Microscopy of urine sediment is part of the laboratory study of clinical (general) urine analysis. The essence of the process lies in the identification or refutation of 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 the state of health.
Microscopic examination of urine sediment is part of a general urinalysis (OAM). A general analysis of urine is able to identify a number of pathologies, chronic diseases, and diagnose the result of latent diseases. Ailments without specific symptoms of manifestation pose a serious threat, affecting many systems of vital activity over time.
General analysis of urine involves a laborious research process in laboratory conditions, part of which is reduced to the study of biomaterial sediment. 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 representation of a 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 erythrocytes in urine, which a woman takes for analysis, may lie in the incorrect sampling of material during menstruation. It was recommended to postpone the analysis to other days, since particles entering 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 causes that will reveal pathologies and various diseases of the body.
- Cylinders are protein coagulated compounds or cellular tissue of the renal epithelium. Substances are epithelial, leukocytic, erythrocytic, hyaline, waxy and granular.
The presence of a single amount of hyaline cells of the cylinders 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.
Deciphering 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.
When diagnosing pathological conditions of various kinds, a general urine test is mandatory. Urine sediment microscopy is part of the general clinical examination. The essence of this analysis is to calculate and assess the quality of the elements of urinary sediment, in order to identify or refute most pathological conditions.
Overview of the study
Material correctly collected and delivered on time (delivery time 1-2 hours) to the laboratory affects the correct interpretation of the analysis. To carry out the analysis, you need a morning single portion of urine stored in a sterile container for analysis. Be sure to perform intimate hygiene before starting the collection of the analysis.
Analysis of the indicator for suspicions of such pathological conditions:
- hematuria (counting red blood cells);
- pyuria (white blood cell count);
- cylindruria (cylinder counting);
- bacteriuria (number of bacteria)
- hemoglobinuria. The presence of salt crystals, epithelial cells, mucus, protozoa is also assessed.
The study makes it possible to assess the function of the kidneys and urinary tract, as well as to identify abnormalities in the work of internal organs. The research procedure consists of the following stages:
- Using a pipette, 10 ml of urine (standing for 1-2 hours) is collected from the bottom of the container.
- The collected material is centrifuged at 1500 rpm. lasting 5-7 minutes.
- The composition of one drop of sediment is analyzed using low and high magnification. The data obtained will help in diagnosing diseases, determining the ongoing inflammatory or infectious process, changes in metabolism.
Explanation of sediment analysis results: norm
It is important to keep in mind that some external factors can affect the result of the urine sediment microscopy analysis, such as:
- excessive physical activity;
- taking medications (diuretics or antibiotics);
- violation of the rules for the collection and delivery of urine;
- diet.
The elements that are present in the sediment are usually classified as organized, having an organic origin, and unorganized - inorganic sediment. For all the identified elements of urinary sediment, there are certain norms, the excess of which indicates various pathological conditions.
Hemoglobin
The presence of hemoglobin in the urine indicates severe infectious diseases. The presence of hemoglobin in the urine sediment is considered a deviation, since it is considered a sign of the breakdown of red blood cells. It is often caused by various diseases - flu, pneumonia, acute infection. But external reasons can also provoke its occurrence in urine, for example, hypothermia, injury, poisoning. In this case, the urine acquires a reddish-brown hue, painful sensations in the lumbar region may appear. Very often, urine saturated with hemoglobin indicates a failed blood transfusion when the donor's blood is incompatible with the patient's blood.
Red blood cells in urine sediment
Erythrocytes in urine are unchanged and leached. Their difference lies in the content of hemoglobin, leached does not contain it. Leached present in the microscopic material indicate disorders in the functioning of the kidneys, unchanged ones - on violations of the urinary tract. The normal red blood cell count for the female sex is 3, for the male sex - 1. With other indicators, hematuria is noted. Allocate microhematuria (the color of urine does not change) and macrohematuria (urine changes color due to the presence of red blood cells). Avoid microscopic examination of urine sediment during critical days, as blood can enter the sample in the urine. The reasons for the appearance of hematuria include:
- kidney pathology and injury;
- diathesis;
- the presence of kidney stones;
- tumors of the urinary system;
- urinary tract infections;
- poisoning of various kinds.
Leukocytes in urine sediment
A large number of white blood cells causes clouding of the urine. The boundary values of leukocytes in urine are 0-5 for women, 0-3 for men. If the values are increased, it means that pus is excreted in the urine (pyuria or leukocyturia). Pyuria always indicates an inflammatory focus. To determine the approximate localization of the passing inflammation, glass urine samples are prescribed, namely. The concentration of leukocytes in the first glass of urine is the initial pyuria, it indicates urethritis or prostatitis. Ultimate pyuria is determined by the presence of leukocytes in the third glass and suggests cystitis. An excess of leukocytes in three glasses is ailments of the kidneys and bladder.
Epithelium in urine sediment
Epithelial cells (epithelial cells) are found in urine quite often, their presence in single values is considered the norm. Epithelial cells are classified by nature of origin. The renal epithelium identified in the sediment is of great importance, since this type of epithelium passes from the renal tubules. This fact indicates serious kidney damage. An increase in the permissible values of squamous epithelium often indicates an incorrect collection of analysis or an acute inflammatory process in the organs of the urinary system. Urine sediment containing polymorphic epithelium in values higher than permissible carries information about diseases of the urinary tract (oncology, cystitis, stones, intoxication).
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 the urine, as well as hormones, electrolytes, dead cells of the urinary tract mucosa, salts, leukocytes, etc. General urine analysis (OAM) provides a set of information about the physical and chemical parameters of urine, about 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 methods, which 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 doctor's recommendations, for healthy people, for preventive purposes, it should be done every 6-12 months. After 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 examinations, medical examinations.
- Monitoring the development of complications.
- Evaluation of the effectiveness of treatment.
- In a comprehensive examination of the body.
- For the purpose of differential diagnosis.
- 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 state of the kidneys when taking nephrotoxic drugs.
In the 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 the 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 medications - 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 collecting the sample, you should refuse:
- Drinking alcohol;
- Drinking a lot of fluids;
- Sexual conduct;
- Performing cystoscopy.
Before collecting urine, wash yourself without using soap or 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:
- By appearance and with the help of the necessary equipment, the physical indicators of urine are assessed.
- A pipette is lowered to the bottom of the container, which has stood for 2 hours.
- Collect 10 ml of urine, which is centrifuged for 5-7 minutes.
- The composition of the sediment droplet is analyzed to obtain all basic data.
Decoding
The standards for OAM 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 | No | Mmol / l |
| Glucose | No | Mmol / l |
| Bilirubin | No | Mmol / l |
| Hemoglobin | No | Ery / uL |
| Nitrite | No | - |
| Urobilinogen | No | Mmol / l |
Deciphering abnormalities in the general analysis of urine with sediment microscopy:
| Parameters | Norms | 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 | No | In sight |
| Cylinders | No or single hyaline | In sight |
| Bacteria | No | 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:
- Colour. Darkening of urine means 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.
- Reaction. The abundance of animal food leads to acidification of urine, dairy-plant 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.
- 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 decreases due to hormonal imbalance, with some kidney pathologies.
- Transparency. If the urine is cloudy, this is due to the presence of fat, salts, epithelial cells, erythrocytes, leukocytes.
- 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.
- Bilirubin. Appears in urine with pathologies of the liver, biliary tract.
- Urobilinogen makes urine more yellow, it is observed in liver diseases, enteritis, hemolytic anemia.
- Nitrite in urine is associated with the presence of bacteria and products of the inflammatory reaction in it.
- Glucose. Appears in diabetes mellitus, thyrotoxicosis, acromegaly, Fanconi syndrome.
- Ketone bodies. They grow with diabetes mellitus, less often with starvation, a sharp decrease in carbohydrate foods, a prolonged increase in temperature.
- Epithelium. Appears in large quantities in the inflammatory process in the urinary system.
- Red blood cells. Blood in the urine is present in severe cardiac pathologies, kidney and urethral injuries, cystitis, kidney infarction, bladder tuberculosis, vasculitis, polycystic kidney disease, infectious process, and oncological diseases.
- 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.
- Cylinders. They appear when renal filtration is impaired, they are typical for serious diseases of the kidneys and heart, for dehydration, overheating, and poisoning.
- Slime. It increases with inflammation in the kidneys and the lower parts of the urinary system.
- Bacteria. Indicates the presence of a bacterial infection.
- 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 prolonged storage, poor hygiene, excessive consumption of liquids, drugs and dyes, as well as stress, pregnancy, menstruation.
In the video about sediment microscopy:
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 settling for at least 2 hours. Sediment diagnostics is the most effective and accurate method, which indicates the work of all vital systems, in particular, the functioning of the kidneys.
Many diseases of the genitourinary system at the initial 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:
- Urine settles for two hours, after which 10 milliliters of material is collected from the bottom of the flask.
- The collected sample is placed in a centrifuge for 7 minutes.
- The drop is placed under a microscope and study at different magnifications.
Such a 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.
Methods for the study of urine sedimentappoint in such situations:
- Diagnosis of kidney diseaseimpossible without microscopy. The doctor makes appointments if there is a suspicion of the presence of pathologies of the genitourinary system.
- Differential research is carried out on the basis of a general analysis of urine.
- To diagnose the presence of inflammatory processes, infectious diseases.
- 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.
- Monitoring the patient's condition using urine analysis, preventing the occurrence of complications.
- Before and after surgery the patient gives urine daily for diagnosis, as prescribed by the doctor.
- 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 has 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:
- The number of red blood cells in the urine- an important indicator of health, a minimum number of them is allowed.
- The presence of leukocytes is permissible in urine, but only if their number does not exceed the established standards.
- Epithelial cells divided into types, each subspecies is counted during diagnosis. The flat cell type is allowed in the urine sediment, other types indicate the development of the disease.
- Hyaline casts in urine - allowed in small dose, other varietiesrenal cellsepithelium is unacceptable.
- Bacteria in urine a healthy person is absent, if such components have been diagnosed, then additional diagnostics and examination are prescribed.
- 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 sediment
Urine has a sediment, which does not always indicate the development of pathology, with individual characteristics of the body, a characteristic color of urine, 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 such a factor indicates the presence of salt, epithelial particles, and is detected in many diseases. Change urine 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, urine collection spend in the morning. The collected material is sent to the laboratory, before taking a sample, 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:
- 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 indicates pathology , therefore, only a comprehensive conclusion will indicate the true state of the body.
- 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.
- Fetid odor. A healthy body excretes odorless urine, but it does not have any pronounced indicators.
- A test is carried out for chemical reactions, the norm for a person is established by general recommendations.
- To determine the protein, a reagent is added to the material; with an unarmed eye, you can detect the protein - the urine becomes cloudy.
- 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 extensive decryption that the doctor deals with. Before starting the decryption, 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:
- Increased red blood cell countindicates kidney disease, infectious diseases.
- An increased leukocyte count indicates pyelonephritis , inflammatory processes.
- The presence of epithelial cells indicatespoisoning with heavy metals.
- Hyaline cylinders are high blood pressure, heart disease, physical activity.
- A high concentration of bacteria indicates an infectious lesion.
- Salt is a lack of fluid in the body, frequent diets, kidney disease.
- Mucus is an inflammatory process, diseases associated with hypothermia.
The end result is affected by non-compliance with the rules for collecting and storing urine. Microscopy can re-prescribe if mistakes were made. Deviations from the norm in an adult when deciphering, 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 microscopyprescribed when obtaining a high-quality result for each chemical component. Hemoglobin in urine indicates serious infectious foci. Hemoglobin is formed when the breakdown of red blood cells 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 red blood cells 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 urineis 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 allow you to 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 a classifier of the epithelium, 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 infections cysts, oncology.
Availability of cylinders
Hyaline casts in urineare 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 causes of the appearance of a substance in a significant amount are kidney pathologies, poor blood circulation, and infectious foci.
Salt on urine microscopy
Uric Salt Crystalscannot exceed the established rate from 20 to 40 mg. If the excretory system malfunctions, the balance changes, and the amount of salt 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 to be an important indicator of a person's health status. 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. The reasons for the presence of bacteria are infections,cystitis. Mucus in the urineappears after hypothermia.
Deviations from the norm
After diagnosis, deviations from the norm are allowed, which indicates various pathological conditions. The main reason for the deviations is diseases of the excretory system. Indicators fluctuate under various conditions of the body. The composition and structure of urine is influenced by:
- pregnancy;
- chronic diseases;
- blood transfusion;
- neoplasms, infections, inflammations.
Indicators can be affected by both major changes in the body and dieting, wrong lifestyle. To correct deviations from the norm, refer to doctors 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 lifestyle of a person, both external and internal factors are distinguished, which require competent correction by the doctor.Treatment of prostatitisstart after a complete examination, delivery of laboratory analysis of urine for microscopy.
Indicators that are not normal
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 on a regular basis.
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)
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.
Red blood cells in urine
Erythrocytes (blood cells) 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. During the study, it is necessary to exclude the contamination of urine with blood 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.
Norm: absent; with microscopy - up to 2 in the field of view
Erythrocytes in urine - excess of the norm:
- stones of the urinary tract;
- tumors of the genitourinary system;
- glomerulonephritis;
- pyelonephritis;
- hemorrhagic diathesis (with intolerance to anticoagulant therapy, hemophilia, coagulation disorders, thrombocytopenia, thrombocytopathy);
- urinary tract infections (cystitis, urogenital tuberculosis);
- kidney injury;
- arterial hypertension with involvement of renal vessels;
- systemic lupus erythematosus (lupus nephritis);
- poisoning with derivatives of benzene, aniline, snake venom, poisonous mushrooms;
- inadequate anticoagulant therapy.
Leukocytes in 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 thorough toilet of the external genital organs when collecting urine for analysis.
Norm: absent; with microscopy:
Men - 0 - 3 in sight
women, children< 14 лет - 0 - 5 в поле зрения
An increase in leukocytes in urine is observed in almost all diseases of the kidneys and genitourinary system:
- acute and chronic pyelonephritis, glomerulonephritis;
- cystitis, urethritis, prostatitis;
- stones in the ureter;
- tubulointerstitial nephritis;
- lupus jade;
- rejection of a kidney transplant.
Epithelial cells in urine
Epithelial cells are almost constantly present in urine sediment. Epithelial cells originating from different parts of the genitourinary system are different (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 is usually of 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, and 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 a threat of allograft rejection.
Norm: absent;
microscopy: squamous epithelial cells:
- women are isolated in the field of vision
- men - single in the drug
other epithelial cells - absent
Detection of renal epithelial cells:
- pyelonephritis;
- intoxication, intake of salicylates, cortisol, phenacetin, bismuth preparations, poisoning with salts of heavy metals, ethylene glycol);
- tubular necrosis;
- rejection of a kidney transplant;
- nephrosclerosis.
Cylinders in urine
Cylinders - elements of the sediment of a cylindrical shape (a kind of casts of the 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. Hyaline casts can be found in the urine in all kidney diseases. Sometimes hyaline casts can be found in healthy people. As a pathological symptom, they acquire significance when constantly detected and in significant quantities, especially when erythrocytes and renal epithelium are superimposed on them.
Granular cylinders 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 in the tubules with a wide lumen. They are found in severe kidney disease with a predominant lesion and degeneration of the epithelium of the tubules, more often in chronic than in acute processes.
Erythrocyte casts are formed when erythrocytes are layered on hyaline casts, leukocytes - leukocytes. The presence of erythrocyte casts confirms the renal origin of hematuria.
Epithelial casts(rarely) are formed when tubular epithelium is detached. They occur with severe degenerative changes in the tubules at the beginning of acute diffuse glomerulonephritis, chronic glomerulonephritis. Their presence in the analysis of urine a few days after the operation is a sign of rejection of the transplanted kidney.
Pigment (hemoglobin) cylinders are formed when pigments are included in the cylinder, and is observed with myoglobinuria and hemoglobinuria.
Cylindroids- long formations of mucus. Single cylindroids are found in urine at normal levels. A significant number of them occur in inflammatory processes of the mucous membrane of the urinary tract. They are often observed when the nephritic process subsides.
Norm: hyaline cylinders are single, the rest are absent
Hyaline casts in urine:
- renal pathology (acute and chronic glomerulonephritis, pyelonephritis, kidney stones, renal tuberculosis, tumors);
- congestive heart failure;
- hyperthermic conditions;
- high blood pressure;
- taking diuretics.
Granular cylinders (nonspecific pathological symptom):
- glomerulonephritis, pyelonephritis;
- diabetic nephropathy;
- viral infections;
- lead poisoning;
- fever.
Wax cylinders:
- amyloidosis of the kidneys;
- nephrotic syndrome.
Erythrocyte casts (renal hematuria):
- acute glomerulonephritis;
- kidney infarction;
- renal vein thrombosis;
- malignant hypertension.
Leukocyte casts (renal leukocyturia):
- pyelonephritis;
- lupus nephritis with systemic lupus erythematosus.
Epithelial casts (most rare):
- acute tubular necrosis;
- viral infection (eg, cytomegalovirus);
- poisoning with salts of heavy metals, ethylene glycol;
- overdose of salicylates;
- amyloidosis;
- kidney transplant rejection reaction.
Bacteria in urine
The excretion of bacteria in the urine is of significant diagnostic value. Bacteria persist in the urine for no more than 1-2 days after the start of antibiotic therapy. The first morning urine sample is preferable 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.
Norm: negatively
Bacteria in the urine:
- infections of the urinary system, pyelonephritis, urethritis, cystitis).
Yeast fungi
- candidiasis, which occurs most often as a result of inappropriate antibiotic therapy.
Reference values: negatively
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 urine is usually small. Increased doses of ampicillin and sulfonamides lead to the formation of crystals.
Under physiological conditions, uric acid is found with a high concentration of urine, after a plentiful meat meal, after profuse sweating.
Norm: absent
Uric acid and its salts (urates):
- highly concentrated urine;
- acidic urine reaction (after exercise, meat diet, fever, leukemia);
- uric acid diathesis, gout;
- chronic renal failure;
- acute and chronic nephritis;
- dehydration (vomiting, diarrhea);
- in newborns.
Hippuric acid crystals:
- eating fruits containing benzoic acid (blueberries, lingonberries);
- diabetes;
- liver disease;
- putrefactive processes in the intestines.
Ammonia-magnesia phosphates, amorphous phosphates:
- alkaline urine reaction in healthy people;
- vomiting, gastric lavage;
- cystitis;
- Fanconi syndrome, hyperparathyroidism.
Calcium oxalate (oxaluria occurs with any urine reaction):
- eating foods rich in oxalic acid (spinach, sorrel, tomatoes, asparagus, rhubarb);
- pyelonephritis;
- diabetes;
- ethylene glycol poisoning.
Leucine and Tyrosine:
- severe metabolic disorder;
- phosphorus poisoning;
- destructive liver diseases;
- pernicious anemia;
- leukemia.
Cystine:
- congenital disorder of cystine metabolism - cystinosis.
Fat and fatty acids:
- degenerative changes in the epithelium of the renal tubules;
- eating a lot of fish oil.
Cholesterol:
- hiluria;
- fatty degeneration of the kidneys;
- echinococcosis of the kidneys;
- cystitis;
- cholesterol stones.
Bilirubin:
- hepatitis;
- liver cancer;
- infectious diseases;
- phosphorus poisoning.
Hematoidin:
- chronic bleeding along the urinary tract, especially if the blood stagnates anywhere.
Mucus in the urine
Mucus is secreted by the epithelium of the mucous membranes. Normally present in urine in small amounts. In 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.
Norm: insignificant amount.
