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Decoding of indicators of the general analysis of urine. General urine analysis

A general urine test is a complex laboratory study that reveals a number of physical and chemical characteristics of a substance; on its basis, a number of diagnoses can be made.

Due to its ease of implementation, as well as high information content, this analysis is an integral part of any research. Based on the data obtained, the doctor makes a diagnosis, and, if necessary, writes out a referral for further research and assigns visits to the appropriate specialists.

The subject of the review of this article will be the decoding of the results of a general urine test in adults in the form of a table, as well as normal indicators.

What are the indicators for decoding?

Decoding a general urine test involves a description of urine according to the following indicators:

  • transparency;
  • Colour;
  • specific gravity and acidity index.

Then, the presence of specific substances in the urine is assessed, such as:

  • protein;
  • glucose;
  • bile pigments;
  • ketone bodies;
  • hemoglobin;
  • inorganic substances;
  • blood cells (leukocytes, erythrocytes, etc.), as well as cells found in the urinary tract (epithelium and its derivatives - cylinders).

This procedure is assigned in the case of:

  • auxiliary study of the work of the urinary system (urinalysis can also be prescribed for pathologies associated with other organs);
  • monitoring the development of diseases and checking the quality of their treatment;
  • diagnostics of pathologies of the urinary system;
  • preventive examination.

With the help of the analysis, it is possible to diagnose a variety of renal diseases, problems with the prostate gland, diseases of the bladder, tumors, pyelonephritis, as well as a number of pathological conditions in the early stages, when clinical manifestations as such are absent.

How to collect and pass a general urine test correctly?

Before collecting urine, you need to make a thorough toilet of the genitourinary organs to exclude the ingress of third-party contaminants into the liquid. It is necessary to collect urine in sterile containers, the so-called containers for biological samples.

12 hours before collecting the substance, it is necessary to stop taking any medications that can change the physicochemical parameters of urine. The analysis itself must be carried out no later than two hours after sampling.

To conduct a general urinalysis, it is necessary to collect the morning fluid, which physiologically accumulated throughout the night. It is this material that is considered to be optimal, and the results of its research are reliable.

Norm and interpretation of results: table

The table shows the indicators of the general analysis of urine in the norm in adults, in the presence of any deviations, it is necessary to decipher.

Urine analysis is currently performed rather quickly, despite the large number of indicators and criteria. The properties and composition of urine can vary widely depending on the state of the kidneys and the body as a whole, therefore it is of great diagnostic value.

Urine color

The color of urine depends on the amount of fluid taken and on the concentration of the kidneys. Prolonged discharge of pale, colorless, or watery urine is characteristic of

  • insipid and;
  • chronic renal failure.

Intensely colored urine is excreted with large extrarenal fluid loss (with fever, diarrhea). Pink-red or red-brown color due to the admixture of "fresh" blood occurs when:

  • tumors;
  • kidney infarction;

Excretion of urine of the "meat slop" type is typical for patients with acute glomerulonephritis. Dark red urine appears with massive hemolysis of erythrocytes. With jaundice, the urine becomes brown or greenish-brown ("beer color"). Black urine is typical for alkaptonuria, melanosarcoma, melanoma. Milky white urine appears with lipiduria.

Transparency

It is also a very important criterion in diagnosis. Normally, it should be transparent. This property persists for a few hours after collecting the analysis.

Causes of cloudy urine:

  • inclusion of erythrocytes in urolithiasis, glomerulonephritis, etc.
  • a large number of leukocytes in inflammatory diseases.
  • the presence of bacteria.
  • high content .
  • increased content of epithelial cells.
  • in large volumes.

Slight turbidity is allowed due to epithelial cells and a small amount of mucus. Usually urine has a specific, mild odor. Most people know him well. In some diseases, it can also change. With infectious diseases of the bladder, a strong smell of ammonia may appear, or even rot. With diabetes, urine smells like rotten apples.

Urine reaction (acidity, pH)

The usual reaction of urine is slightly acidic, fluctuations in urine pH in the range of 4.8-7.5 are allowed.

  • The pH rises with some infections of the urinary system, chronic renal failure, prolonged vomiting, hyperfunction of the parathyroid glands, hyperkalemia.
  • A decrease in pH occurs with tuberculosis, diabetes mellitus, dehydration, hypokalemia, and fever.

Specific gravity

This indicator normally has a fairly wide range: from 1.012 to 1.025. The specific gravity is determined by the amount of substances dissolved in the urine: salts, uric acid, urea, creatinine.

An increase in relative density over 1026 is called hypersthenuria. This condition is observed when:

  • an increase in edema;
  • nephrotic syndrome;
  • diabetes mellitus;
  • toxicosis of pregnant women;
  • the introduction of X-ray contrast agents.

A decrease in HC or hypostenuria (less than 1018) is detected when:

  • acute damage to the tubules of the kidney;
  • diabetes insipidus;
  • chronic renal failure;
  • malignant increase in blood pressure
  • taking certain diuretics
  • plentiful drink

The specific gravity reflects the ability of the human kidney to concentrate and dilute.

Protein

In a healthy person, the protein concentration should not exceed 0.033 g / liter. If this figure is exceeded, then we can talk about nephrotic syndrome, the presence of inflammation and many other pathologies.

Among the diseases that cause an increase in the concentration of protein in the urine are:

  • colds,
  • diseases of the urinary tract,
  • kidney disease.

Inflammatory diseases of the genitourinary system:

  • cystitis,
  • vulvovaginitis,
  • BPH.

In all these cases, the protein concentration rises to 1 g / liter.

Glucose (sugar)

In a normal state, glucose should not be detected, however, its content in a concentration of no more than 0.8 mmol per liter is permissible and does not indicate deviations.

Deciphering a urine test in Latin with a large amount of glucose may indicate:

  • Cushing's syndrome;
  • pregnancy;
  • abuse of sweet foods.

However, the most common cause of excess urine sugar is. A complete blood count is usually done in addition to a urinalysis to confirm this diagnosis.

Ketone bodies

These are acetone, acetoacetic acid and hydroxybutyric acid. The reason for the presence of ketone bodies in urine is a violation of metabolic processes in the body. This condition can be observed with pathologies of various systems.

Causes of ketone bodies in urine:

  • diabetes;
  • alcohol intoxication;
  • acute pancreatitis;
  • after injuries affecting the central nervous system;
  • acetemic vomiting in children;
  • prolonged fasting;
  • the predominance of protein and fatty foods in the diet;
  • increased levels of thyroid hormones (thyrotoxicosis);
  • Itsenko Cushing's disease.

Epithelium

Cylinders

A cylinder is a protein coagulated in the lumen of the renal tubules and includes any contents of the lumen of the tubules. In the urine of a healthy person, single cylinders in the field of view can be found per day. Normally, there are no cylinders in the general analysis of urine. The appearance of cylinders (cylindruria) is a symptom of kidney damage. The type of cylinders (hyaline, granular, pigmented, epithelial, etc.) has no particular diagnostic value.

Hemoglobin

Hemoglobin is absent in normal urine. A positive test result reflects the presence of free hemoglobin or myoglobin in the urine. This is the result of intravascular, intrarenal, urinary hemolysis of erythrocytes with the release of hemoglobin, or muscle damage and necrosis, accompanied by an increase in plasma myoglobin levels.

The presence of myoglobin in urine:

  • muscle damage;
  • heavy physical activity, including sports training;
  • myocardial infarction;
  • progressive myopathies;
  • rhabdomyolysis.

The presence of hemoglobin in urine:

  • severe hemolytic anemia;
  • severe poisoning, for example, sulfonamides, phenol, aniline. poisonous mushrooms;
  • sepsis;
  • burns.

It is quite difficult to distinguish hemoglobinuria from myoglobinuria, sometimes myoglobinuria is mistaken for hemoglobinuria.

Bilirubin

Normally, bilirubin should be excreted as part of bile into the intestinal lumen. However, in some cases, there is a sharp increase in the level of blood bilirubin, in this case, the function of removing this organic matter from the body is partially taken over by the kidneys.

Reasons for the presence of bilirubin in urine:

  • hepatitis;
  • cirrhosis of the liver;
  • liver failure;
  • cholelithiasis;
  • von Willebrand disease;
  • massive destruction of red blood cells (malaria, toxic hemolysis, hemolytic disease, sickle cell anemia).

Erythrocytes

Erythrocytes in the analysis of urine of healthy people should be absent. Single erythrocytes, detected in several fields of vision, are maximally permissible. The appearance of erythrocytes in the urine can be both pathological and physiological.

Leukocytes

In the urine of a healthy person, they are contained in small quantities. An increase in the number of leukocytes in the urine (leukocyturia) indicates inflammatory processes in the kidneys (pyelonephritis) or urinary tract (cystitis, urethritis).

The so-called sterile leukocyturia is possible. This is the presence of leukocytes in urine in the absence of bacteriuria and dysuria (with exacerbation of chronic glomerulonephritis, contamination during urine collection, condition after antibiotic treatment, bladder tumors, renal tuberculosis, interstitial analgesic nephritis).

Bacteria

Mushrooms in urine

Candida often gets into the bladder from the vagina. If they are found, antifungal treatment is prescribed.

Slime

Mucus should not normally be present in the urine. Its presence speaks of an acute or chronic inflammatory process of the genitourinary system.

Salts in urine

In the end, I would like to add that the general analysis of urine is an important diagnostic indicator. A person can independently pay attention to the change in urine and consult a doctor. Even healthy people are recommended to take this test at least once a year. It should also be remembered that a single result is not an indicator of pathology. It is very important to be tested in dynamics in order to make a final conclusion about the presence of the disease.

Urine is a metabolic product formed in the kidneys as a result of filtration of the liquid part of the blood, as well as the processes of reabsorption and secretion of various analytes. It consists of 96% of water, the remaining 4% are dissolved in it nitrogenous products of protein metabolism (urea, uric acid, creatinine, etc.), mineral salts and other substances.

General analysis of urine in children and adults includes an assessment of the physicochemical characteristics of urine and sediment microscopy. This study allows you to assess the function of the kidneys and other internal organs, as well as to identify the inflammatory process in the urinary tract.

Physicochemical studies of urine include an assessment of the following indicators:

  • Colour;
  • clarity of urine;
  • specific gravity (relative density);
  • protein concentration;
  • glucose concentration;
  • the concentration of bilirubin;
  • urobilinogen concentration;
  • concentration of ketone bodies;
  • concentration of nitrites;
  • concentration of hemoglobin.

Microscopy of urinary sediment includes the assessment of the following items:

The assessment of the physical properties of urine, such as smell, color, turbidity, is carried out by the organoleptic method. The specific gravity of urine is measured using a urometer, refractometer or assessed by "dry chemistry" methods (test strips) - visually or on automatic urine analyzers.

Urine color

An adult has yellow urine. Its shade can range from light (almost colorless) to amber. The saturation of the yellow color of urine depends on the concentration of substances dissolved in it. With polyuria, urine has a lighter color; with a decrease in urine output, it acquires a rich yellow tint. The color changes when taking medications (salicylates, etc.) or eating certain foods (beets, blueberries).

Pathologically changed color of urine occurs when:

  • hematuria - a type of "meat slop";
  • bilirubinemia (beer color);
  • hemoglobinuria or myoglobinuria (black color);
  • leukocyturia (milky white color).

Clarity of urine

Normally, freshly collected urine is completely clear. Turbidity of urine is due to the presence in it of a large number of cell formations, salts, mucus, bacteria, fat.

Urine smell

Normally, the smell of urine is mild. When urine is decomposed by bacteria in the air or inside the bladder, for example, in the case of cystitis, an ammonia odor appears. When urine that contains protein, blood, or pus decays, such as in bladder cancer, the urine smells like rotten meat. In the presence of ketone bodies in the urine, the urine has a fruity odor, reminiscent of the smell of rotting apples.

Urine reaction

The kidneys excrete "unnecessary" substances from the body and retain the necessary substances to ensure the exchange of water, electrolytes, glucose, amino acids and maintain the acid-base balance. The reaction of urine - pH - largely determines the efficiency and peculiarity of these mechanisms. Normal urine reaction is weakly acidic (pH 5.0-7.0). It depends on many factors: age, diet, body temperature, physical activity, kidney condition, etc. The lowest pH values ​​are in the morning on an empty stomach, the highest - after meals. When eating predominantly meat food, the reaction is more acidic, when eating vegetable food, it is alkaline. With prolonged standing, urine decomposes, ammonia is released and the pH shifts to the alkaline side.

An alkaline urine reaction is characteristic of a chronic urinary tract infection, and is also noted with diarrhea and vomiting.

The acidity of urine increases with febrile conditions, diabetes mellitus, tuberculosis of the kidneys or bladder, renal failure.

Specific gravity (relative density) of urine

Relative density reflects the functional ability of the kidneys to concentrate and dilute urine. Normal functioning kidneys are characterized by wide fluctuations in the specific gravity of urine during the day, which is associated with periodic intake of food, water and loss of fluid by the body. The kidneys under various conditions can excrete urine with a relative density of 1.001 to 1.040 g / ml.

Distinguish:

  • hypostenuria (fluctuations in the specific gravity of urine less than 1.010 g / ml);
  • isostenuria (the appearance of a monotonous nature of the specific gravity of urine corresponding to that of primary urine (1.010 g / ml);
  • hypersthenuria (high specific gravity values).

The maximum upper limit of the specific gravity of urine in healthy people is 1.028 g / ml, in children - 1.025 g / ml. The minimum lower limit for the specific gravity of urine is 1.003-1.004 g / ml.

To assess the chemical composition of urine, diagnostic test strips (the "dry chemistry" method) produced by various manufacturers are usually used. The chemical methods used in test strips are based on color reactions that change the color of the test area of ​​the strip at different analyte concentrations. Color change is determined visually or by reflective photometry using semi-automatic or fully automated urine analyzers, the results are assessed qualitatively or semi-quantitatively. If a pathological result is found, the study can be repeated using chemical methods.

Protein

Protein is normally absent in urine or is present in concentration that cannot be detected by conventional methods (traces). There are several types of proteinuria (the appearance of protein in the urine):

  • physiological (orthostatic, after increased physical activity, hypothermia);
  • glomerular (glomerulonephritis, the action of infectious and allergic factors, hypertension, cardiac decompensation);
  • tubular (amyloidosis, acute tubular necrosis, interstitial nephritis, Fanconi syndrome).
  • prerenal (multiple myeloma, muscle necrosis, erythrocyte hemolysis);
  • postrenal (with cystitis, urethritis, colpitis).

Glucose

Normally, there is no glucose in the urine. The appearance of glucose in urine can have several reasons:

  • physiological (stress, intake of an increased amount of carbohydrates);
  • extrarenal (diabetes mellitus, pancreatitis, diffuse liver damage, pancreatic cancer, hyperthyroidism, Itsenko-Cushing's disease, traumatic brain injury, strokes);
  • renal (renal diabetes, chronic nephritis, acute renal failure, pregnancy, phosphorus poisoning, some drugs).

Bilirubin

Bilirubin is normally absent in urine. Bilirubinuria is detected in parenchymal lesions of the liver (hepatitis), obstructive jaundice, cirrhosis, cholestasis, as a result of the action of toxic substances.

Urobilingen

Normal urine contains low concentration (traces) of urobilinogen. Its level increases sharply with hemolytic jaundice, as well as with toxic and inflammatory lesions of the liver, intestinal diseases (enteritis, constipation).

Ketone bodies

Ketone bodies include acetone, acetoacetic and beta-hydroxybutyric acids. An increase in the excretion of ketones in the urine (ketonuria) appears when carbohydrate, lipid or protein metabolism is disturbed.

Nitrite

There are no nitrites in normal urine. In urine, they are formed from foodborne nitrates under the influence of bacteria if the urine has been in the bladder for at least 4 hours. Detection of nitrite in properly stored urine samples indicates an infection of the urinary tract.

Hemoglobin

Normally, it is absent in urine. Hemoglobinuria - the result of intravascular hemolysis of erythrocytes with the release of hemoglobin - is characterized by the release of red or dark brown urine, dysuria, and often back pain. With hemoglobinuria, erythrocytes are absent in the urine sediment.

Microscopy of urine sediment

Urine sediment is divided into organized (elements of organic origin - erythrocytes, leukocytes, epithelial cells, cylinders, etc.) and unorganized (crystals and amorphous salts).

Research methods

The study is carried out visually in a native preparation using a microscope. In addition to visual microscopic examination, research using automatic and semi-automatic analyzers is used.

Erythrocytes

During the day, 2 million erythrocytes are excreted in the urine, which in the study of urine sediment is normally 0-3 erythrocytes in the field of view for women and 0-1 erythrocytes in the field of view for men. Hematuria is an increase in red blood cells in the urine above the indicated values. Allocate macrohematuria (the color of urine is changed) and microhematuria (the color of the urine is not changed, erythrocytes are detected only by microscopy).

In the urinary sediment, erythrocytes can be unchanged (containing hemoglobin) and altered (devoid of hemoglobin, leached). Fresh, unchanged erythrocytes are characteristic of urinary tract lesions (cystitis, urethritis, stone passage).

The appearance of leached erythrocytes in the urine is of great diagnostic value, because they are most often renal in origin and occur in glomerulonephritis, tuberculosis, and other kidney diseases. To determine the source of hematuria, a three-glass test is used. When bleeding from the urethra, hematuria is greatest in the first portion (unchanged red blood cells), from the bladder - in the last portion (unchanged red blood cells). With other sources of bleeding, red blood cells are distributed evenly in all three portions (leached red blood cells).

Leukocytes

Leukocytes in the urine of a healthy person are contained in small quantities. The norm for men is 0-3, for women and children 0-6 leukocytes in the field of view.

An increase in the number of leukocytes in the urine (leukocyturia, pyuria) in combination with bacteriuria and the presence of clinical symptoms indicates inflammation of an infectious nature in the kidneys or urinary tract.

Epithelial cells

Epithelial cells are almost always found in the urinary sediment. Normally, in the analysis of urine, no more than 10 epithelial cells in the field of view.

Epithelial cells are of various origins:

  • squamous epithelial cells enter the urine from the vagina, urethra, their presence is of no particular diagnostic value;
  • cells of the transitional epithelium line the mucous membrane of the bladder, ureters, pelvis, large ducts of the prostate gland. The appearance in the urine of a large number of cells of such epithelium can be observed with urolithiasis, neoplasms of the urinary tract and inflammation of the bladder, ureters, pelvis, large ducts of the prostate gland;
  • cells of the renal epithelium are detected with damage to the renal parenchyma, intoxication, febrile, infectious diseases, circulatory disorders.

Cylinders

A cylinder is a protein coagulated in the lumen of the renal tubules and includes any contents of the lumen of the tubules in its matrix. The cylinders take the shape of the tubules themselves (cylindrical cast). Normally, there are no cylinders in a urine sample taken for general analysis. The appearance of cylinders (cylindruria) is a symptom of kidney damage.

There are cylinders:

  • hyaline (with overlapping erythrocytes, leukocytes, renal epithelial cells, amorphous granular masses);
  • grainy;
  • waxy;
  • pigmented;
  • epithelial;
  • erythrocyte;
  • leukocyte;
  • fatty.

Fugitive sludge

The main component of unorganized urine sediment is salts in the form of crystals or amorphous masses. The nature of the salts depends on the pH of the urine and other properties of the urine. For example, with an acidic reaction of urine, uric acid, urates, oxalates are found, with an alkaline reaction of urine - calcium, phosphates, uric ammonium. The unorganized sediment has no special diagnostic value; indirectly, one can judge the patient's tendency to urolithiasis. In a number of pathological conditions, crystals of amino acids, fatty acids, cholesterol, bilirubin, hematoidin, hemosiderin, etc. may appear in the urine.

The appearance of leucine and tyrosine in the urine indicates a pronounced metabolic disorder, phosphorus poisoning, destructive liver disease, pernicious anemia, and leukemia.

Cystine is a congenital disorder of cystine metabolism - cystinosis, liver cirrhosis, viral hepatitis, hepatic coma, Wilson's disease (congenital copper metabolism defect).

Xanthine - Xanthinuria is caused by the absence of xanthine oxidase.

Bacteria

Normally, the urine in the bladder is sterile. When urinating, germs from the lower urethra enter it.

The appearance of bacteria and leukocytes in the general analysis of urine against the background of symptoms (dysuria or fever) indicates a clinically manifested urinary infection.

The presence of bacteria in the urine (even in combination with leukocytes) in the absence of complaints is regarded as asymptomatic bacteriuria. Asymptomatic bacteriuria increases the risk of a urinary tract infection, especially during pregnancy.

Yeast mushrooms

The detection of fungi of the genus Candida indicates candidiasis, which occurs most often as a result of irrational antibiotic therapy, the intake of immunosuppressants, cytostatics.

In the urine sediment, eggs of the blood schistosome (Schistosoma hematobium), elements of the echinococcal bladder (hooks, scolexes, brood capsules, scraps of the bladder membrane), migrating larvae of intestinal acne (strongylids), washed off by urine from the perineum of the oncosphere tenidobius ) and pathogenic protozoa - Trichomonas (Trichomonas urogenitalis), amoeba (Entamoeba histolitika - vegetative forms).

Sample collection and storage conditions

For a general analysis, a morning urine sample is collected. The collection of urine is carried out after a thorough toilet of the external genital organs without the use of antiseptics. For the study, freshly collected urine is used, which was stored for no more than four hours before analysis. Samples are stable at 2–8 ° С for no more than 2 days. The use of preservatives is undesirable. Before testing, the urine is thoroughly mixed.

Urinalysis, general urine analysis, leukocytes in urine, erythrocytes in urine, salts in urine, urine bacteria, mucus in urine. A general urine test should be performed in all patients, regardless of the nature of their disease. For a general analysis, you need 100-200 ml of the first morning urine. This is a laboratory study of urine, carried out for the needs of medical practice, as a rule, for diagnostic purposes. Includes organoleptic, physicochemical and biochemical studies. General clinical analysis of urine includes the study of the physical, chemical properties of urine and sediment microscopy. Clinical analysis of urine (general urine analysis) - a study of the physical and chemical properties of urine and sediment microscopy. Deciphering its indicators gives a general picture of the state of the body as a whole. The general analysis of urine is deciphered by determining 3 main indicators: acidity, water content, the presence of sugar.

GENERAL URINE ANALYSIS

A general urine analysis is included in the list of mandatory studies that should be carried out for all primary patients, regardless of the alleged diagnosis.

It must be remembered that deviations in the general analysis of urine can be observed not only in kidney diseases, but also in pathology of other organs. Even Hippocrates (430-377 BC) in his "Aphorisms" noted: "The doctor must observe whether the patient's urine is the same as that of a healthy one, and the less the similarity, the more severe the disease."

General urinalysis standards (standards for decoding general urine analysis)

Indicators: Result

The amount of urine delivered for analysis: No diagnostic value

Urine color: Various shades of yellow

Clarity of urine: Transparent

Urine odor: Vague, non-specific

Urine reaction or pH: Acidic, pH less than 7

Specific gravity (relative density) of urine: 1.018 or more in the morning portion

Protein in urine: None

Glucose in urine: None

Ketone bodies in urine: None

Bilirubin in urine: Absent

Urobilinogen in urine: 5-10 mg / l

Hemoglobin in urine: Absent

Red blood cells in urine (microscopy): 0-3 per field of view for women

0-1 in sight for men

Leukocytes in urine (microscopy): 0-6 in the field of view for women

0-3 in the field of view for men

Epithelial cells in urine (microscopy): 0-10 per field of view

Cylinders in urine (microscopy): None

Salts in urine (microscopy): None

Bacteria in urine: None

Fungi in urine: None

Collection of samples and preparation for general urine analysis

For a general analysis, collect the entire portion of the morning urine after a thorough toilet of the genitals.

The urine collection container must be clean and dry. In poorly washed dishes, urine quickly becomes cloudy and becomes alkaline.

You can store urine before the general analysis for no more than 1.5 hours. A later study of urine will be unreliable, because its cellular composition changes. Deciphering the analysis of urine in pregnant women helps to detect possible problems during pregnancy in time

Urine analysis according to Nechiporenko

Urine analysis according to Nechiporenko is a laboratory study of urine, with the help of which the doctor can assess the condition, function of the kidneys and urinary tract.

Why is urine analysis performed according to Nechiparenko?

Urine analysis Nechiporenko is usually prescribed after a general urinalysis, if the clinical analysis reveals deviations from the norm. Analysis of urine according to Nichiporenko will allow a more detailed study of these disorders for the correct diagnosis.

You may have to take a urine test according to Nicheporenko several times, because with this diagnostic method the doctor can control the effectiveness of the treatment.

How is Nichiporenko's urine analysis performed?

To analyze Nicheporenko's urine, doctors use 1 milliliter from the patient's urine portion and count the number of urine components (per 1 milliliter): erythrocytes, leukocytes and cylinders using a special counting chamber.

Nechiporenko urine analysis standards:

Erythrocytes - no more than 1000 per 1 ml of urine.

Leukocytes - no more than 2000 per 1 ml of urine.

Cylinders - no more than 20 per 1 ml of urine.

An increase in certain formed elements of urine can confirm or deny the results of a general urine analysis. The studies carried out ensure the maximum accuracy of the diagnosis.

How to take a urine test according to Nechiporenko?

After a thorough toilet of the genitals, the middle portion of urine is collected: for this, the first amount of excreted urine (15-20 milliliters) is passed, and the middle portion of the morning urine is placed in a prepared clean dish.

Material for research: an average portion of morning urine.

Deadline for urine analysis according to Nechiporenko: 1.5 hours.

An increase in leukocytes in urine analysis according to Nechiporenko occurs in the following diseases:

1. Pyelonephritis is an inflammatory kidney disease in which the level of white blood cells in the urine is high. Pyelonephritis is an infectious inflammation of the pelvis and other parts of the kidneys. The presence of an infection provokes the accumulation of leukocytes in this area, which leads to an increase in the number of leukocytes in the urine - leukocyturia. The main symptoms of pyelonephritis: dull pain in the lumbar region (on one or both sides), fever, weakness, headaches, loss of appetite, etc. erythrocytes in the urine), pyuria (the presence of pus in the urine), bacteriuria (the presence of bacteria in the urine), proteinuria (excretion of protein in the urine).

2. Kidney stones (nephrolithiasis, nephrolithiasis) is a disease characterized by the formation of stones of various sizes, shapes and compositions in the kidneys. In the presence of kidney stones, the main symptoms are: acute pain in the lumbar region, especially after shaking in transport, the pain radiates to the external genital organs, an increase in body temperature, general malaise. Blood (hematuria) is found in the urine. The presence of leukocytes in the urine indicates an infection.

An increase in erythrocytes in urine analysis according to Nechiporenko occurs in the following diseases:

1. Acute glomerulonephritis is a disease of the glomeruli of the kidneys (the main parts responsible for filtering and purifying the blood). As a rule, in acute glomerulonephritis, gross hematuria (urine of the color of "meat slops") is noted. The main symptoms of acute glomerulonephritis are as follows: the appearance of blood in the urine, an increase in blood pressure, severe edema, a decrease in the amount of urine discharge (oliguria). In the analysis of urine, hematuria (the presence of erythrocytes in the urine), proteinuria (the presence of protein in the urine), cylindruria (the presence of cylinders in the urine, "covered" with erythrocytes - erythrocyte casts).

2. Chronic glomerulonephritis can also be accompanied by hematuria, but the presence of red blood cells in the urine is unstable. The main symptom of chronic glomerulonephritis is proteinuria - an increase in protein excretion in the urine, cylindruria - the presence of casts in the urine. The symptoms of chronic glomerulonephritis are as follows: increased blood pressure, edema, and blood in the urine.

3. Kidney stones (kidney stones, nephrolithiasis) damage the walls of the urinary tract, which leads to rupture of the smallest vessels and the ingress of red blood cells into the blood. The symptoms of kidney stones are described above.

4. Tumors of the kidneys and urinary tract are the cause of hematuria. Tumors can be benign (papilloma, fibroma, hemangioma) and malignant. Hematuria in kidney tumors differs from hematuria in other diseases in that, as a rule, the appearance of blood in the urine against the background of a tumor is not preceded by any other symptoms of the disease. Hematuria begins suddenly and also suddenly goes away. Other symptoms of a kidney tumor are: a prolonged slight increase in body temperature, general weakness, loss of appetite, weight loss, dull aching pains in the kidney area, etc. The main symptoms of a bladder tumor: the appearance of blood in the urine (macrohematuria - blood can be secreted throughout urination or only at the end when the bladder contracts), frequent urination, false urge to urinate, pain during urination, etc.

Cylinders in urine in the analysis according to Nechiporenko

Cylinders are protein casts of the formed tubules of the kidneys. Depending on the composition, several types of cylinders are distinguished, which are found in various diseases. Normally, urine should not contain protein. With the appearance of protein and an acidic reaction in the urine, proteins clump together, forming cylinders. Cells (erythrocytes, cells lining the renal tubules - epithelium, etc.) can be deposited on protein casts. The main diseases in which cylindruria (casts in the urine) is observed:

1. Glomerulonephritis is a kidney disease characterized by hematuria (presence of red blood cells in the urine), cylindruria, and some other symptoms. As a rule, the cylinders in glomerulonephritis are "covered" with erythrocytes, and are called erythrocyte casts. The symptoms of glomerulonephritis are described above.

2. Pyelonephritis is an inflammatory disease of the kidneys. With pyelonephritis, in the analysis of urine according to Nechiporenko, as a rule, leukocyturia (an increase in leukocytes in the urine), bacteriuria (the presence of bacteria in the urine) and cylindruria are observed. In pyelonephritis, the most common casts are simple (or hyaline) casts, as well as epithelial casts (casts containing epithelial cells of the kidney tubules).

3. Poisoning with nephrotoxic (poisonous for the kidneys) substances is also the cause of the appearance of casts in the urine. With toxic lesions of the kidneys in the urine, the so-called waxy cylinders are observed. The waxy casts are composed of cells of the destroyed tubules of the kidneys.

What determines the Zimnitsky test?

Analysis of urine according to Zimnitsky allows the doctor to determine the ability of the kidneys to concentrate urine. Concentrating ability of the kidneys is a natural regulatory mechanism that allows the body to maintain a constant fluid environment. So, for example, with an increase in the amount of fluid in the body (drinking plenty of fluids, liquid food), the kidneys excrete more urine and diluted urine.

On the contrary, if the human body receives little water, the kidneys begin to produce highly concentrated urine and thus save fluid.

One of the most informative fragments of a general urine analysis is sediment microscopy, in which the number of different elements in one field of view is counted.

The analysis of urine according to Zimnitsky determines the density of urine - this is an indicator that expresses the amount of metabolic products dissolved in urine (salts, proteins, ammonia, etc.). The density of urine depends on the amount of fluid consumed, as well as on the concentration ability of the kidneys. Normal urine density ranges from 1.003 to 1.035. During the day, a person consumes an unequal amount of fluid, therefore, the density of urine at different times of the day changes: during the day, urine is less dense due to fluid intake, morning urine, on the contrary, has the highest density.

With the help of Zimnitsky's test, daily diuresis is also determined - the total amount of urine excreted during the day. Normally, about 1.5-2 liters of urine are released during the day. With the help of the Zimnitsky test, they determine how much urine was released during the day and how much at night. Daily fluctuations in urine output (different amounts of urine excreted during the day and during the night) reveal some abnormalities in the work of the kidneys or heart.

How is urine collected for Zimnitsky's sample?

Collection of urine for Zimnitsky's test is carried out within one day. During the collection of urine, the subject should eat as usual and take the usual amount of fluid for himself (preferably no more than 1.5-2 liters of fluid per day). In parallel with the collection of urine, it is necessary to calculate the amount of fluid taken (including liquid food), since this is important in calculating the test results.

The examinee is given 8 jars, in each of which urine must be collected after a day. At 6 o'clock in the morning of the first day, the subject empties the bladder into the toilet. Then, exactly every 3 hours, all the urine should be collected in the appropriate jar. Thus, urine is collected at 9, 12, 15, 18, 21, 24, 3, and 6 o'clock in the morning of the following day. In total, there are 8 portions of urine, one portion of urine in each jar.

All jars of urine, as well as data on how much liquid was drunk during the day, are sent to the laboratory. It is recommended to keep the urine samples in the refrigerator before sending urine samples to the laboratory.

What are the sample rates of Zimnitsky?

With the help of the Zimnitsky test, several parameters of kidney function are assessed: urine density, fluctuations in urine density during the day, the amount of fluid excreted during the day, fluctuations in the amount of fluid excreted day and night. With normal kidney function, the results of the Zimnitsky test are as follows:

The amount of urine excreted during the day (daily urine output) - 1500 - 2000 ml

The ratio of the amount of fluid excreted by the kidneys to the amount of fluid drunk during the day is 65 - 80%.

The amount of urine excreted during the day significantly exceeds the amount of urine excreted at night (during the day 2/3 of the total amount of urine, at night 1/3)

The density of urine in one or more portions is not less than 1.020

Significant fluctuations in the amount and density of urine in different portions during the day. For example, during the day one serving is 300 ml, and at night a serving is 50 ml. Or, in one portion of urine the density is 1.008, and in the other portion - 1.022.

Interpretation (decoding) of the results of the Zimnitsky test.

When carrying out the Zimnitsky test in people with impaired renal function, various deviations from the norm are observed. The main violations detected using the Zimnitsky test are as follows:

1. Low urine density is the result of Zimnitsky's test, in which in any portion the urine density does not exceed 1.012-1.013. Low urine density is called hypostenuria and indicates impaired renal concentration.

2. Violation of urine concentration occurs while taking diuretic drugs (furosemide, ethacrynic acid, etc.), as well as in the following diseases:

3. Late stages of chronic renal failure are found in people who have been suffering from certain kidney diseases for a long time (glomerulonephritis, pyelonephritis, renal amyloidosis, etc.) bad breath. In biochemical analysis

4.In the blood, there is an increase in the level of creatinine, urea, etc.

5. Exacerbation of bilateral pyelonephritis, or inflammation of the pelvis of both kidneys, also causes a decrease in urine density. With pyelonephritis, the main symptoms are: periodic pain in the lumbar region, an increase in body temperature to high numbers, headaches, nausea, etc.

6. Severe heart failure in some cases leads to kidney damage and impaired urine concentration. With poor heart function, blood stagnates in the kidneys and other organs, which leads to disruption of their work. With heart failure, there is marked shortness of breath, weakness, headaches, swelling in the legs, and dropsy (ascites) is possible.

Low urine density, which practically does not change depending on the time of day or the amount of fluid taken, is called hypoisostenuria. With hypoisostenuria, the density of urine in each portion of Zimnitsky's sample, as a rule, does not exceed 1.009 and practically does not change throughout the day. This result of the Zimnitsky test suggests that the kidneys are not able to adapt to the changing conditions of fluid intake and indicates severe renal failure.

Reberg-Tareev test

The Reberg-Tareev test helps the doctor determine the excretory function of the kidneys and the ability of the renal tubules to secrete or reabsorb (reabsorb) certain substances.

The test method consists in collecting urine from a patient in the morning on an empty stomach in a supine position for 1 hour and in the middle of this period of time taking blood from a vein to determine the level of creatinine.

Using a simple formula, the amount of glomerular filtration (characterizes the excretory function of the kidneys) and tubular reabsorption are calculated.

In healthy men and women of young and middle age, the glomerular filtration rate (CF), calculated in this way, is 130-140 ml / min.

A decrease in CF is observed in acute and chronic nephritis, kidney damage in hypertension and diabetes mellitus - glomerulosclerosis. The development of renal failure and the growth of nitrogenous toxins in the blood occurs with a decrease in CF to about 10% of the norm. In chronic pyelonephritis, the decrease in CF occurs later, and in glomerulonephritis, on the contrary, before violations of the concentration ability of the kidneys.

A persistent drop in CF to 40 ml / min in chronic kidney disease indicates severe renal failure, and a decrease in this indicator to 15-10-5 ml / min - on the development of the final (terminal) stage of renal failure, usually requiring the patient to be connected to the apparatus " artificial kidney "or kidney transplant.

Tubular reabsorption normally ranges from 95 to 99% and can decrease to 90% or lower in people without kidney disease when drinking a lot of fluids or taking diuretics. The most pronounced decrease in this indicator is observed in diabetes insipidus. A persistent decrease in water reabsorption below 95%, for example, is observed with a primary wrinkled (against the background of chronic glomerulonephritis, pyelonephritis) or secondary wrinkled kidney (for example, observed in hypertension or diabetic nephropathy).

Plain urogram covers the area from the upper poles of the kidneys to the beginning of the urethra. Any X-ray examination of a patient with a urological disease should begin with an overview image. Often, a diagnosis can be made from the overview image. When interpreting a plain radiograph, it is necessary to take into account the state of the skeleton. Of great diagnostic value is the identification of anomalies in the development of the spine (lumbarization, sacralization, spina bifida), pathological changes in the musculoskeletal system (scoliosis, spondylosis deformans, spondylitis, tuberculosis, tumor metastases).

It is more correct to determine the localization of the kidneys by the spine. The contours of normal kidneys on the roentgenogram are even and their shadows are homogeneous.

The shadow of the lumbar muscles normally on the roentgenogram looks like a truncated pyramid, the apex of which is located at the level of the body of the XII thoracic vertebra. Changes in the contours or disappearance of the shadow of these muscles can be a sign of a pathological process in the retroperitoneal space.

The unchanged ureters are not visible in the general picture. The shadow of a bladder filled with urine is elliptical.

Additional, i.e., pathological, shadows can be very diverse and relate to various organs and tissues. Any shadow that has one or another degree of density and is located in the area of ​​the urinary tract should be interpreted as a possible calculus. Often, shadows in the projection of the pelvis are caused by phlebolitis - vein stones, calcified fibromatous nodes of the uterus or calcified vessels. It is possible to resolve the issue of the relation of the detected shadow to the urinary tract using radiopaque research methods.

Intravenous urography - This is an X-ray study that is used to assess the pathology of the kidneys, bladder, urethra. These structures make up the urinary tract. On a routine x-ray, the urinary tract is not well visualized. However, with intravenous urography, a contrast agent is injected into the vein. The contrast enters the bloodstream, concentrates in the kidneys, and is excreted in the urine through the ureter.

The contrast blocks X-rays in accordance with the structure of the kidneys, ureter, bladder, which is detected on the X-ray image as a white image.

The x-rays taken are called intravenous urograms, sometimes called intravenous pyelograms.

What is intravenous urography used for?

Intravenous urography is indicated in the following situations:

Kidney stones. Kidney or ureteral stones can be clearly visualized with intravenous urography.

Urinary tract infection. If a bladder or kidney infection recurs, EH can help find the cause of the obstruction or other urinary tract abnormalities.

Blood in the urine. This can occur for various reasons, such as infection, inflammation, and kidney swelling. EHM will help establish the cause.

Obstruction or damage to any level of the urinary tract can often be identified with EH.

What preparation is needed before intravenous urography?

Your kidneys should be able to produce contrast agent. Therefore, this procedure is rarely performed in case of renal failure. A biochemical blood test may be required prior to the procedure to confirm that you do not have kidney failure.

Inform your doctor if you have any allergies, especially to contrast media containing iodine.

You should not eat a few hours before the study. This ensures that your intestines are sufficiently free of food, which makes the picture on the X-ray clearer.

You may need to take laxatives about one day before the study. This is necessary to cleanse the intestines for a clearer X-ray image.

You will need to sign your consent to this procedure.

If you have diabetes and are taking metformin, you must stop taking metformin 2 days before your procedure. This is necessary as the combination of metformin and contrast medium can damage the kidney tissue (you should discuss this with your doctor and how to manage your diabetes during this period).

How is intravenous urography done?

You will be asked to take off your clothes and lie down on a couch. The contrast agent is injected into a vein in your arm. Some burning sensation may occur. The contrast penetrates the kidneys and ureter. Several x-rays will be taken, usually every 5-10 minutes. You remain on the couch between shots and may be asked to stand up to empty your bladder before the final shot. The procedure usually takes 30-60 minutes. However, sometimes delayed snapshots are taken after a few hours. You can go home right after the end of the procedure. After the procedure, you can eat.

Adverse Effects and Risks of Intravenous Urography

After the contrast is injected, you may feel warmth and a metallic taste in your mouth, and they usually pass quickly.

An allergic reaction to paint is rare. It may be mild, such as a rash and mild swelling of the lips.

More serious manifestations such as difficulty breathing and a drop in blood pressure are rare. It should be emphasized that serious undesirable effects are rare and in the department where the procedure is performed, all the necessary medications are always available to eliminate this condition.

Renal failure is a rare complication.

Some other information about excretory urography:

In pregnant women, if possible, no x-rays should be performed, as there is a risk that the contrast agent will cause developmental abnormalities in the unborn child.

What are, how and why are urethrography and cystography performed?

Urethrography - This is a type of contrast X-ray examination that is used to diagnose diseases of the urethra (urethra), such as narrowing or strictures, neoplasms, stones and foreign bodies, as well as damage, trauma and fistulas of the urethra.

Cystography is also a type of contrast X-ray examination that is used to diagnose diseases of the bladder and prostate gland, such as stones and foreign bodies, tumors, diverticula, chronic cystitis and pathological wrinkling (atrophy with a decrease in functioning volume), hyperplasia or excessive stretching, fistulas Bladder. Cystography can detect abnormalities in the function of the bladder, including abnormal contractions and so-called vesicoureteral reflux (abnormal flow of urine from the bladder into the ureter). Cystography is also used to determine the causes and plan treatment for various forms of urinary incontinence.

How are urethrography and cystography performed and how painful are they? Do you need special preparation for these studies?

Urethrography and cystography are ascending and descending, and can also be performed in a static and dynamic mode (the so-called vocal urethrocystography or a study that is carried out during urination). These studies are performed in an X-ray room, with the patient lying on the X-ray table. The studies are carried out and / or supervised and interpreted by a urologist. In ascending research options, an X-ray contrast agent (Urografin ™, Ultravist ™, Omnipak ™, etc.) is injected by a urologist into the urethra and into the bladder with a special syringe through a catheter. At the command of the doctor who performs the study, an X-ray is taken. With top-down urethrography and cystography, an X-ray contrast agent is injected into a vein and after the bladder is filled with contrast urine, an X-ray is taken. Descending urethrography is always vocal, i.e. performed during urination. To obtain good quality images, it is sometimes necessary to take multiple images or radiographs.

Urethrography and cystography in all variants are not painful or completely painless and do not require anesthesia. Some male patients, especially sensitive to pain, as well as women with interstitial cystitis, are injected with an anesthetic substance into the urethra and bladder (we use Cathejel ™ or 2% lidocaine solution). No special preparation for urethrography and cystography is required. The procedures are performed on an outpatient basis.

Isotope renography - a safe, inexpensive, fairly objective method for the separate study of renal and upper urinary tract function.

As an isotope, nephrotropic drugs are used, that is, selectively secreted by the kidneys, labeled with radioactive iodine. The greatest application is found by hippuran. Due to the short half-life (20 min) and the low dose of radioactivity required for one study, it can be repeated many times, which is especially valuable also in the postoperative period. There are practically no contraindications to the use of the method.

On the renographic curve of a normal kidney, three phases or segments are distinguished: vascular, secretory (tubular) and excretory (excretory). The vascular segment (AV) reflects the degree of blood filling, vascularization of the kidney and perirenal space. The duration of this phase is normally 20 s. The secretory (BC) segment reflects the process of transport of hippuran from the capillary bed of the kidneys to the tubules and to the upper urinary tract. The duration of this phase is 2-4 minutes, and the height is approximately V3 of the height of the first segment. The excretory (excretory) segment (C) reflects the process of excretion of hippuran into the lumen of the tubules and urinary tract.

The interpretation of the renogram is carried out on the basis of its shape (qualitative analysis) and the assessment of numerical indicators, the most common of which are:

Tmax is the time to reach the maximum rise of the curve (normally 3-4 minutes);

T 1/2 is the half-life of the isotope from the kidneys (from the moment the curve reaches its maximum until it falls by half of this value; normally 6-8 minutes);

blood clearance - half-cleansing time (normally 8 minutes).

The lengthening of the pre-motor segment of the renogram is noted more often with a significantly pronounced stenosis of the renal artery. In case of complete occlusion, thrombosis of the renal artery, an "afunctional" type of curve is observed, characterized by a sharp decrease in the size of the vascular segment with an almost complete absence of a secretory rise in the curve and a slight decline in the excretory phase.

Although the isotope renography method has a fairly high sensitivity, functional changes are recorded on the renogram if the renal artery is stenosed by at least 50%. Both false-positive and false-negative renographic findings are possible, since with good development of collateral vessels, the presence of a normal renogram before surgery is not excluded with severe renal artery stenosis. We have seen similar cases.

The most reliable data of radioisotope renography (coincidence with the results of angiography on average in 85-90% of patients) are observed in unilateral occlusive lesions of the renal artery (A.A. Kramer, 1968; A.I. Matveeva et al., 1970; Kaufman et al. , 1969, etc.). First of all, a decrease in the height of the vascular segment and a lengthening of the time of the maximum rise of the curve are characteristic. With bilateral lesions, the assessment of the results of isotope renography is difficult and the diagnostic value of this study is much less.

Although there are no changes in the isotopic renogram, which are especially specific for vasorenal hypertension, the very fact of the presence of these changes is decisive. The method is of great importance for the differential diagnosis of renovascular hypertension only in combination with other methods.

Isotope renography allows you to easily and quickly identify impaired renal function and their degree, which is of great importance in solving practical issues of surgical treatment, as well as for monitoring its effectiveness and timely diagnosis of complications, in particular thrombosis of a reconstructed vessel in the postoperative period.

Kidney scintigraphy (nephroscintigraphy)

Kidney scintigraphy or kidney radionuclide scan (renal scintigraphy, nephroscintigraphy) Is a diagnostic research method that involves the introduction into the body of a small amount of a radioactive medicinal product (radioactive label) and obtaining an image of the kidneys using a gamma camera. The images obtained can aid in the diagnosis and treatment of various kidney diseases.

Purpose of kidney scintigraphy (nephroscintigraphy)

While most research methods - such as x-rays, ultrasound, or computed tomography (CT) - provide information about the structure of the kidneys, radionuclide tests provide an opportunity to study kidney function. Candidates for kidney scintigraphy may include patients with acute or chronic renal failure, obstruction (blockage) of the urinary system, renal artery stenosis, kidney transplant, kidney injury, reflux nephropathy, renal vascular disease and / or hypertension, or congenital anomalies ...

Precautions when performing a kidney scintigraphy (nephroscintigraphy)

Kidney scintigraphy requires the use of radioactive material; therefore, in pregnant women or women who suspect that they are pregnant, kidney scintigraphy is performed only when absolutely necessary. Women should inform their doctor if they are breastfeeding. The doctor recommends that the woman stop breastfeeding for a period of time that depends on the type and dose of the radioactive drug.

Description of performing kidney scintigraphy (nephroscintigraphy)

Kidney scintigraphy is performed in the nuclear medicine department of a hospital or polyclinic. The patient is positioned in front of or under the gamma camera. A gamma camera is a special piece of equipment that detects radiation (gamma rays) emitted by a radioactive drug that has accumulated in the patient's body and forms an image. A radioactive drug is administered intravenously. Immediately after the injection, the study begins - the blood flow in each kidney is assessed. A sequence of images is obtained at regular intervals, which depend on the radioactive medicinal product used. A kidney scan is done to determine the patient's glomerular filtration rate. A radioactive drug called technetium DTPA (Tc99m DTPA) is used for kidney scintigraphy. This radioactive drug can also detect a blockage in the urine collection system in the kidneys.

The radioactive drug technetium, DMSA (Tc99m DMSA), is used to study the function of the renal tubules.

A kidney scintigraphy takes 45 minutes to three hours, depending on the purpose of the study. Most often, the duration of a kidney scintigraphy ranges from an hour to an hour and a half. It is important to understand that kidney scintigraphy can reveal impaired renal function, but may not always determine the nature of the impairment. Kidney radionuclide studies are useful for obtaining information about how the various structures of the kidneys work, which in turn can help in making a correct diagnosis.

Typically, images are taken in frontal projection, but oblique angles are possible. If necessary, the patient can be positioned to obtain data on kidney mobility, that is, to sit or lie down while acquiring images. If obstruction (blockage) or kidney function is being evaluated, a diuretic (drug to induce urination) such as Lasix is ​​given. If renal artery hypertension or stenosis is being evaluated, Captopril or Enalopril (ACE inhibitors, angiotensin converting enzyme inhibitors) are given.

Preparation for kidney scintigraphy (nephroscintigraphy)

No special preparation is required for a kidney scintigraphy. For some examinations, the patient must drink extra fluid and empty the bladder before the exam. If the patient has recently undergone another radionuclide study, then it is necessary to refuse repeated studies for a certain period of time so that residual radioactivity does not accumulate. The patient should remove all metal objects from the study area.

After kidney scintigraphy (nephroscintigraphy)

Patients can return to their daily routine immediately after kidney scintigraphy. Most radioactive drugs are eliminated through the urinary system, so increasing fluid intake after a kidney scintigraphy will help remove the radioactive drug from the body more quickly.

Complications of kidney scintigraphy (nephroscintigraphy)

Nuclear medicine research is safe. Unlike some contrast agents used in kidney x-rays, radioactive drugs rarely cause side effects. There are no long-term effects of radioactive drugs, since they quickly decay and have no direct functional effects on body tissues. With the introduction of radioactive drugs, blood pressure may temporarily rise or fall, or the urge to urinate may appear.

Kidney scintigraphy (nephroscintigraphy) results

Kidney scintigraphy shows normal kidney function depending on the patient's age and health status, as well as the relative position, size, configuration, and location of the kidneys. Primary blood flow images reflect blood circulation in both kidneys. Patients who are suspected of kidney damage or obstruction on scintigraphy may need other diagnostic tests, such as CT (computed tomography) or ultrasound, for more information. In addition, other imaging techniques may be required if the kidneys are irregular, contoured, or unusually positioned.

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what is urine- what are my eyes ... Russian spelling dictionary

Spread. 1. Very loud (screaming, yelling, yelling, crying, etc.). FSRYa, 425; BMS 1998, 389. 2. Very fast (run, drive, race, etc.) FSRYa, 425; BMS 1998, 389. 3. With all his might, with great strength; very strongly, to the fullest (to do what l.) ... ... A large dictionary of Russian sayings

Strong, like a madman, briskly, like an arrow, sticking out his tongue, not feeling his legs, like a madman, in all sails, in all his shoulder blades, like mad, not hearing his legs, as if on fire, like a mad cat, in full steam, like on fire , sticking out his tongue, not feeling his legs, ... ... Synonym dictionary

Cm … Synonym dictionary

what is the spirit- see in full spirit; What is the spirit (urine), uptr. to indicate the intensity of which l. actions; very strong, very fast, etc ... Dictionary of many expressions

1) what, what, what, what, about what, places. 1. interrogative. Indicates a question about an object, phenomenon, attribute, etc. What is he looking for in a distant country? What did he throw in his native land? Lermontov, Parus. What do you want: tea or coffee? Hey Afanasya, coffee for the doctor, yes ... ... Small academic dictionary

1. WHAT [piece], what, what, what, about what and unchanged; pronoun. noun and allied. sl. 1. Indicates the object, phenomenon, situation in question. What happened? Tell me what happened. What do you want: tea or coffee? What are you saying? (also: as an expression ... ... encyclopedic Dictionary

The ability of urine to have power, strength that l. do (2): Great Prince Vsevolod! ... You can sprinkle the oars on the Volga, and pour out the Don helmets. Even if you were, you would have chaga for legs, and koshchei for cut. You can live on dry land Shereshirs ... ... Dictionary-reference book "The Word about Igor's Regiment"

Urine, urine; and suffering. last soaked, chen, ah, oh; nonsov., cross. 1. (sov. Wet and soak). Make wet, damp. Something, higher and higher approaching the throat, like thin needles pricked in the nose and palate, and tears imperceptibly wet his cheeks ... Small academic dictionary

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General urine analysis (OAM) Is a laboratory study. It is necessary for making an accurate diagnosis for most diseases. It is carried out to monitor the patient's condition during treatment. Necessarily appointed for prophylactic purposes during medical examination. one

What are the conditions for collecting urine samples for analysis?

Urine(urine) is a biological fluid. It is produced by the kidneys by filtering blood plasma. 96% of urine is pure water. The remaining 4% are end products of metabolism in the form of minerals, salts and other substances. They contain valuable information about the state of human health. The reliability of the results depends on the purity of the sample taken for analysis.


The rules for collecting urine for a general analysis recommend preparing for the delivery of a sample in the evening. For this:
  1. Rinse with clean water and dry a clear glass dish with a lid with a capacity of about 200 ml.
  2. Do not eat foods for dinner that can affect the color of urine: beets, carrots, spicy foods.
  3. Eliminate alcohol.
  4. Do not take medication.
  5. Wash the genitals with soap and water.
  6. Do not drink diuretics.
  7. Fill the prepared dishes with urine. The amount of urine for general analysis should be 150-200 ml.
  8. Deliver the sample to the laboratory in 1.5-2 hours.

Collect a general urine test in the morning. Do not take a sample in the evening and store it in the refrigerator. This will skew the results.

2

What do the indicators of the general analysis of urine mean?

Clinical analysis of urine examines:

  1. Physical properties;
  2. The presence of organic matter.
  3. Indicators of urinary sediment.


Indicators of physical properties are:
  1. Transparency... Determined by a laboratory assistant by eye. The absence of turbidity in a freshly collected sample indicates a healthy body. The cloudiness will begin to appear after a few hours of storage due to the loss of salts. This is normal. It only says that urine for analysis should not be stored for a long time.
  2. Colour... It is determined visually and compared with the standard. In a healthy person, the color of urine varies from light yellow to straw yellow. Nutritional features, as well as medications, change the color of urine. It can turn brown, red, green, and even black. But this is not a pathology and is considered the norm.
  3. Specific gravity urine shows how much salt, urea, and other substances are in a unit of its volume. It characterizes the ability of the kidneys to carry out the filtering function of biological fluid. Determined using a urometer instrument. The reciprocal of specific gravity is called density. In the analysis, the density of urine is compared with the density of pure water. The relative density shows how many times the urine is heavier than water due to the substances in it. The density of urine is normally 1.012-1.025. This indicator is often expressed in units without a comma. For example, 1022 units indicate the normal urine density of a person who eats meat food and drinks little water.
  4. Acidity urine depends on the content of acids and alkalis in it. It can be neutral, acidic or alkaline. Determined by the value of the reaction rate pH. The urine reaction is normally within 5-7 units. In laboratories, it is determined using indicator solutions. It is possible to use test strips or litmus paper. The deviation of the pH value from normal values ​​indicates the prerequisites for the formation of kidney stones.
  5. Smell a fresh portion of the urine of a healthy person is specific, but moderate. It can also be affected by certain foods and medications. The smell changes very quickly when urine is oxidized in the open air. The resulting ammonia fumes make it harsh. This cannot be considered a pathology. To obtain reliable results, keep the sample container tightly closed. Calculating how much urine is needed for analysis, the container should be completely filled to avoid oxidation.


Detection of the presence (or absence) of organic substances is included in the general analysis of urine. A deviation from the norm is the detection in the sample:
  1. Squirrel;
  2. Bilirubin;
  3. Ketone bodies;
  4. Bile pigments;
  5. Indikana.
The urinary sediment in OAM is examined by the latter. It is examined under a microscope to detect:
  1. Epithelium;
  2. Mucus;
  3. Bacteriological particles;
  4. Crystals of various salts;
  5. Leukocytes;
  6. Erythrocytes;
  7. Cylinders.

The presence of urobilinogen in the amount of 5-10 mg / l is allowed.

3

How are the analysis results deciphered?

Decoding the analysis of urine assumes knowledge of certain symbols denoting the main indicators. On letterheads of laboratories, symbols are affixed in Latin letters. Alongside the numbers indicate the limits of the normal values ​​of the data.

The symbols of the indicators and the interpretation of the general analysis of urine in the norm are given in the table

Laboratory specialists put down the actual values ​​obtained during the analysis. The completed form shows a general urine analysis of a particular patient.

4

How to evaluate the results of laboratory analysis of urine?

A complete urinalysis allows you to identify pathologies at an early stage. Research indicators will warn about the presence or development of various pathologies:

  1. BUL... Bilirubin is produced by the liver. It enters the urine through the kidneys with the following diseases:
    - Acute viral hepatitis;
    - Chronic alcoholism;
    - Poisoning with poisons;
    - Antibiotic overdose;
    - Chronic hepatitis;
    - Neoplasms of the liver;
    - Cerose.
  2. BLD... Erythrocytes indicate the appearance of traces of blood in the urine. Causes:
    - Movement of kidney stones and urinary tract.
    - Kidney tumors.
    - Uterine bleeding and cervical erosion (in women).
    - Injury to the kidneys and urethra during the passage of stones.
    - Prostatitis and prostate cancer (in men).
  3. LEU... Leukocytes are observed in urine in large quantities in inflammatory processes. These white cells can even be seen with the naked eye. They can stick together and precipitate in flakes. Causes:
    - Infections in the kidneys and urinary tract.
    - Blockage of the ureters.
    - Pregnancy.
    - Appendicitis.
    - Inflammation of the appendages, ovaries and fallopian tubes (in women).
    - Taking some medications.
  4. URO- urobilinogen is formed in the intestine from bilirubin, absorbed into the bloodstream, and captured by liver cells. It is excreted from the body along with bile. A test for urobilinogen allows you to:
    - Identify hepatitis at the earliest stage.
    - Distinguish obstructive jaundice from other similar diseases.
    - Monitor the functional state of the liver.

  5. PRO... Protein is a building material for the body. Finding it in the blood is an alarm signal about serious illnesses:
    - Lupus erythematosus and other connective tissue diseases.
    - Multiple myeloma - a malignant tumor of plasma cells that carry out the functions of immunity.
    - Diabetes mellitus.
    - Malignant tumors of the kidneys.
    - Progressive arterial hypertension.
  6. pH... Acidity depends a lot on the food system. The predominance of meat and fatty foods increases acidity. Plant food lowers it. Normal acidity indicates a balanced diet and rational consumption of drinking water. The acidity index can reveal some diseases.

    Reduced acidity:
    - Diabetes;
    - renal failure;
    - Acidosis (insufficient excretion of organic acids from the body);
    - Urolithiasis with the formation of phosphate stones.

    Increased acidity:
    - Diseases of the thyroid gland;
    - Increased potassium levels;
    - Alcolosis (violation of the acid-base balance of the body due to the accumulation of alkaline substances;
    - Urolithiasis with the formation of urate urate stones.

    Attention! With normal acidity, oxalate stones can form.

  7. S.G in urine analysis denotes density (specific gravity). Density shows the filling of a biological fluid with various substances and salts. Throughout the day, it can change depending on the amount of fluid you drink. Stable deviations of the density of the morning sample from normal values ​​indicate some diseases or physiological problems of the body.

    High density(hypersthenuria) is caused by:
    - Insufficient blood circulation;
    - Blood loss;
    - Large losses of fluid due to diarrhea, vomiting;
    - Intestinal obstruction;
    - Toxicosis in pregnant women.

    Low density(hypostenuria) is caused by:
    - Diabetes insipidus;
    - Renal failure, chronic or acute;
    - Malignant hypertension (extremely high blood pressure).

  8. KET... Ketone bodies are the general name for metabolic products in the body:
    - Acetone;
    - Acetoacetic acid;
    - Betaoxybutyric acid.

    Ketones are synthesized in the liver during the breakdown of fats and the formation of glucose. Their accumulation in urine is called ketonuria. Associated with the following reasons:
    - Prolonged fasting;
    - General hypothermia;
    - Physical overload:
    - Oncological diseases;
    - Excessive consumption of protein foods;
    - Insufficient use of drinking water, especially in hot weather;
    - Total anemia (anemia) associated with the breakdown of blood cells;
    - Diseases of influenza, ARVI;
    - In women, it is observed during pregnancy.

  9. NIT... Nitrite appears in urine due to the presence of various microorganisms in it. There is no nitrite in normal urine, but there is nitrate. Some pathogenic bacteria release enzymes that convert nitrates to nitrites. This indicates the course of infectious processes in the body. Major diseases:
    - Pyelinephritis;
    - Cystitis.

    For nitrite studies to give objective results, it is very important that the dishes are sterile clean.

  10. GLU... Glucose (sugar) in urine should normally be absent. Its detection should be considered as a manifestation of:
    - Diabetes mellitus;
    - Acute pancreatitis (inflammation of the pancreas);
    - Prolonged fasting;
    - Traumatic brain injury;
    - Meningitis;
    - Encephalitis;
    - Intracranial hemorrhage.
  11. COLOR... The color of urine can indicate various diseases. A dark yellow color indicates diseases of the biliary tract. Black is about skin cancer. Blue color - about typhoid, cholera. Hyperchromuria of urine is a physiological change in its color. With acidification of urine, the color changes to a rich yellow. When a pale straw color appears, they speak of hypochromuria.
  12. Transparency incomplete urine indicates the presence of epithelium, mucus and salts. Salts in the urine of an elderly woman will determine which stones are formed in her with urolithiasis. But this is not a prerequisite. For the appearance and growth of kidney stones, special conditions are needed.
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Decoding urine analysis