Urine analysis - one of the methods of laboratory diagnosis, which allows to identify diseases of the urinary, cardiovascular, immune systems of the body. The study takes into account the physical and chemical properties of the material, the microscopy of the sediment is carried out. Thanks to this testing, one can not only recognize the pathology, but also monitor the dynamics of recovery, so the deciphering of the results should be handled by a specialist.
- Types of tests and standards
- collect daily urine
- Rules collection
- fees on Zimnitskiy
- collection rules
- collection rules
- Three-glassed sample
- Collection rules
- Standards for men
- Standards for women
- According to Sulkowicz
- Collection rules
- For sugar
- Collection rules
- BAK-crop on sterility
- collecting At iodo
- collection on diastase( amylase)
- collecting At salts
- collection pregnancy
collecting urinary system
A group of organs that form, accumulate and secrete urine are united by the name of the urinary system. It includes:
- Kidney - paired organ, located at the back wall of the abdominal cavity, at a palm distance above the lumbar spine. They are abundantly supplied with blood, which enters the renal arteries, is cleansed of metabolic products and returns to the bloodstream along the renal veins. The substances filtered by the kidneys form urine.
- UDTs - represent a paired muscular organ in the form of tubes about 30 centimeters long. Due to contractions of the ureters, urine moves from the kidneys to the bladder.
- Bladder - a hollow muscular organ located in a small pelvis, serves as a reservoir for urine. An empty urea does not cause any sensations in a person, but filling it with 150-200 milliliters of fluid causes urination to urinate.
- Urethra( urethra) is an unpaired tubular organ through which urine is excreted from the bladder into the external environment. The structure of the urethra depends on the sex of the person - in men it is narrow and long, for women - short and wide. Normally, the number of urination is 4-8 times a day.
Types of analyzes and their norms
Depending on the purpose of the study, the patient is assigned various urine tests:to the table of contents ^
The most common clinical diagnostic method is most often used to detect systemic diseases and pathologies of the urinary system.to contents ^
Normally, urine is sterile, bacteria can enter it from the urinary tract or if the material collection rules are not followed:
- The procedure is carried out in the morning, immediately after sleep, on an empty stomach. It is desirable that from the time of the last urination passed no less than 5-6 hours.
- Immediately before collecting urine it is necessary to hold a toilet: women - rinse with clean water the perineal area, men - the glans penis and the external hole of the urethra. Use aggressive detergents undesirable.
- An average urine sample of 50-100 milliliters is required for analysis. The first few seconds of urination is made in the toilet, then a jar is used to collect the material.
- The analytical container must be clean, dry, wide-necked and tightly closed with a lid. It is recommended to buy a ready container in the pharmacy.
- When urine is taken from infants, a urine collector is often used, which is attached around the genitals, and after urination is poured from it into the container. In this case, you should notify the doctor that all of the urine has been handed over.
- During menstruation, women should refrain from collecting material.
- It is forbidden to collect urine from a duck, diaper, or a night pot.
- On the eve it is desirable to exclude from the diet products containing pigments( beets, carrots, berries), as well as fatty foods, chocolate and alcohol.
- A few days before the analysis, you need to refrain from exhausting workouts and heavy physical work.
- Sexual contact should be avoided for 2 days before the procedure.
- The results of the analysis may affect the intake of medications, so it is desirable to cancel them a week before the study, if you can not refuse medication, they should be warned by a doctor.
- The collected liquid must be delivered to the laboratory as soon as possible - its storage period does not exceed 1.5-2 hours.
In the general analysis of urine, the following indicators are determined:
- color - from straw-yellow to yellow;
- smell - blurred;
- transparency - transparent;
- specific gravity( density): in newborns - 1005-1017 grams per liter, for children 1-4 years - 1007-1016 grams, for children 5-10 years - 1011-1021 grams, for children 11-15 years - 1013-1024 grams, in adults - 1018-1026 grams;
- pH reaction is neutral or slightly acidic, from 4.5 to 7;
- protein - missing or up to 0.24 grams per liter;
- glucose is absent or up to 2.8 millimoles per liter;
- urobilinogen - traces or 5-15 micromolar per 1 liter;
- ketone bodies( acetone) - are absent;
- bilirubin - is absent;
- hemoglobin is absent.
A manual microscopy of the urine sediment is also carried out - examination under the microscope of a layer that did not dissolve after placing the material in a centrifuge:
- erythrocytes - absent, in men - up to 2 units in the field of view, in women - up to 3 units, in newborns - up to 7 units;
- white blood cells - single in the preparation, in men - up to 3 cells in the field of view, in women - up to 6 units, in children-boys - 5-7 units, in child-girls - 8-10 units;
- epithelial cells( flat, transitional, renal, bladder) - absent or single in the preparation;
- mucus - absent or in small amounts;
- cylinders are not available;
- salts - not available;
- bacteria are absent;
- yeast-like fungi - none.
Depending on which indicator deviates from the norm, the doctor can diagnose the disease and send the patient for an additional examination.
All urine released within 24 hours is called daily or diurnal diuresis. In contrast to the average portion of morning urine, the study of daily material is more informative and allows a more complete assessment of the state of the body.to contents ^
- Within a day all the material is collected in one container, therefore it is first necessary to prepare a clean dry jar or container with a lid of 2-3 liters.
- The first morning urination( preferably at 6-8 am) should be done in the toilet - this urine was excreted by the kidneys during the night and refers to the previous day.
- All subsequent urination is performed in a prepared container. The last time to empty the bladder is necessary at the time that on the previous day, when the first material was poured into the toilet bowl( 6-8 am).
- During the collection period, containers with biological fluid must be stored in a cool dark place covered with a lid.
- At the end of the collection, you should fix the total volume of urine, mix it, pour 50-100 milliliters into a container and deliver it to the laboratory. To the analysis attach a note with the amount of daily volume of material, as well as the weight and age of the patient - these data are necessary for counting the results.
- During the collection it is important to observe the usual drinking regimen, not to limit yourself in the liquid.
In the study of daily diuresis, the parameters included in the general and biochemical analyzes of urine are determined.to the table of contents ^
To identify diseases of the genitourinary system - cystitis, urethritis, pyelonephritis, glomerulonephritis, prostatitis. In more severe diseases, for example, chronic renal failure, nephrotic syndrome, the analysis is used to monitor the effectiveness of the treatment. Also with the help of the study, metabolic disorders in the body are revealed.to contents ^
Collection rules for
- For analysis, 50-100 milliliters of daily diuresis is needed, and collection is performed according to standard rules.
- In some cases, biochemical analysis can be carried out in the express mode, collecting the average portion of morning urine.
- Daily amount of urine - 1000-2000 milliliters;
- density - 1012-1022 grams per liter;
- alpha-amylase( diastase) - 28-100 units in 1 liter;
- uric acid for men - 202-417 micromolar per 1 liter, for women - 142-340 micromolar;
- urea - 2.76-8.07 micromol per 1 liter( 250-570 millimoles per day);
- albumin - 35-52 grams per liter;
- total protein: excretion - 0,08-0,24 grams per day, concentration - up to 0,14 grams per 1 liter;
- creatinine in men is 0.64-1.58 grams per liter( 7-18 millimoles per day), in women 0.48-1.43 grams per liter( 5.3-16 millimoles per day);
- bilirubin common in adults - up to 21 micromolar per 1 liter, in an infant above 1 month - up to 17 micromolar, in newborns of the first week of life - more or equal to 300 micromolar;
- potassium - 30-100 millimoles per day;
- calcium - 2,5-7,5 millimole per day;
- magnesium - 2,5-8,5 millimole per day;
- sodium - 130-260 millimoles per day;
- phosphorus - 12,9-40 millimole per day;
- ammonia is 29-88 millimoles per day;
- bacteria are absent.
According to Zimnitskii
The analysis is designed to assess the performance of the organs of the urinary system. The main criterion is the density of the material - the deviation of the indicators from the norm signals a change in the concentration of urine and a violation of the filtration capacity of the kidneys. Also the volume of the released liquid is important.
Thanks to the research, it is possible to detect such diseases as pyelonephritis, glomerulonephritis, renal or heart failure, blood diseases, sugar and diabetes insipidus.to contents ^
- For sample it is necessary to prepare 8 containers - sterile containers or clean and dry jars with lids, up to 0.5 liters. The whole volume of urine released during the day takes part in the study, so the volume of the container should be at least 250 milliliters.
- The first urination is carried out at 6 am in the toilet.
- Every 3 hours, starting at 9 o'clock, the material is collected in a container - with each subsequent urination a new container is used. The last time the urine is collected is at 6 am the next day. In order not to miss the appointed time, it is recommended to start an alarm clock with the timer function - on 9, 12, 15, 18, 21, 24, 3, 6 hours.
- Bottles should be signed( specify the time of urination) and stored in the refrigerator.
- In case the patient has no urge to urinate at the appointed time, the container is left dry, but signed and brought with him to the laboratory.
- If you need to urinate between certain periods, this is done in additional capacity, which is also signed and taken to the laboratory.
- During the period of urine collection, fluid intake should be normal - do not limit yourself to drinking or, conversely, do it more often than before.
- For the accuracy of the analysis it is necessary to record the amount of liquid drunk per day - tea, compote, milk, first courses.
- In the morning after collection of urine, the containers are delivered to the laboratory together with a note indicating the amount of liquid drunk per day.
Specific gravity of urine varies from 1013 to 1025 grams per liter, so different capacities will have different values.
- daily volume of urine - 1,5-2 liters;
- in 2-3 containers density of not less than 1020 grams per liter;
- density values above 1035 grams per liter are not available;
- volume of daily portions of urine is at least 2/3 of the total;
- the amount of liquid withdrawn is 65-80% of the consumed.
According to Nechiporenko
Is an additional study of the composition of urine. It is prescribed if, in a general analysis, an increased content of leukocytes, erythrocytes or the presence of cylinders was detected.
The analysis diagnoses inflammatory processes of acute or chronic nature in the kidneys or urinary tract.to table of contents ^
Collection rules for
Same as for general analysis - the average morning dose of urine takes part in the study.to table of contents ^
- Leukocytes - up to 2 thousand cells per 1 milliliter of urine( 0-2 * 10⁶ units per 1 liter).
- Erythrocytes - up to 1 thousand cells in 1 milliliter of material( 0-1 * 10⁶ units per 1 liter).
- Cylinders are not available. Allowed up to 20 units of hyaline cylinders per 1 milliliter of urine.
It is performed to clarify the localization of the inflammatory process in the organs of the genitourinary system. For women, the analysis is modified into a two-glass sample, which is due to anatomical features. Currently, the study is being conducted less and less - it is replaced by more highly accurate methods( ultrasound diagnosis, computed tomography).
During the analysis, an increase in the number of red blood cells and leukocytes is investigated. By the way in which portions of urine are more, determine the place of inflammation.to contents ^
- For analysis, women need to prepare 2 sterile containers for collecting urine, men - 3 containers.
- The volume of containers should be at least 250 milliliters - all morning urine is needed for the study.
- After carrying out hygienic procedures, urinate is produced in a prepared container - in men a second container should contain slightly more than half of the total material( approximately 3/5 of the total volume), and in the first and third containers - by 1/5.In women, the amount of liquid in two containers can be approximately the same.
Rates for men
- The predominance of cells in the first glass - the pathological process is localized in the urethra;
- in the second container - indicates a bladder injury;
- in the third - inflammation of the bladder, kidney, prostate( prostate);
- increase in erythrocytes and( or) leukocytes in all three vessels - there is a kidney damage.
Standards for women
- Most of the detectable cells are in the first glass - inflammation of the urethra or bladder;
- in the second - disease of the bladder or kidney;
- significant increase in cells in both portions - renal pathology.
Used to determine the quantitative and qualitative content of calcium in the body. The analysis is especially relevant for newborns and small children, whose skeleton is just beginning to form. The sample is performed to determine the required amount of vitamin D, as well as suspected Wilson's disease( metabolic disorder of copper), seizures, pancreatitis, tuberculosis, sarcoidosis, hypo- or hyperparathyroidism, cancerous and benign tumors.to contents ^
Collection rules for
Complies with the rules for general urine analysis. Among the additions are the following:
- For analysis, the average and last portions of urine are needed, so the first 1-2 seconds of urination is made into the toilet bowl and then into the bowl. The container should be of a suitable size.
- 3 days before the test, do not eat foods high in calcium - mineral water, milk and sour milk drinks, greens, muffins, coffee, alcohol.
In the analysis, the urine is mixed with Sulkovich's reagent. The result depends on the cloudiness of urine, due to the concentration of salt in it. The scale consists of the following values:
- "+" - Weak turbidity. Variant of the norm;a small amount of calcium, which is subject to adjustment with minor doses of vitamin D.
- "++" - Minor haze. Norm;the optimum amount of calcium in the body.
- «+++» - Significant clouding of urine. The concentration of calcium exceeds the norm, and vitamin D is produced in excess.
- "++++" - marked turbidity. An increase in the level of the microelement indicates hyperfunction of the parathyroid glands or an overdose of vitamin D.
- "-" - Negative result means complete absence of calcium in the urine. Diagnosed usually in children who do not have enough milk or it is poorly digested by the gastrointestinal tract. It can also indicate abnormalities of the parathyroid glands.
The presence of glucose in the urine is called glucosuria and can indicate diabetes, kidney, liver or pancreas, endocrine disorders, cerebral hemorrhages or tumors.to contents ^
Collection rules for
The analysis can be carried out by examining the morning urine - for this it is necessary to collect about 50 milliliters of an average portion. The algorithm is the same as for the general analysis.
More detailed is the study of daily urine - it allows not only to detect the presence of sugar, but also to determine the severity of glucosuria:
- The collection of daily urine for sugar is carried out according to standard rules - from 6 am one day to 6 am the next liquid, excluding the first urination,suitable capacity.
- All material is mixed and delivered to the laboratory in a volume of 50-100 milliliters.
- It is not recommended to eat sweets during collection time - this can cause a splash of sugar and affect the results of the analysis.
- A note with the total daily urine volume, as well as the weight, height and age of the patient should be attached to the urine container.
It is also possible to carry out the analysis at home with the help of indicator test strips - they contain a reagent that is stained with glucose in the test liquid.to contents ^
- In a healthy person, sugar in the urine should be absent or traceable - no more than 0.06-0.083 millimoles per liter. In some cases, it is possible to increase this figure to 0.2 millimoles per liter.
- In daily urine analysis, the concentration is normal to 2.8 millimoles per liter.
BAK-seeding on sterility
This high-precision laboratory analysis is performed to identify infection in the organs of the urinary system and identify the pathogen.
Normally, urine is sterile, but it becomes contaminated, passing through the urethra and flushing microorganisms from its walls - the natural flora of a healthy person or pathogenic microbes. Bacteriological( or bacterial) seeding involves evaluating the sterility of the material and determining the level of bacteriuria, that is, the concentration of microorganisms in the urine.to table of contents ^
Collection rules for
- The study requires an average dose of morning urine in the amount of 10-50 milliliters. It should be collected according to the scheme corresponding to the general analysis. Hygienic procedures before collection of urine should be carried out using boiled water.
- It is not necessary to follow the diet before the analysis - the food does not influence the result.
- Before urinating women are advised to insert a swab so that mucus from the vagina does not get into the material.
In the laboratory, the test liquid is placed in containers with nutrient material - if pathogenic microorganisms are present in the urine, their concentration will increase significantly after a certain period of time. The result of the analysis will be ready in 5-7 days.
The number of bacteria is measured in colony forming units - CFU.Each CFU is a living microbial cell or a group of cells that cause the growth of a visible colony of microorganisms:
- The number of bacteria less than 1000( 103) CFU per 1 milliliter of urine is negative, the sample is contaminated by normal human flora.
- The number of bacteria is 1000-10000( 103-104) CFU in 1 milliliter is a dubious result, requires repeated or additional investigation.
- Concentration of microorganisms from 100,000( 105) CFU per 1 milliliter - a positive test, treatment is necessary. Usually, the results of the analysis indicate the causative agent of infection - a bacterium, a fungus, the simplest.
- Positive results often assess the sensitivity of the pathogenic flora to the effects of antibiotics - an antibioticogram is made showing the drugs that inhibit the growth of bacteria.
- If the urine is contaminated by the colonies of one microorganism, they speak of the acute course of the infectious and inflammatory process. In CFE of different microbes there is a chronic disease.
It is used mainly in epidemiological studies, and is also prescribed for thyroid dysfunction and for the prevention of iodine deficiency disorders. Since the element enters the body mainly with food, and 90% of it is excreted in the urine, the results of the analysis can change daily.to contents ^
Collection rules for
Meets requirements for general urine analysis. When transferring the container to the laboratory, the age of the patient should be indicated.to table of contents ^
- In children up to one year - 40-50 micrograms per 1 liter;
- children 1-7 years old - 50-90 micrograms;
- children 8-12 years old - 90-120 micrograms;
- adolescents 13-16 years old - 100-150 micrograms;
- adults - 100-500 micrograms, the value below 100 micrograms is considered iodine deficiency.
Amylase is a digestive enzyme involved in the breakdown of carbohydrates. It is formed in the pancreas and salivary glands, and is excreted through the kidneys with urine, calling it diastase. Analysis for diastasis is prescribed for suspected pancreatic diseases, inflammation in the peritoneum, metabolic disorders, the presence of tumors.to contents ^
The material for the study can be collected in two ways:
- The average portion of morning urine is carried out according to the rules of general analysis.
- Daily urine - also collected according to the standard scheme.
The level of diastase in urine should correspond to the following values:
- in an adult - 16-128 units per 1 liter;
- in the elderly - 20-159 units;
- in a child - 10-64 units.
The reference values in different laboratories may differ slightly.to table of contents ^
salts The presence of salts in urine can indicate abnormalities in kidney function or diseases of the gastrointestinal tract, and also presage the development of cholelithiasis or the formation of kidney stones. In children, their presence often indicates an error in nutrition. Also, the content of salt crystals largely depends on the acidity of urine - urate and oxalate are found in the acidic medium, oxalate and phosphate in the alkaline urine precipitate.to contents ^
Collection rules for
For analysis, the average portion of morning urine is most often used. However, a more accurate result is given by the study of daily diuresis. The material is collected according to standard schemes.to table of contents ^
In a healthy person there is no salt in the urine, that is, the urine precipitate after centrifugation should not contain the following inclusions:
- urate( uric acid salts);
- crystals of hippuric acid.
The analysis is based on the detection of human chorionic gonadotropin( hCG) - a hormone produced by the embryo envelope. The level of this substance in the urine of pregnant women is determined already in 2-3 weeks after conception, and in the blood even earlier - for 6-8 days.to contents ^
- The highest concentration of hCG is present in the morning urine, therefore for analysis it is desirable to examine the last batch of material by collecting it in a clean dry container.
- Liquid should be delivered to the laboratory or run the test yourself using test strips with reagent applied on them.
- When carrying out the analysis at home, it is necessary to follow the instructions given - to lower the strip in the urine for the specified time( usually 5-30 seconds), so that the liquid level does not reach the restrictive line, then put the strip on a clean, dry surface. After 1-30 minutes, the result will appear on it.
In a laboratory study:
- up to 5 micro-international units per 1 milliliter of urine( mIU / ml) - negative result, pregnancy has not occurred;
- 25 or more micro-international units per 1 milliliter of urine - the result is positive.
In the first weeks after fertilization, the level of HCG daily doubles, so the result can be obtained as early as 7-10 days of pregnancy. As the probability of error decreases over time, the analysis using home tests is best carried out 2-3 weeks after the alleged conception:
- the appearance on the test of one strip of red color - the result is negative, conception did not occur;
- two red strips on the test( one of them can be pink) - a positive result, the pregnancy has come.