Nowadays, urine analysis is a standard laboratory test, with the help of which virtually any disease is diagnosed. He gives the doctor in charge a lot of useful information about the patient's state of health. Analysis of urine, the decoding of which will show the state of the cardiovascular, genitourinary and immune system, even healthy people should be performed at least once a year. Let's figure out what kinds of clinical indicators there are and what are their characteristics.
Types of clinical urinalysis
The most common is a general urine test, when the study includes decoding its color, specific gravity, transparency, acidity and the presence of substances such as:
- protein;
- hemoglobin;
- glucose;
- bile pigments;
- ketone bodies;
- inorganic substances;
- blood elements;
- epithelial cells or cylinders( their residues).
In a biochemical study, the level in urine of substances such as creatine, urea, amino acids, uric acid, enzymes is determined. When diagnosing endocrine diseases, biochemical analysis allows you to determine the level of certain hormones. There are also special urine samples that will show the transcription of pathological changes in the patient's body. For example, with the help of Reberg's or Zimnitsky's samples, the excretory and concentrating function of the kidneys is judged, and the Nechiporenko and Kakovsky-Addis samples will give accurate information about the elements of the blood in the urine.
General study in adults
Thanks to the deciphering of the general analysis of urine, the doctor can promptly identify malfunctions in the urinary system, prescribe adequate treatment. Most indicators are determined only in laboratories, but general, such as transparency or the color of urine, an adult person can determine by himself if he knows what is the norm and what is the inflammatory process. However, this knowledge is not a guide to self-medication - this is only an excuse to think about the need to visit a doctor. Read more about how to read a general urinalysis in a video doctor:
Decoding of the general urine analysis
To date, there is an accurate laboratory equipment( analyzers), through which a detailed study of biological fluids is carried out. But to decipher the urine sediment was as true as possible, it is important for a person to know how to properly do this procedure:
- Spend the toilet of the genitals.
- Stock up with a clean jar, which will serve as a reservoir for collecting urine.
- On the eve of the test, do not drink alcohol, drink diuretics, there are products that color urine( beets, carrots, oranges).
- For general analysis, you need not only the average urine, but the entire morning portion as a whole.
- Morning urine is collected only on an empty stomach.
- Do not allow collected urine to freeze or overheat.
- To be accurate, you need to deliver the analysis to the laboratory no longer than 2 hours after the fence.
Color and Transparency
These indicators relate to the physical properties of urine. The color and transparency of biological excretions in deciphering the analysis show the presence of certain diseases. The norm is the entire spectrum of yellow urine from light-straw to rich honey. Allocations can be generally clear and colorless, but this shows their low density, the presence of frequent and profuse urination, especially at night. Too saturated color in the clinical interpretation of the analysis indicates a strong concentration of secretions and high density.
The very color of urine does not represent any diagnostic value, but it is worth paying attention to possible diseases when deciphering the analysis. So, if the shade of urine:
- is red, it signals about urolithiasis, pyelonephritis, leukocyturia, bladder cancer;
- dark brown color means problems with the liver or gallbladder;
- red-brown - indicates that the patient is taking a lot of medications;
- opaque color of meat slops signals of stones, glomerulonephritis, nephropathy or tuberculosis;
- colorless color of the biological fluid indicates the presence of sugar or diabetes insipidus, renal pathology, high protein content( proteinuria);
- dark yellow shade is characterized by a strong dehydration of the body against diarrhea, vomiting, heart failure;
- black color may indicate the presence of melanoma or Marietaafa-Mikeli disease.
- grayish-white color indicates the presence of pus;
- green or blue shade indicates the processes of putrefaction of the intestinal department.
If urine is dark, cloudy - what does it mean
Dark and cloudy fluid can be a symptom of many abnormalities. Sometimes it occurs against the background of dehydration, and then when replenishing the water balance, the color of excretions comes back to normal. But more often opacity of urine at interpretation of analyzes shows a pathology of kidneys or urinary ways. They include:
- Cystitis.
- Kidney stones.
- Vaginitis.
- Prostatitis.
- Urethritis.
- Nephrotic syndrome.
- Retrograde ejaculation.
- Stones of the bladder.
- Crystals of uric acid.
- Goodpasture Syndrome.
Specific gravity of
The indicator of the relative density( specific gravity) of urine is an important point in deciphering the analysis. It characterizes the filtering function of the kidneys. The specific gravity depends on the amount of biological fluid released by a person and the substances dissolved in it. Relative density of urine in a person fluctuates daily in a wide range, which depends on the quality of food consumed, the amount of liquid consumed.
The norm of the specific gravity in an adult is 1012-1025, in a newborn - 1018. Increased or decreased indices of the relative density of urine when deciphering the analysis require additional studies to identify the cause. Low specific gravity can be observed when taking diuretics, after a heavy drink or in the presence of jade, diabetes insipidus. A high index of density is possible renal failure, diabetes mellitus, or other diseases.
The presence of protein in the urine
The causes of the appearance in the urine of a human protein are numerous. This may indicate various diseases of the kidneys, CNS damage, infective endocarditis, congestive heart failure, intestinal obstruction. Often the protein appears when dehydrating the body or fever, due to severe stress or after hypothermia. Also, the protein when decoding the urine test is found in people after muscle strain, significant physical exertion or after a diet with a high protein content.
The protein concentration is considered to be & lt; 0.033 g / l. Higher rates characterize different inflammatory processes in the body. The thing is that in healthy people, through the membrane of the renal glomeruli, most of the proteins do not pass, since they differ in their large size. And if the epithelium of the kidney tubules transmits low-molecular or large proteins, it means that inflammation, infection or swelling occurs.
Norm of organic matter content
When deciphering an overall urine test, an important indicator is the concentration of the following organic substances:
- Bilirubin. It is excreted by the liver, but if it is found in the urine, it indicates a malfunction in the liver or diseases that destroy red blood cells( anemia, malaria, blood diseases).
- of the Urolilinogen. During the day in the urine, this bile pigment can be present no more than 6 mg. If the indicator is exceeded, then this indicates violations in the liver, the destruction of red blood cells, intoxication of the body or bowel disease.
- Glucose. The norm of presence is not more than 0.8 mmol / l. If the rate is exceeded during decoding, the likely causes are: the predominance of sweet food, diabetes, pregnancy, hormonal imbalance.
- Hemoglobin. If there are no problems with health, then it is not present in the urine. The presence of hemoglobin can be a consequence of blood diseases, intoxication, myocardial infarction.
The difference in the parameters of the pregnant
The norm of the indicators when decoding the urinalysis in pregnant women is slightly different from the norm of other people. The thing is that during pregnancy, the urogenital system undergoes a heavy workload in the woman, because during this period the buds and bladder are crushed by a growing fetus, making them difficult to work. Norm of indices in decoding the analysis:
- The color of urine varies from rich yellow to that of straw.
- Slime absent. Healthy urine is a clear and transparent liquid.
- The presence of oxalates( salts of different structures) does not exceed 20-40 mg per day.
- Specific gravity should fluctuate within the limits of 1010-1030 g / l.
- Leukocytes do not exceed 5 units.
- The presence of protein is not more than 0,075 g / l.
- There should be no harmful bacteria, glucose, ketone bodies in the urine.
Features of the results of urinalysis
All pathological processes in the urinary tract and kidneys are reflected in the physico-chemical properties of urine. There are different versions of its research, which are divided into quantitative and qualitative. The first determine the excretion in the urine of cylinders, leukocytes, erythrocytes, and the latter is prescribed for the diagnosis of kidney disease, for monitoring the treatment or for monitoring the dynamics of the disease.
According to Nechiporenko
Assigned for the diagnosis of kidney disease, if the general analysis revealed a high level of white blood cells, red blood cells or the presence in the urine of the cylinders. Decoding of Nechiporenko analysis:
- the norm of leukocytes to 2000, if higher than the norm, then: cystitis, pyelonephritis, kidney stones;
- the norm of erythrocytes up to 1000, if higher - pyelocystitis, renal failure, tumor processes, urolithiasis;
- the norm of cylinders is up to 20, if higher, then possible: nephrosis, kidney tumor, kidney stone disease.
According to Zimnitskiy
The essence of the urine collection in Zimnitskiy is to determine osmoregulatory renal function. Assign analysis for suspected renal failure or inflammation of the kidneys. Collect urine for a day every three hours. Normal indices according to Zimnitsky when analyzing the analysis:
- kidneys deduce 80% of liquids drunk during the day( at the time of the test, you should tell how much fluid the patient drank);
- after a liquid intake, there is a sharp increase in urine output;
- daily diuresis exceeds nighttime;
- the difference between low and high relative density is not less than 0, 007;
- relative density of urine does not vary from 1,004 to 1,032.
Sulkovich
When collecting urine for Sulkovich, the level of calcium in the biological fluid is determined. An analysis is used in pediatrics for the correct selection of a quantitative dose of vitamin D for a child or as a preliminary test for excretion of calcium. For collection, the morning urine of the child is needed, which is taken on an empty stomach. The norm of the Sulkovich analysis is "+" or "++".A negative indicator indicates a lack of vitamin D or an excess of calcium excreted by the body.