Decoding the analysis of urine leukocytes. What does urine analysis show?

Urine analysis in women is an integral research method during pregnancy, and any adult who goes to a doctor for a routine examination or with complaints will confirm that a specialist will definitely issue a referral for a general urine test.

What is checked in urine analysis and when is a study prescribed?

A general urine test is a study that can be used to assess not only the functioning of the kidneys and organs of the urinary system, but also the whole organism. By studying the basic parameters of urine, the doctor has the ability to suggest in which of the organs abnormalities have appeared. Analysis indicators are deciphered according to the following parameters:

• density (specific gravity);
• transparency;
• Colour;
• smell.

• glucose;
• bile pigments;
• ketone bodies;
• shaped elements of blood (erythrocytes, leukocytes;
• hemoglobin;
• protein;
• epithelium and casts.

The main indications for passing a urine test in a woman are:

• complaints of pain during urination;
• frequent urination and an increase in daily urine output (more than 1.5 liters per day);
• lower back pain;
• diseases of the pancreas;
• pregnancy;
• arterial hypertension.

Also, a general urine test is necessarily prescribed to patients undergoing treatment, this helps to assess the effectiveness of therapy and, if necessary, adjust the prescribed doses of drugs.

With the help of a general analysis of urine, it is possible to diagnose diseases of the bladder, ureters, kidneys, the presence of stones and sand in the urinary organs, tumors even before the onset of severe clinical symptoms.

How to prepare for the test: the rules for collecting urine

In order for the indicators of the general analysis of urine to be reliable and as accurate as possible, you should properly prepare for the collection of biological material:

• before collecting urine in a container, you should make a thorough toilet of the external genital organs by blotting them with a disposable towel;
• a woman should close the vagina with a cotton swab before collecting urine so that vaginal discharge does not enter the container - this can lead to incorrect research results;
• during menstruation, urine analysis cannot be taken - this leads to an incorrect interpretation of the analysis;
• 1-2 days before urine collection, sugar, carbohydrates and spicy foods should be limited in the diet;
• urine should be delivered to the laboratory no later than 1-2 hours after collection.

To study urine analysis, it is best to collect the morning portion, but in some situations when an urgent analysis is required, you can collect biological fluid at any time of the day.

Indicators of urine analysis in women: the norm

The indicators of the general analysis of urine and their norms are presented in more detail in the table.

The result of the analysis is usually ready within an hour after delivery; in some laboratories, this may take several hours. Let's take a closer look at each indicator.

Urine color

The color of excreted urine depends not only on the work of the kidneys, but also on the amount of fluid you drink. The release of almost colorless urine in large quantities (more than 2-3 liters per day) may be the first sign of the following conditions:

• diabetes insipidus;
• chronic renal failure.

A deep, dark color (reddish to brown) of urine is a sign of:

• tumors in the organs of the urinary system;
• kidney infarction;
• kidney tuberculosis;
• urolithiasis;
• glomerulonephritis ("meat slop" urine).

Excretion of black urine is characteristic of melanoma and melanosarcoma; dark brown urine (the color of dark beer) is excreted in acute hepatitis.

Urine clarity and odor

Normally, a woman's urine should be absolutely transparent. Slight turbidity is possible if the patient collected the analysis incorrectly and vaginal discharge got into the jar. If all the collection rules were followed, but the urine is still cloudy, then this may signal the following conditions:

• acute and chronic cystitis;
• urolithiasis disease;
• the appearance of protein in the urine is characteristic of hypertension, hypertensive crisis, nephropathy of pregnant women;
• an increased content of leukocytes and epithelium in the urine is the first sign of inflammatory diseases of the urinary system and small pelvis in women;
• excess salt in the urine.

Normally, urine has a mild, specific odor. If the urine starts to smell like acetone or soaked apples, then this is the first sign of diabetes mellitus or the accumulation of ketone bodies in the blood. The smell of rotting from urine is characteristic of the decay of a malignant tumor in the bladder or urinary organs.

Specific gravity and pH

Normally, a woman's urine pH does not exceed 4.9-6.9, slightly acidic. An increase in the pH level is characteristic of chronic renal failure, dehydration, hyperkalemia. A decrease in the pH of urine in a woman is observed with diabetes mellitus, high temperature, hypokalemia.

The density of urine or specific gravity is determined by the amount of dissolved substances in it - salts, creatinine, uric acid and urea. According to the norm, the specific gravity of urine in women does not exceed 1.020, an increase in these indicators is typical for:

• swelling;
• nephrotic syndrome in pregnant women;
• preeclampsia of pregnant women;
• diabetes;
• the use of retingenocontrast substances for diagnostic purposes.

A decrease in specific gravity less than 1.012 is typical for:

• diabetes insipidus;
• the presence in the diet of a large amount of liquid (more than 3 liters);
• acute damage to the renal tubules;
• increased blood pressure as a result of malignant oncological processes in the body;
• chronic renal failure;
• taking diuretics.

Protein

Normally, in the urine of a healthy woman, protein is not detected or its content does not exceed 0.033 g / l. If the indicators are higher than normal, then this indicates such conditions:

• kidney disease with impaired excretory function;
• acute cystitis;
• vulvovaginitis;
• toxicosis of pregnant women;
• arterial hypertension;
• nephropathy during pregnancy.

Glucose

Normally, glucose is not detected in the urine of a healthy woman. The presence of sugar in the analysis indicates the following diseases:

• acute pancreatitis;
• diabetes;
• Itsenko-Cushing's syndrome.

In some cases, the detection of sugar in the urine may be caused by the abuse of sweets, therefore, it is recommended to retake the test or conduct a glucose tolerance test to determine latent diabetes mellitus.

Ketone bodies

Normally, ketone bodies are not found in the urine of a healthy person. Their accumulation in the blood and excretion in the urine is a symptom of diseases such as:

• poisoning of the body with alcohol;
• diabetes mellitus, precomatose state;
• acute pancreatitis;
• diseases of the central nervous system;
• Long-term, grueling, low-protein diets
• severe toxicosis of pregnant women with frequent vomiting;
• dehydration of the body;
• hyperfunction of the thyroid gland (hyperthyroidism).

Epithelial cells

Normally, in the urine of a healthy woman, there are from 5 to 10 epithelial cells in the field of view - this is caused by desquamation of epithelial cells of the squamous epithelium, which is lined with the lower parts of the urinary tract. If a large number of epithelial cells are detected in the analysis of urine, then this may be the first sign of inflammatory processes in the kidneys, bladder, and is also observed when the body is poisoned with salts of heavy metals.

Hemoglobin

Normally, in the analysis of the urine of a healthy woman, hemoglobin is absent. The identification of this component is associated with possible hemorrhages in the kidneys, kidney infarction, and is also observed as a result of the resulting herbs, extensive burns, severe poisoning with sulfonamides and poisonous fungi.

Bilirubin

In the body of a healthy person, bilirubin is excreted into the intestinal lumen as part of bile. When there is a sharp increase in the level of bilirubin in the blood, the function of removing it from the body is partially taken over by the urinary organs. The appearance of bilirubin in the urine is typical for the following conditions:

• hepatitis;
• liver failure;
• cirrhosis of the liver;
• sickle cell anemia;
• cholelithiasis;
• hemolytic disease.

Leukocytes

In women, the norm of leukocytes in the analysis of urine does not exceed 3 in the field of view. An increase in these indicators is called leukocyturia, which is characteristic of inflammatory processes in the bladder, kidneys, and ureters.

Erythrocytes

In the urine of a healthy woman, erythrocytes are normally absent. The appearance of this form element in the analysis can be physiological and pathological in nature. The physiological appearance of erythrocytes in urine is observed when taking certain medications, increased physical exertion, prolonged standing in place.

Pathological reasons for the appearance of red blood cells in urine analysis are:

• glomerulonephritis;
• lumbar injuries;
• kidney infarction;
• hemorrhage in the kidney;
• the presence of stones in the bladder or ureters, which injure the mucous membranes.

Bacteria

During urination, a woman's urine is contaminated with microbes, which is normal. In the presence of infectious and inflammatory diseases of the genitourinary tract, the number of microbes excreted in the urine increases sharply. Severe bacteriuria is typical for:

• acute cystitis;
• pyelonephritis;
• vulvovaginitis;
• urethritis.

Mushrooms

In the analysis of the urine of a healthy woman, there can be no fungi. The identification of yeast-like fungi in the analysis is associated with the accidental ingestion of curdled vaginal discharge into the container with urine during the collection of the analysis.

Mucus and salt in urine

Normally, there should be no mucus in the urine test. Its identification in the analysis indicates the presence of a pronounced or latent inflammatory process in the urinary organs - the urethra, bladder, ureters. Mucus can also come out of the vagina when urine is collected in a jar.

The detection of salts in the analysis of urine (oxalates, phosphates, urates) indicates a violation of the diet, the predominance of meat and carbohydrates in the diet. The detection of salts in a woman's urine is typical for anemia, metabolic disorders, vitamin deficiency.

Every healthy person should take a urine test at least once every six months, even if there are no complaints. The study of urine parameters in a woman allows you to timely identify existing violations and latent diseases, as well as prescribe adequate treatment if necessary.

Also called clinical, it is one of the most commonly performed laboratory tests for diagnostic purposes. It is prescribed for many pathologies and establishes up to twenty indicators, and each of them helps to correctly diagnose.

How to decipher a urinalysis check is interesting to many. More on this later.

Purpose of appointment

Simultaneously with urine, many products of material metabolism are excreted from the human body, and therefore, by its properties, one can indirectly talk about the state of the kidneys and urinary tract, about the composition of the blood. The urine contains substances such as uric acid, urea, amino acids, ketone bodies, glucose, chlorides, creatinine, protein, phosphates and sulfates. Analysis of the microbiological and chemical composition of urine is important for diagnosis: any deviations from normal indicators indicate metabolic disorders in the human body.

When is a general urine test necessary? Such a study is required for any pathologies of the endocrine and genitourinary systems, with suspected diabetes mellitus and impaired functioning of the immune and cardiovascular systems. In addition, a general urine test is prescribed for patients who have had a streptococcal infection. It is also done for prophylactic purposes and as a method of monitoring the dynamics of diseases.

Not everyone knows how to decipher a urine test.

Features of delivery of a general urine test

To reflect the present clinical picture in the analysis results, certain recommendations must be followed in preparation for the procedure, as well as for the collection of urine. The main requirements for preparing a patient are as follows: you need to buy in advance at a pharmacy or take a special sterile container from a doctor where the liquid is collected. The collection is carried out in the morning: for the study, it is advisable to take exactly the morning urine, which has accumulated overnight, and for collection, the "average portion" of urine matters. The night before, it is necessary to stop using any drugs that may affect (it is better to consult a specialist about this), as well as coloring products (bay leaves, rhubarb, carrots and beets) and alcohol. Collect morning urine on an empty stomach, you can not drink or eat anything before that. Do not overheat or overcool before collecting biomaterials.

Collection rules:

• it is recommended to collect from 100 to 150 milliliters (two-thirds of a special container);
• it is necessary to carefully carry out the toilet of the genitals before collection: sometimes women are advised to use a tampon;
• when the liquid is collected, it must be brought to the laboratory as soon as possible (the delay should not exceed two hours);
• if you need to store liquid for some time, you can put the container in a cool and dark place, but not too cold;
• the container is recommended to be transported at positive temperatures ranging from 5 to 20 ˚С.

So how do you decipher a urine test?

Indicators of the general analysis of urine: interpretation of the results

Thanks to the decoding of the urine analysis, it is possible to understand the results obtained before visiting the doctor. However, in no case should one engage in self-medication and self-diagnosis based on the information received: for the correct analysis of the finished results and the determination of the diagnosis, you should consult a doctor. Urine is examined in several categories, including microscopic examination, biochemical characteristics and physicochemical indicators.

How to decipher a general urine test is described below.

Organoleptic properties

Volume. The volume of urine for analysis as a whole does not allow making certain conclusions about diuresis defects. It is only required to establish the specific gravity of urine, that is, the relative density.

Diuresis refers to the volume of urine that is formed over a certain period of time (minute or daily diuresis). Daily urine output is usually equal to one and a half to two liters (from 70 to 80% of the liquid drunk). If the daily urine output increases, this phenomenon is called polyuria, and oliguria - a decrease (less than 500 milliliters). How to decipher the common one Every parent wants to know. More on this below.

The color of urine is determined by eye. The normal color of urine ranges from straw to bright yellow. It is determined by the presence of dyes in the urine - uroerythrin, urosein and urobilin. Other shades may indicate certain pathologies of the body, for example: pink or red - the presence of a blood test; dark brown - hepatitis, jaundice; dark red - porphyrin disease, hemolytic crisis, hemoglobinuria; black color - alkaptonuria; whitish gray - the presence of pus; blue or green - the processes of intestinal putrefaction.

Smell is not critical in general urinalysis, as many foods that contain essential oils, strong-smelling food can give a specific odor to the liquid. However, some smells indicate certain deviations: the smell of ammonia - about cystitis; putrid - gangrenous processes in the urinary tract; fecal - Escherichia coli; the smell of acetone - the presence of ketone bodies in the urine (ketonuria); the smell of rotting fish - the accumulation of trimethylamine in the body (trimethylaminuria). The smell of urine is normal to some extent specific, mild. If the container is open, then the smell becomes more intense, as oxidative processes occur.

Foaminess. When shaking urine, there is normally almost no foam in it, but if it appears, it is unstable and transparent. When staining or persistence of the foam, we can talk about the presence of protein in the urine or jaundice.

Transparency. If a person is healthy, then it approaches absolute. The causes of turbidity are the presence of bacteria, red blood cells, salts, fats, pus and other substances. It is possible to determine the presence of a particular substance by means of special methods (adding different acids, heating, etc.). If epithelium, protein, bacteria or erythrocytes were found in the urine, then we can talk about prostatitis, pyelonephritis, urolithiasis and other pathologies. Leukocytes show cystitis. Salts precipitated indicate the presence of oxalates, phosphates, urates.

How to decipher the general analysis of urine by physical and chemical indicators?

physical and chemical indicators

Acidity. Normal acidity ranges from 4 to 7 pH. A reduced indicator can indicate the presence of a number of diseases: high potassium levels in the blood, chronic kidney failure, ureaplasmosis, thyroid hormones, bladder or kidney cancer, etc. eating meat and high temperatures. If the pH exceeds the norm, we can talk about a decrease in the degree of potassium, diabetes mellitus and defects in the blood acid-base balance.

Density. In urine, specific gravity is an indicator that is due to age. How to decipher the analysis of urine in a child for this indicator?

For children after twelve years of age and adults, the norm is from 1.010 to 1.022 grams per liter, for children from four to twelve years old - from 1.012 to 1.020, from two to three years old - from 1.010 to 1.017, for newborns - from 1.008 to 1.018. In urine, the density is determined depending on the amount of sugars, proteins, salts and other substances dissolved in it. In some diseases, this indicator becomes higher due to the presence of red blood cells, leukocytes and bacteria. An increased number may indicate infectious processes of the urinary tract, diabetes mellitus. In pregnant women, this indicates toxicosis. In addition, the density may increase due to insufficient fluid intake or loss. A reduced rate indicates kidney failure and diabetes insipidus. It can also appear when using diuretics or drinking plenty of fluids.

How to decipher the results of urine analysis by biochemical parameters?

Biochemical indicators

Protein. Its normal concentration should be more than 0.333 grams per liter. If a higher rate is found, we can talk about inflammation of the genitourinary system, kidney disorders, allergic reactions, heart failure, epilepsy, leukemia. The amount of protein increases with heavy sweating, intense physical exertion, and long walking. Also, an increased protein in urine is established in physically poorly developed children - from seven to sixteen years old, as well as in pregnant women.

Glucose (sugar) in urine normally does not exceed 0.8 mmol per liter. The increased content may be a consequence of excessive consumption of sweets, diabetes, impaired renal function, Cushing's syndrome, acute pancreatitis, increased adrenaline due to inflammation of the adrenal glands. In addition, high concentration of sugar in urine can occur in pregnant women.

Bilirubin is a bile pigment; it should normally be absent in urine. Its detection indicates a sharp increase in the content of bilirubin in the blood, as a result of which the kidneys are engaged in its excretion, take over this function (bilirubin is normally excreted completely through the intestine). If the level of this pigment is increased in the urine, this indicates hepatitis, cirrhosis of the liver, its failure, gallstone disease. The reason can also be massive destruction of red blood cells in the blood due to hemolytic disease, toxic hemolysis, malaria, sickle cell anemia.

Acetone (ketone bodies) should not normally be detected in a general urine analysis. Their detection indicates metabolic disorders as a result of a number of diseases: diabetes mellitus, thyrotoxicosis, acute pancreatitis, Itsenko-Cushing's disease. The formation of ketone bodies also occurs during starvation, increased consumption of fatty and protein foods, due to alcohol intoxication, toxicosis during pregnancy, after injuries that have affected the central nervous system of a person.

How to decipher the analysis of urine microscopic examination?

Microscopic examination

Sediment (inorganic and organic). In general urine analysis, sediment is understood to mean salt crystals, cylinders, cells after a short centrifugation. The different substances identified in the sediment will be discussed in more detail below.

Blood cells (leukocytes, erythrocytes). Erythrocytes, that is, red blood cells, can be present in urine in small quantities (for women - from zero to three in the field of view, for men - single). An increased concentration of red blood cells indicates serious diseases, for example, nephrotic syndrome, urolithiasis, cancer of the prostate, bladder, kidney, acute glomerulonephritis. Leukocytes identified in the sediment during the general analysis of urine can be a consequence of diseases of the urinary tract (cystitis, urethritis, prostatitis, urolithiasis, pyelonephritis). Leukocytes normally in children's and women's urine range from zero to six in the field of view, in men's - from zero to three. When an increased content of leukocytes is found in the results of a general urine analysis, you need to visit a urologist, who will most likely prescribe additional tests - a repeated OAM or, along with an analysis of urine according to Nechiporenko, an ultrasound of the kidneys, a three-glass test. Often, all fears are dispelled after additional and repeated research.

Hyaline cylinders are cylindrical formations, which contain the most protein and kidney tubule cells. Normally, they should not be in the urine. Their detection (more than twenty in one milliliter) indicates glomerulonephritis, pyelonephritis and hypertension. Such cylindrical formations can also appear with the use of diuretics.

Granular cylinders. They are dominated by cells of the renal tubules and erythrocytes. The presence of granular in any quantity speaks of glomerulonephritis, pyelonephritis and viral infections. There may also be lead poisoning.

Wax cylinders are formed as a result of a long stay in the lumen of the renal tubule of the granular or hyaline cylinder. Their presence in urine in any quantity indicates such diseases as chronic kidney failure, nephrotic syndrome, renal amyloidosis (deposition of amyloid, an insoluble protein, in the renal tissue).

Bacteria. Their presence in the general analysis of urine indicates the inflammatory processes of the urinary system. That is, bacteria should normally be absent. Their detection speaks of such infectious diseases as prostatitis, cystitis, urethritis, etc. In order for the result of the analysis to be reliable, careful hygiene of the genitals is required before collecting material.

Fungi in urine, which should not normally be detected, are the result of fungal infections of the external genital organs and urinary tract. In addition, they may indicate a long-term use of antibiotics and immunodeficiency states. It is necessary to decipher the analysis of blood and urine when it is not possible to contact a medical facility.

Salt. Their absence in urine is the norm, while their presence in the sediment can indicate the possibility of kidney stones formation.

An increased amount of urates (uric acid) can be the result of chronic kidney failure, nephritis, gout. Often, urates are the result of dehydration or some kind of diet. The presence of urates in newborns is the norm.

Oxalates can appear due to pyelonephritis and diabetes mellitus, crystals of hippuric acid - due to liver failure and intestinal dysbiosis, phosphates - due to the high concentration of calcium in urine. But you must always remember that the determination of any salts is often associated with excessive consumption of a number of products, that is, their concentration can be reduced due to a change in the diet.

How to decipher the general analysis of urine in Latin letters?

Decoding of Latin letters in the study of urine

Currently, urine is processed by special analyzers, and the patient receives the results in the form of a table with Latin letters, which can only be read by a doctor. The following is how these letters are deciphered:

• GLU is glucose (absent).
• PRO is a protein (should also be absent).
• BIL is bilirubin (absent).
• URO is urobilinogen (five to ten milligrams per liter).
• PH stands for acidity (5.0 to 6.0). Many people try to decipher the urine analysis by Latin letters, but not all of them succeed.
• BLD is erythrocytes (absent either from zero to three for women, from zero to one for men).
• SG (S.G.) is the density, its rate is from 1.003 to 1.035.
• LEU are leukocytes (absent in the norm or from zero to six in the field of view in women and from zero to three in men).
• NIT - absent bacteria.
• KET - absent ketone bodies.
• COLOR - color indicators.

Now, how to decipher the general analysis of urine in Latin letters has become a little clearer.

Urine analysis according to Nechiporenko

A urine analysis according to Nechiporenko is prescribed in the case when a general analysis of blood or urine in a patient showed abnormalities and the doctor needs to clarify the features of the pathology, confirm its presence, since a general analysis can not give the correct result in all cases.

How to decipher a urine test according to Nechiporenko? Patients are also often interested in this. In most situations, such a study is not a replacement for the general analysis of urine, but only supplements it. It is most commonly prescribed by nephrologists, therapists, surgeons, and urologists.

The advantages of this method:

• easy for medical personnel to carry out;
• does not need expensive equipment;
• does not require special difficulties in preparation;
• does not require a lot of urine.

For the appointment of a urine test according to Nechiporenko, the following deviations may become the basis: an increase in the content of creatinine and urea; the presence of protein and leukocytes; traces of blood.

When do you need to decipher the results of urine analysis according to Nechiporenko?

The study is prescribed for diagnosing chronic or acute diseases of the urinary system, kidneys, for example, with ultrasound. For the analysis according to Nechiporenko, the basis may be an increase in temperature without symptoms, systemic pathologies with a high risk of renal impairment, as well as preventive examinations. In addition, periodic research is carried out in the treatment of diseases of the urinary organs in order to monitor the effectiveness of therapy.

It is important to find out in advance how to decipher the urine test.

The analysis is often prescribed to pregnant women, since it allows you to determine some diseases that can threaten the process of bearing a child and childbirth.

Indicators of the norm

We will learn how to decipher the clinical analysis of urine from the printout?

The parameters of a healthy person should not be higher than the following values: hyaline cylinders - 20 / ml; 2000 / ml - leukocytes; 1000 / ml - erythrocytes.

Also, urine should not contain other types of cylinders (waxy, erythrocytic, epithelial, granular), bacteria, dead erythrocytes. These rates are the same for all genders and ages.

Interpretation of results

How to decipher What diseases can be with deviations from the norm, if the analysis was carried out according to Nechiporenko? Let's consider some indicators:

• More than 2000 / ml leukocytes - vesiculitis, prostatitis, cystitis, appendicitis, bladder tumors, urolithiasis, fever, systemic lupus erythematosus, acute pancreatitis, glomerulonephritis, pyelonephritis.
• More than 1000 / ml erythrocytes - stones in the bladder and kidney, tumors of the bladder, kidney and prostate, polyps, damage and trauma to the urinary tract, heart failure, purulent cystitis, hemophilia, vitamin C deficiency, systemic lupus erythematosus, kidney tuberculosis.

How to decipher a child's urine test from a printout? This is the question most parents ask themselves. Analysis may show the following:

• The presence of dead red blood cells - glomerulonephritis, nephropathy, hypertension, nephrotic syndrome.
• More than 20 / ml hyaline cylinders - taking large amounts of diuretics, hypertension, pyelonephritis, emotional stress, glomerulonephritis, overheating and dehydration, toxicosis during pregnancy.
• The presence of granular casts - malignant pyelonephritis along with urolithiasis, glomerulonephritis, infections, intoxication, systemic and autoimmune pathologies of connective tissue, hydronephrosis at the stage of structural renal changes, strong physical activity.
• Waxy casts speak of nephrotic syndrome, amyloidosis, chronic kidney failure, and rejection of the transplanted kidney.
• Erythrocyte casts: renal vein thrombosis, kidney infarction, hypertension, acute stage of glomerulonephritis.
• Epithelial casts - intoxication, viral infection, acute tubular necrosis.

An accurate diagnosis can only be made by a urologist.

We looked at how to decipher a general urine test in adults and children.

A clinical blood test is one of the most frequently prescribed: hardly in a civilized country there is at least one person who has not been performed. Doctors of various specialties can prescribe an analysis: therapist, ENT, pulmonologist, cardiologist, gastroenterologist, hematologist. It must be carried out in order to:

• identify various inflammatory and infectious diseases, confirm the alleged diagnosis;
• diagnose blood diseases;
• monitor the effectiveness of the selected treatment;
• to assess a person's condition before a planned surgical intervention or during hospitalization;

conduct a preventive examination.

How to take?

Blood for research can be taken both from a vein and from a finger (the latter option is observed less and less often). It is advisable to take it on an empty stomach, at least not earlier than 4 hours after eating. On the eve, it is advisable to exclude increased physical activity, stress and anxiety, as well as alcohol intake.

Please be aware that standards may differ from laboratory to laboratory. This is due to the use of different equipment and reagents. We give the most common norms, but in each case, you must first of all take into account the values ​​written in your form. If it is necessary to monitor the state of the body in dynamics, it is advisable to donate blood again in the same laboratory as for the first time.

We look at the form!

There are many indicators in the general blood test form, but many of them are of interest only to doctors. It is important for patients to pay attention only to some of the columns.

Important!
ESR increases with any inflammation - both completely harmless and life-threatening. It grows with pneumonia, and with tuberculosis, and with arthritis, and in the event that a person cuts his finger. One analysis does not make a diagnosis - only after a wide examination.

General urine analysis(also called clinical) is one of the most important laboratory tests. What information about health can be obtained from it?

Important

For the results of the general analysis of urine to be reliable, it is important to collect it correctly.

On the eve, you need to avoid food that can stain urine, spicy and too salty foods. The drinking regimen should be normal - you don't need to drink more or less. Do not take a diuretic.

The first morning urine should be collected for analysis. It is advisable that the collection container is sterile - these are sold at the pharmacy.

Before collection, you must thoroughly wash with a means for intimate hygiene or soap.

Having started urination, the first 1-2 seconds you need to urinate in the toilet and only then, without interrupting the stream, substitute the container and collect 50-100 ml of urine in it (the rest can be flushed down the toilet).

Having closed the container tightly with a lid, it must be delivered to the laboratory collection point as soon as possible - maximum within one to one and a half hours.

A general urine test is a laboratory study, the results of which are the main diagnostic indicator for most diseases, since urine contains more than 150 chemical compounds.

The processes of urine formation begin in the kidneys: special formations - nephrons - filter blood from waste products, forming urine. Further, waste products accumulate in the renal pelvis and enter the bladder.

The whole process of formation and excretion of urine is called diuresis. The daily urine output of a healthy person is on average from 1.5 to 1.8 liters, depending on the air temperature, the food and liquid consumed, and the time of day.

Also, the volume of daily urine changes under the influence of pathological processes in the body:

• the presence of diabetes mellitus or diabetes insipidus and some renal pathologies leads to increased fluid secretion (the so-called polyuria);
• stones in the urinary system lead to a decrease in the volume of diuresis (oliguria);
• advanced forms of kidney failure and a blockage in the urinary tract can cause a lack of urination (anuria).

Indications for

A clinical study of urine is one of the most widely used tests and is prescribed in such cases:

• preventive examination during the annual medical examination;
• suspicion of diseases of the urinary system;
• for the diagnosis of inflammatory processes of internal organs;
• assessment of the dynamics of treatment of the kidneys, bladder and urinary tract, streptococcal infection.

The results of urine indicators are evaluated in conjunction with other laboratory tests (complete blood count, feces, etc.).

How to properly collect urine

A prerequisite for correct clinical trial results is appropriate preparation and collection of urine. The composition and amount of chemical compounds in urine is influenced by many factors that contribute to a false positive or false negative result, namely:

• medications (if the composition contains caffeine, ethyl alcohol, rauwolfia, glycerin trinitrate, diuretics, pain relievers, antipyretics, then glucose rises in the urine, etc.);
• alcoholic beverages, coffee, green tea, drinks and food with a high concentration of dyes in the composition;
• too salty and sweet food;
• non-compliance with hygiene standards.

Urine is collected immediately after sleep during the first urination. Immediately after waking up, it is necessary to carry out hygiene procedures using soap and sterile wipes. Prepare a sterile container in advance, or use any carefully cleaned, suitable container.

All morning urine is conventionally divided into three portions, each of which may indicate the presence of inflammatory processes in the upper and lower urinary tract. Depending on this, there are two options for collecting morning urine:

• collection of medium urine - the first milliliters of urine must be skipped, and then the liquid must be drawn into the prepared container;
• collection of common urine - the entire volume is released into a wide container, then the liquid must be mixed and the required amount is poured into a prepared container.

Norms and interpretation of the results of a general urine analysis in adults (table)

The standards of laboratory research of urine include indicators of the physical and chemical characteristics of diuresis. Physical parameters include density, color, odor, clarity, and the presence of sediment in the urine. Chemical parameters - the presence of erythrocytes, leukocytes, bilirubin, etc.

In the analysis results, opposite the names of chemical compounds in urine, the neg indicator is often found (from the Latin negative - negative), which means the absence of the specified element in the urine.

Deciphering the indicators of the general analysis of urine is an assessment of all chemical and physical parameters in the complex. An increase or decrease below the norm of one of the chemical compounds is not critical and should be confirmed by additional studies of the state of the body.

Colour

The color of urine depends on the volume of fluid you drink and how long you have not urinated. Normal urine color in adults is light yellow, straw yellow, or orange. Discoloration can be caused by food, medications or diseases, namely:

• urine acquires a red or pink tint due to the use of brightly colored fruits, berries, vegetables (beets, blueberries, carrots) and taking aspirin;
• a distinctly red color of urine occurs with serious kidney disease (kidney infarction, renal colic);
• dark yellow urine is caused by edema, poisoning with vomiting and diarrhea, heart failure;
• yellow-brown (beer) color appears with the development of viral hepatitis, as well as with an increased level of bilirubin and urobilin in the urine;
• urine acquires a red-brown hue after the use of drugs with the active substance metronidazole, sulfanilamide and bearberry-based drugs;
• a greenish-yellow tint indicates obstructive jaundice caused by a complication of gallstone disease;
• milky color is caused by kidney lymphostasis or urinary tract infections;
• a whitish shade of the liquid is given by an increased concentration of phosphates and fats.

Density

Density or specific gravity is a mandatory parameter of the general urine analysis, examined using a urometer and depending on the amount of dissolved substances in the urine: urea, salt, uric acid, electrolytes, etc.

An increase in the specific gravity is observed under the influence of the following factors:

• protein in the urine (glomerulonephritis);
• toxicosis in pregnant women;
• dehydration after vomiting, diarrhea;
• glucose in the urine (diabetes mellitus);
• intravenous infusion of medications (dextran, mannitol).

A decrease in urine density may indicate the development of diabetes insipidus, chronic renal failure, acute kidney damage, and is manifested after the use of diuretics.

Acidity

The pH value in urine analysis in adults is from 4.5 to 8.0, while the ideal indicator is 4-5, which can vary significantly depending on many factors, for example:

• eating meat in large quantities leads to acidification of urine (pH below 5.5), and eating dairy and plant foods - to the formation of alkaline urine (pH above 7.0);
• in diseases accompanied by a change in the acidity of the blood, the pH in the urine also changes in the appropriate direction.

An increase in urine pH is observed with hypercalinemia, urinary tract infections, tumors, parathyroid hyperfunction, chronic renal failure, after the use of medications (bicarbonates, adrenaline, nicotinamide).

A decrease in pH (acidic environment in the urine) may indicate diabetes mellitus, tuberculosis and hypokalemia. Urine acidification occurs during fasting, diarrhea and dehydration.

Protein

The norm of protein in urine ranges from 0 to 0.3 grams per liter. An increase in the protein content in morning urine is called proteinuria, and there are several degrees of pathology:

• mild proteinuria is a consequence of the development of post-streptococcal, chronic, interstitial, hereditary glomerulonephritis;
• moderate proteinuria develops in chronic glomerulonephritis;
• a high degree of pathology manifests itself in nephrotic syndrome or amyloidosis.

Also, an increase in the concentration of protein in the general analysis of urine is observed with tumors in the bladder, cystitis, urethritis and other urinary tract infections.

Glucose

The presence of glucose in the urine is an indicator of diseases such as diabetes mellitus, heart attack, acute pancreatitis, Cushing's syndrome, burns, and poisoning. Sugar in urine is increased during pregnancy, after consuming large carbohydrate foods (including sugar) and medications (corticosteroids, thyroxine, furosemide, nicotinic acid).

Nitrite

A general urinalysis should not show the presence of nitrites under normal health conditions. The formation of nitrite occurs under the influence of bacteria in the bladder, therefore a positive test result for nitrite indicates a bacterial infection of the bladder and urinary tract.

Bilirubin

During normal liver function, bilirubin is not detected in the urine. The presence of bilirubin in the general analysis of urine indicates pathological processes in the liver or blockage of the biliary tract, namely:

• obstructive jaundice;
• cirrhosis of the liver;
• viral hepatitis;
• swelling in the liver.

Urobilinogen

Urobilinogen (UBG) is a breakdown product of bilirubin and enters the urine in small amounts (normally up to 10 milligrams per liter) from the blood. There are several reasons for an increase in urobilinogen levels:

• liver dysfunction (hepatitis, cirrhosis);
• gastrointestinal diseases (intestinal obstruction, enterocolitis);
• increased breakdown of hemoglobin (anemia, polycythemia, intravascular hemolysis);
• secondary hepatic failure (due to heart attack, tumor in the liver, cardiovascular failure);
• alcohol poisoning.

Ketone bodies

Ketone bodies are formed with the increased breakdown of fatty acids. An increased content of ketone bodies in urine is called ketonuria.

Diseases in which there is an increased content of ketone bodies in the urine:

• eclampsia;
• hyperinsulinemism;
• fever;
• hyperglycemic coma.

Urinalysis for ketone bodies can be positive after prolonged fasting, a lack of carbohydrates in food, alcohol poisoning, and with the wrong dosage of insulin for the treatment of diabetes mellitus.

Erythrocytes

Erythrocytes are observed in urine in small quantities (1-3 per microliter) with normal kidney function. In this case, erythrocytes can be contained unchanged (with hemoglobin in the composition), and without hemoglobin.

A significant number of red blood cells in urine analysis indicates the following diseases:

• disruption of the renal vessels;
• pyelonephritis;
• glomerulonephritis;
• systemic lupus erythematosus;
• kidney tuberculosis;
• cystitis;
• mushroom poisoning;
• kidney injury;
• prostate adenoma;
• hypertension;
• circulatory failure.

Leukocytes

The norm of leukocytes in urine depends on gender and age: in adult men, 3 leukocytes in the field of view are permissible, in women and children (up to 14 years old) - up to 5. An excess of the norm of leukocytes in urine is called leukocyturia (up to 60 leukocytes in the field of view) and pyuria (more than 60 leukocytes).

Detection of leukocyturia and pyuria is a sign of the following pathologies:

• amyloidosis, renal tuberculosis;
• pyelonephritis;
• acute and chronic form of glomerulonephritis;
• urinary tract infections (urethritis, cystitis).

If leukocytes are detected in the urine, additional tests are prescribed: the Krakowski-Addis test, the Nechiporenko test, the Amburge test for a more detailed study of the blood cells contained in urine.

ASC

In the decoding of the general analysis of urine, the ASC or VC indicator may be found, which means the presence of ascorbic acid in urine (vitamin C). The norm for ASC in urine is 20-30 milligrams.

An increase in ASC in urine is observed after eating fruits (such as citrus fruits) or acetylsalicylic acid.

A decrease in ASC levels is a sign of a lack of vitamin C in the body, which is caused by improper diet, excessive fluid intake, and stress. There are also pathologies with a reduced level or absence of ASC in the body:

• scurvy;
• tumors;
• malabsorption syndrome.

General (clinical) urine analysis, or OAM, is one of the standard studies, an obligatory stage in the diagnosis of almost any disease. It also helps to track the course of diseases, to control therapy. OAM can be done in any clinic, but it is better to choose institutions that have modern analyzers and reagents.

Urine is a biological fluid secreted by the kidneys, along with which the body removes various metabolic products, metabolites. Changes in the chemical, physical and microbiological composition of urine can be due to both physiological and pathological reasons. The indicators of the general analysis of urine of adults are necessarily taken into account in the diagnosis of diseases of the genitourinary, cardiovascular, immune, endocrine systems, with suspicion of diabetes, as well as after infections.

How to properly collect urine for analysis?

Any biomaterial provided for analysis must be of high quality. The correctness of the result depends on this. In the case of urine analysis, the patient will need to be careful, since he collects the biomaterial himself.

You will need a small sterile container, they are sold in pharmacies, laboratories, some clinics. Collect urine in the morning on an empty stomach, at the first urination. Before that, it is necessary to carry out hygiene procedures using ordinary soap. The container collects an average portion of urine (one second after the onset of urination) in a volume of 100-150 ml.

The day before, you should give up alcohol, food rich in coloring pigments - for example, beets and carrots, in consultation with your doctor - from medications. The drinking regimen is observed as usual. Twelve hours before collecting the biomaterial, you must also refrain from sexual intercourse.

After the biomaterial is collected, the container should be tightly closed and delivered to the laboratory within two hours, making sure that the liquid in it does not freeze and overheat. The lack of light is important. During transportation, a temperature range of 5–20 ° C is permissible.

The norm of indicators of the general analysis of urine of an adult

At the sight of a urine test form, most adults have a reasonable desire to understand the set of indicators and decipher the results. There is nothing wrong with that, the main thing is not to engage in self-diagnosis and self-medication.

Those who wish to expand their understanding of laboratory tests a little should first of all know that urine is examined according to several categories of indicators.

Organoleptic characteristics of urine

These indicators do not require special equipment, there is enough knowledge, vision and smell of the laboratory assistant.

• Colour ... Normally it ranges from light straw to bright yellow. If other shades are mixed, this is a reason to be wary. The urine acquires a dark brown color in liver diseases, red or pinkish - if blood is mixed, grayish-white indicates the presence of pus, and a green or bluish tint - about intestinal diseases.
• Smell ... The urine of a healthy person has a faint, specific odor. It can intensify with cystitis and have an ammonia tinge. A fecal odor speaks of Escherichia coli, putrefactive - of necrotic processes in the urinary tract, it smells of acetone if there are ketone bodies in the urine, and rotten fish - when trimethylamine accumulates in the body.
• Frothiness ... If the urine is shaken, it normally foams a little, and the foam settles quickly. Resistant foam indicates the presence of protein.
• Transparency ... Clouding of urine or precipitation indicates the possible presence of erythrocytes, bacteria, mucus, fats, salts, pus and other substances in it that should not normally be contained. The urine should be clear.

physical and chemical indicators

• Density urine normal for adults and children over 12 years old is 1.010-1.022 g / l. If it contains foreign substances or cells in large quantities due to infection or metabolic disorders, or if the body is dehydrated, the density increases. Decreased density can be the result of diuretics, kidney failure, diabetes insipidus.
• Acidity ... According to this indicator, in the form of the general analysis of urine in adults, the numbers 4–7 pH are normally acceptable, that is, from a moderately acidic environment to a moderately alkaline one. Slightly reduced acidity is characteristic of chronic renal failure, elevated blood potassium levels, increased parathyroid activity, ureaplasmosis, and kidney or bladder cancer. High acidity can be noted during dehydration or starvation, frequent consumption of meat, taking certain medications, and an increase in body temperature. It is also a sign of possible diabetes mellitus.

Biochemical characteristics of urine

To assess these parameters, special analyzers and reagents are used.

• Protein ... The normal concentration of protein in urine is close to zero - no more than 0.033 g / l. Physiological reasons for deviations from the norm can be increased physical activity, high sweating, long walking. If we talk about pathological reasons, then kidney damage, inflammatory processes in the genitourinary system, leukemia, heart failure are possible.
• Sahara. The maximum allowable concentration of sugars in the urine of an adult is 0.8 mmol / l. If this figure is exceeded, physiological reasons such as pregnancy, excessive consumption of sweets, adrenaline rush due to stress are possible. But most likely we are talking about one of the following pathologies: diabetes mellitus, kidney dysfunction, acute pancreatitis, Cushing's syndrome, adrenal gland damage.
• Bile pigments (bilirubin, urobilinogen) - the breakdown products of hemoglobin, appear in urine with lesions of the liver and biliary tract, as well as due to the destruction of red blood cells in the blood with sickle cell anemia, malaria, hemolytic disease, toxic hemolysis.
• Ketone bodies ... The presence of ketone bodies in the urine may indicate endocrine diseases: diabetes mellitus, acute inflammation of the pancreas, thyrotoxicosis, Cushing's syndrome. You should also bear in mind the possibility of ketone bodies appearing in the urine during fasting, alcohol intoxication, low-carbohydrate diets, traumatic brain injuries.
• Indican ... The presence of this substance in the urine indicates the processes of fermentation and putrefaction in the intestines. Normally, it should not be in the urine analysis.

Note! A number of indicators in OAM are influenced by trauma, stress, the release of adrenaline into the blood, high physical activity, diet, medication or dietary supplements. Athletes or individuals undergoing medical therapy should inform the physician about all of these factors before submitting a urine sample for analysis. Remember that even such a primitive drug as aspirin, taken in large doses, can turn urine pink in the morning.

Microscopic indicators

The name of these parameters is due to the fact that traditionally they were determined using a microscope, but now automatic analyzers can cope with this task. Examination of urine under a microscope is prescribed additionally when abnormalities are detected.

The analysis form is a table with indicators, their normative and obtained values. A short description is usually written under the table: for which positions the results do not meet the standards for adults. Below is an example of an entry on a urine test result form:

"The color of the urine is dark, bilirubin is found, the rest of the indicators are within the normal range."

The results obtained are used for diagnostics along with other analyzes and data on the patient's condition. For example, with an increased erythrocyte sedimentation rate (ESR) in the blood test, high urine density and the presence of bilirubin in it, patient complaints of active gas formation, the liver, urinary system and gastrointestinal tract should be checked.

With only a form of urinalysis results in hand, it is impossible to make a diagnosis. Therefore, the patient's main task is to transfer high-quality biomaterial and select a reputable laboratory for analysis. The rest will be handled by a qualified diagnostician.

Wednesday, 28.03.2018

Editorial opinion

Health problems are especially annoying if you have a business trip. Using the services of reputable all-Russian networked laboratories and medical centers, you can minimize inconvenience without interrupting treatment and keeping your health under control.