

Urobilinogen and stercobilinogen are formed in the intestine from bilirubin secreted with bile. Urobilinogen is reabsorbed in the large intestine and enters the liver through the portal vein system, and then is excreted together with bile. A small part of this fraction enters the peripheral bloodstream and is excreted in the urine. Normally, in the urine of a healthy person, urobilinogen is determined in trace amounts - its excretion in the urine per day does not exceed 10 μmol (6 mg). When urine stands, urobilinogen is converted to urobilin.

Reference values: 0 - 17.

Increased urinary excretion of urobilinogen:

1. increased hemoglobin catabolism: hemolytic anemia, intravascular hemolysis (transfusion of incompatible blood, infections, sepsis), pernicious anemia, polycythemia, resorption of massive hematomas;
2. an increase in the formation of urobilinogen in the gastrointestinal tract: enterocolitis, ileitis, intestinal obstruction, an increase in the formation and reabsorption of urobilinogen in infections of the biliary system (cholangitis);
3. increased urobilinogen in violation of liver function: viral hepatitis (excluding severe forms);
4. chronic hepatitis and cirrhosis of the liver;
5. toxic damage: alcoholic, organic compounds, toxins in infections, sepsis;
6. secondary hepatic failure: after myocardial infarction, cardiac and circulatory failure, liver tumors;
7. increased urobilinogen during liver bypass surgery: liver cirrhosis with portal hypertension, thrombosis, renal vein obstruction.

Ketone bodies in urine (ketonuria).

Ketone bodies (acetone, acetoacetic and beta-hydroxybutyric acids) are formed as a result of increased fatty acid catabolism. The determination of ketone bodies is important in the recognition of metabolic decompensation in diabetes mellitus. Insulin-dependent juvenile diabetes is often first diagnosed by the appearance of ketone bodies in the urine. With inadequate insulin therapy, ketoacidosis progresses. The resulting hyperglycemia and hyperosmolarity lead to dehydration, electrolyte imbalance, and ketoacidosis. These changes cause dysfunction of the central nervous system and lead to hyperglycemic coma.

Reference values: 0 - 0,4.

"SEE COMM."

• < 0,5 - отрицат;
• 0.5 - 0.9 - traces;
• \u003e 0.9 - positive.

Detection of ketone bodies in urine (ketonuria):

1. diabetes mellitus (decompensated - diabetic ketoacidosis);
2. precomatose state, cerebral (hyperglycemic) coma;
3. prolonged fasting (complete refusal of food or a diet aimed at reducing body weight);
4. severe fever;
5. alcohol intoxication;
6. hyperinsulinism;
7. hypercatecholaminemia;
8. isopropranolol poisoning;
9. eclampsia;
10. glycogenosis types I, II, IV;
11. lack of carbohydrates in the diet.

Nitrite in urine.

There are no nitrites in normal urine. In urine, they are formed from foodborne nitrates under the influence of bacteria if the urine has been in the bladder for at least 4 hours. Detection of nitrite in urine (positive test result) indicates an infection of the urinary tract. However, a negative result does not always rule out bacteriuria. Urinary tract infection varies in different populations, depending on age and gender.

The increased risk of asymptomatic urinary tract infections and chronic pyelonephritis, other things being equal, are more susceptible to: girls and women; elderly people (over 70 years old); men with prostate adenoma; patients with diabetes; patients with gout; patients after urological operations or instrumental procedures on the urinary tract.

Reference values: negative.

Hemoglobin in urine.

Hemoglobin is absent in normal urine. A positive test result reflects the presence of free hemoglobin or myoglobin in the urine. This is the result of intravascular, intrarenal, urinary hemolysis of erythrocytes with the release of hemoglobin, or muscle damage and necrosis, accompanied by an increase in plasma myoglobin levels. Distinguishing hemoglobinuria from myoglobinuria is quite difficult, sometimes myoglobinuria is mistaken for hemoglobinuria.

Reference values:negatively.

The presence of hemoglobin in urine:

1. severe hemolytic anemia;
2. severe poisoning, for example, sulfonamides, phenol, aniline. poisonous mushrooms;
3. sepsis;
4. burns.

The presence of myoglobin in urine:

1. muscle damage;
2. heavy physical activity, including sports training;
3. myocardial infarction;
4. progressive myopathies;
5. rhabdomyolysis.

Microscopy of urine sediment.

Microscopy of urine components is carried out in the sediment formed after centrifugation of 10 ml of urine. The sediment consists of solid particles suspended in urine: cells, cylinders formed by protein (with or without inclusions), crystals or amorphous deposits of chemicals.

Erythrocytes in the urine.

Erythrocytes (formed elements of blood) enter the urine from the blood. Physiological erythrocyturia is up to 2 erythrocytes / μl of urine. It does not affect the color of the urine. When examining, it is necessary to exclude blood contamination of urine as a result of menstruation! Hematuria (the appearance of red blood cells, other corpuscles, as well as hemoglobin and other blood components in the urine) can be caused by bleeding anywhere in the urinary system. The main reason for the increase in the content of red blood cells in the urine is renal or urological diseases and hemorrhagic diathesis.

Reference values: < 2 в поле зрения.

Erythrocytes in urine - exceeding the reference values:

1. stones of the urinary tract;
2. tumors of the genitourinary system;
3. glomerulonephritis;
4. pyelonephritis;
5. hemorrhagic diathesis (with intolerance to anticoagulant therapy, hemophilia, coagulation disorders, thrombocytopenia, thrombocytopathy);
6. urinary tract infections (cystitis, urogenital tuberculosis);
7. kidney injury;
8. arterial hypertension with involvement of renal vessels;
9. systemic lupus erythematosus (lupus nephritis);
10. poisoning with benzene derivatives, aniline, snake venom, poisonous mushrooms;
11. inadequate anticoagulant therapy.

Leukocytes in the urine.

An increased number of leukocytes in the urine (leukocyturia) is a symptom of inflammation of the kidneys and / or lower urinary tract. In chronic inflammation, leukocyturia is a more reliable test than bacteriuria, which is often undetectable. With a very large number of leukocytes, pus in the urine is determined macroscopically - this is the so-called pyuria. The presence of leukocytes in the urine may be due to an admixture of discharge from the external genital organs in the urine with vulvovaginitis, insufficiently careful toilet of the external genital organs when collecting urine for analysis.

Reference values:

• men:< 3 в поле зрения;
• women, children< 14 лет: < 5 в поле зрения.

An increase in leukocytes in urine is observed in almost all diseases of the kidneys and genitourinary system:

1. acute and chronic pyelonephritis, glomerulonephritis;
2. cystitis, urethritis, prostatitis;
3. stones in the ureter;
4. tubulointerstitial nephritis;
5. lupus jade;
6. rejection of a kidney transplant.

Epithelial cells in the urine.

Epithelial cells are almost constantly present in urine sediment. Epithelial cells originating from different parts of the genitourinary system differ (usually they secrete squamous, transitional and renal epithelium). Squamous epithelial cells, characteristic of the lower genitourinary system, are found in the urine of healthy people and their presence usually has little diagnostic value. The amount of squamous epithelium in the urine increases with a urinary tract infection. An increased number of cells of the transitional epithelium can be observed with cystitis, pyelonephritis, kidney stones. The presence of renal epithelium in the urine indicates damage to the renal parenchyma (observed in glomerulonephritis, pyelonephritis, some infectious diseases, intoxications, circulatory disorders). The presence of more than 15 renal epithelial cells in the field of view 3 days after transplantation is an early sign of the threat of allograft rejection.

Reference values:

• squamous epithelial cells: women -< 5 в поле зрения;
• men -< 3 в поле зрения;
• transitional epithelial cells -< 1;
• renal epithelial cells - absent.

Detection of renal epithelial cells:

1. pyelonephritis;
2. intoxication (intake of salicylates, cortisone, phenacetin, bismuth preparations, poisoning with heavy metal salts, ethylene glycol);
3. tubular necrosis;
4. rejection of a kidney transplant;
5. nephrosclerosis.

Cylinders in urine.

Cylinders are elements of a cylindrical sediment (a kind of casts of renal tubules), consisting of protein or cells, may also contain various inclusions (hemoglobin, bilirubin, pigments, sulfonamides). According to the composition and appearance, several types of cylinders are distinguished (hyaline, granular, erythrocytic, waxy, etc.). Normally, the cells of the renal epithelium secrete the so-called Tamm-Horsfall protein (absent in the blood plasma), which is the basis of the hyaline casts. Sometimes hyaline casts can be found in healthy people.

Granular casts are formed as a result of the destruction of tubular epithelial cells. Finding them in a patient at rest and without fever is indicative of renal disease. Waxy cylinders are formed from compacted hyaline and granular cylinders. Erythrocyte casts are formed by layering erythrocytes on the hyaline casts, leukocyte - leukocytes. Epithelial casts (rarely) are derived from renal tubular cells. Their presence in the analysis of urine a few days after the operation is a sign of rejection of the transplanted kidney. Pigment cylinders are formed when pigments are included in the cylinder and are observed in myoglobinuria and hemoglobinuria.

Reference values: absent.

Hyaline casts in urine:

1. renal pathology (acute and chronic glomerulonephritis, pyelonephritis, kidney stones, renal tuberculosis, tumors);
2. congestive heart failure;
3. hyperthermic conditions;
4. high blood pressure;
5. taking diuretics.

Granular cylinders (nonspecific pathological symptom):

1. glomerulonephritis, pyelonephritis;
2. diabetic nephropathy;
3. viral infections;
4. lead poisoning;
5. fever.

Wax cylinders:

1. chronic renal failure;
2. amyloidosis of the kidneys;
3. nephrotic syndrome.

Erythrocyte casts (hematuria of renal origin):

1. acute glomerulonephritis;
2. kidney infarction;
3. renal vein thrombosis;
4. malignant hypertension.

Leukocyte casts (leukocyturia of renal origin):

1. pyelonephritis;
2. lupus nephritis with systemic lupus erythematosus.

Epithelial casts (most rare):

1. acute tubular necrosis;
2. viral infection (eg, cytomegalovirus);
3. poisoning with salts of heavy metals, ethylene glycol;
4. overdose of salicylates;
5. amyloidosis;
6. kidney transplant rejection reaction.

Bacteria in urine

Excretion of bacteria in the urine has significant diagnostic value. Bacteria persist in the urine no more than 1 - 2 days after the start of antibiotic therapy. The first morning urine sample is preferred for research. It is possible to determine the type of bacteria and assess the level of bacteriuria, as well as to identify the sensitivity of microorganisms to antibiotics using bacteriological culture of urine.

Reference values:negatively.

Bacteria in urine: infections of the urinary system (pyelonephritis, urethritis, cystitis).

Yeast fungi... Detection of yeast of the genus Candida indicates candidiasis, which occurs most often as a result of inappropriate antibiotic therapy.

Inorganic urine sediment (crystals), salts in urine.

Urine is a solution of various salts that can precipitate (form crystals) when urine stands. Low temperature favors crystal formation. The presence of certain crystals of salts in the urinary sediment indicates a change in the reaction to the acidic or alkaline side. Excessive salt content in urine contributes to the formation of calculi and the development of urolithiasis. At the same time, the diagnostic value of the presence of salt crystals in the urine is usually small. Increased doses of ampicillin and sulfonamides lead to the formation of crystals.

Reference values absent.

Uric acid and its salts (urates):

1. highly concentrated urine;
2. acid reaction of urine (after exercise, meat diet, fever, leukemia);
3. uric acid diathesis, gout;
4. chronic renal failure;
5. acute and chronic nephritis;
6. dehydration (vomiting, diarrhea);
7. in newborns.

Triple phosphates, amorphous phosphates:

1. alkaline urine reaction in healthy people;
2. vomiting, gastric lavage;
3. cystitis;
4. fanconi's syndrome, hyperparathyroidism.

Calcium oxalate (oxaluria occurs with any urine reaction):

1. eating foods rich in oxalic acid (spinach, sorrel, tomatoes, asparagus, rhubarb);
2. pyelonephritis;
3. diabetes;
4. ethylene glycol poisoning.

Mucus in the urine.

Mucus is secreted by the epithelium of the mucous membranes. Normally present in urine in small amounts. With inflammatory processes, the content of mucus in the urine increases. An increased amount of mucus in the urine may indicate a violation of the rules for proper preparation for taking a urine sample.

Reference values:insignificant amount.