Urinalysis : decoding the norm , how to collect
Analyses And Studies / / August 12, 2017
- How to collect Urinalysis: the basic rules
- normal and pathological
- As the analysis in children?
- urinalysis during pregnancy
Urinalysis (or clinical urine analysis) is a laboratory study allows to evaluate the physical and chemical properties of urine.Appointed by almost all patients regardless of the presumptive diagnosis.
Urine - a product of human activity resulting from the filtration of blood plasma.Consists of 96% water, the remaining 4% it is the final metabolic products, minerals and other substances.
How to collect urine test: basic rules
urine collection is carried out in the morning, as it was the morning portion of the most informative.Previously held the preparation for the general analysis of urine:
- sure to follow the toilet of external genitals.Women need to take a sterile cotton swab, moisten it with warm soapy water and thoroughly clean labia from front to back.After the pressed wet a clean cloth.When menstrual bleeding analysis of the change should be postponed.Men also washed the area opening of the urethra warm water with soap.Then rinsed with pure water and dried with sterile cloth.
- Dishes must first prepare for urine.It should be dry and thoroughly cleaned, otherwise the results may be distorted.It is best for this purpose purchased at the pharmacy sterile container for bioassay.
- If the patient cystoscopy was performed, to obtain reliable results can only be to pass urine 6-8 days after the procedure;
- eve prohibited medication (some of which affect the results of the analysis) and alcohol.
going any portion of the first morning urine (not necessarily the average).The required amount of urine for general analysis - 120-200ml.
Keep urine recommended 1.5-2 hours.In a later study, indicators often unreliable.This is due to the fact that during this time the urine can get microorganisms that begin to multiply there.
We can not allow supercooling capacity in the urine, as falling in salt sediment can be wrongly interpreted as renal pathology.Therefore, when transporting the winter temperature should ensure positive support.
normal and pathological
So, let's look at that shows urinalysis.In this study determined:
- specific gravity;
- urine pH.
also revealed the presence (or absence):
- blood cells (white blood cells, red blood cells);
- certain substances (hemoglobin, protein, ketone body, glucose, bile pigments, inorganic substances);
- urinary components (cylinders, epithelial cells).
normal values of total urine indicate good work of the kidneys and other organs of the urinary system.
norm in adults:
- amount of urine - it does not matter;
- transparency taken in the analysis of urine - transparent;
- urine color - straw (light) - yellow;
- smell - a non-specific, not sharp;
- urine pH - less than 7 is acidic reaction;
- specific weight - more than 1,018 (for the morning portion);
- urobilinogen - from 5 to 10 mg / l;
- protein, hemoglobin, bilirubin, glucose and ketone bodies in the analysis
- erythrocytes: in the field of view are present up to 3 (in women), men - to 1;
- leukocytes: there are up to 6 and (in women), men - to 3;
- epithelial cells - up to 10 in the field of view;
- cylinders, salt - are absent;
- bacteria, parasites, fungi - are absent.
Deciphering Deciphering the general analysis of urine in children and adults is almost the same.Consider each of the indicators separately:
amount of urine
amount of urine in the overall analysis does not allow to judge the deviation of the daily urine output (diuresis - is the entire volume of urine secreted per day).From this index it depends only on the possibility of determining another indicator - the relative density of urine (specific gravity).To do this, you need about 100ml (at least) of urine.If the analysis test strips are used, the urine takes a lot less - 15-20ml.
Normally a person Freshly collected urine clear.To determine this index is used gradation of transparency: full, cloudy, incomplete.Clouding
often occurs due to the presence in urine of external elements, salts, leukocytes, bacterial cells, erythrocytes, epithelial fats.If turbidity urine must be established, it is allocated such, or becomes over a period of time, during standing.
If the urine is cloudy immediately after urination, it speaks of the presence of certain pathological elements: bacteria, phosphates, pus (white blood cells).Lactic haze is often a sign of chyluria when determined in urine lymph.Sometimes, the urine may be the elderly.
If turbidity appears in the urine only after a time, it is a sign of finding it urate.Such urine when heated becomes normal transparency.With high content of urate seen pink or brownish-yellow precipitate.
The urine of a healthy person has a yellow color.Its shade can vary from light to deep.Painting is determined by the presence of pigments in the urine: uroeritrina and urochrome.The volume of urine and its relative density have a direct impact on the intensity of the color.
If urine color saturation yellow and it is small, it means concentrated, with high specific gravity.Light urine often weakly concentrated.It is a lot, and its relatively low density.If present in the urine bile pigments, it becomes yellowish-green color, or the color reminiscent of beer.
hemoglobin and red blood cells urine give shade "meat slops".Taking certain medications can also change the color of urine: refampitsin makes it red, naphthol - black or dark brown.
smell of urine
The urine of a healthy person has a specific, but not pungent odor.For diagnostic purposes, the smell of urine is of minor importance.If the urine smells like feces, can be suspected puzyrnorektalny fistula.The ammonia smell characteristic for cystitis, putrid - for urinary tract pathologies gangrenous nature, the smell of unripe fruit (acetone) - diabetes, fetid smell - in the use of sharp-smelling products (horseradish, garlic).
This indicator, depending on the power, can be weakly basic, neutral or acidic.If a person eats mostly plant foods, or has an inflammatory pathology, urine will often have an alkaline reaction.At the meat lovers, as well as in metabolic disorders, urine acidic reaction.Character
calculi in urolithiasis depends on the reaction (pH) of urine.If the pH rises above 5.5, the form uric acid stones.At pH values in the range 5.5-6.0 - oxalate stones, with a pH of 7.0 - phosphate stones.
This indicator normally has a fairly wide range, from 1,012 to 1,025.Specific gravity is determined by the amount of dissolved substances in urine, such as salts, uric acid, urea, creatinine.
If the urine specific gravity decreases (gipostenuriya), and not more than 1, 010, this indicates low concentration ability excretory organs - kidneys.By repeating these numbers in some tests in a row, your doctor may suspect pyelonephritis.And in combination with nocturia (nocturnal urine output when more than a day), chronic pyelonephritis developed with a high degree of probability.
increasing proportion of numbers (1,030 or more) are characteristic of the state of oliguria (daily urine output of less than 400ml), observed in cardiovascular disease and glomerulonephritis.Index specific weight, surpasses 1,040 mark, often indicates diabetes.
presence of protein in the urine
In a healthy person there is protein in the urine.If identified traces, additional diagnostics.Proteinuria (the presence of protein in urine) may be observed in inflammatory renal pathologies with renal insufficiency.
Bilirubin Normally, bilirubin in urine is also missing.It may be detected in patients with viral hepatitis, obstructive jaundice, cirrhosis, cholestasis.Hemolytic jaundice often does not give an increase of bilirubin in the urine.
During the day with the urine from the body goes to 50 mg of ketone bodies.But the one-time portion is not possible to determine them.And normally they should not be.Vomiting, fever, diarrhea, anemia, constipation - a condition in which urine ketone bodies are determined.
Appears when erythrocyte hemolysis in the presence of myoglobin in the urine.
high level of urobilinogen in the urine accompanied by such diseases as: hemolytic jaundice, liver pathology of inflammatory and toxic nature, bowel disease.
obstructive jaundice due to obstruction of the bile duct, leading to the absence of urobilinogen in the urine.
pyuria (increased number of leukocytes in urine) observed in pathologies of the genitourinary system.
Red blood cells in urine Normally they are not.Tumors, stones in the kidneys and ureters, inflammation of the urogenital system, hypertension, bleeding in the urinary tract, poisoning, bleeding disorders are the cause of red blood cells in the urine.
Cylinders and epithelial cells in the urine
Normally, they are not.Acidosis, infectious diseases, nephrosis, nephritis and other organic kidney pathology cylindruria often result in which a lot of cylinders found in urine.Simultaneously determined in urine protein and epithelial cells.
salts in the urine
appearance in the urine salts (phosphaturia, oksalaturiya) - a sign of vitamin deficiency, metabolic disorders, anemia prevalence in the diet of a particular range of products (such as meat).
Urine, located in the bladder and kidneys, which normally sterile.While urinating, it shatters microbes (one in 10,000 mL) of penetrating the urethra.For infections of the urinary tract number of bacteria in the urine increases dramatically.
urine often Candida fungi get into the bladder from the vagina.If so, it is assigned to an anti-fungal treatment.
parasites in urine
Their discovery is accompanied by such a state as dysbiosis, and requires mandatory treatment.
As the analysis in children?
Urinalysis children assigned at the health center, etc. Hospitals.Collected urine as well as in adults.If a child can do it myself, after he needed to explain how to be washed away by preparing a sterile container.If the child is small, you can use a special container (sold in the pharmacy).
can not pour the urine into the container from the pot, squeeze it out of diapers (nappies).
Clinical Analysis of urine during pregnancy
Urine pregnancy performed before each reception at the gynecologist.Normal pregnancy is the same as in the adult in the normal state.Allowed the presence of protein (up to 0,075g / l), single cylinder and a small amount of some salts (oxalate, urate).
If performance of urinalysis are abnormal, the doctor suggests a specific diagnosis and appoint an additional examination for its refinement.
12 Aug, 2017
12 Aug, 2017