The influence of various factors on the change in the color of urine. When the baby has bright yellow urine

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A very interesting activity for young parents is the study of the child's analyzes, with their interpretation according to the norms given in the form. Dear, these are the norms, firstly, for adults, and in children, the normal indicators sometimes differ very much. And secondly, the forms printed a hundred years ago under Tsar Pea and since then have not been edited. Therefore, before dragging your obstinate child through all sorts of doctors, let's figure out if there is any pathology in the analyzes.

See our tables and their transcripts!

Urine analysis - what to look for and decoding: Urine analysis in children. How to collect, what to look for

Urine is an aqueous solution of electrolytes and organic matter. The main component of urine is water (92-99%), in which about a thousand different components are dissolved, many of which have not yet been fully characterized. Every day, about 50 - 70 dry substances are removed from the body with urine, most of which are urea and sodium chloride. The composition of urine varies significantly even in healthy children, so urinalysis is complicated and makes one be very careful when interpreting the results.

The daily volume of urine and the concentration of certain components in it depends on the intensity of glomerular (in the glomeruli of the kidneys) filtration, the degree of tubular reabsorption and / or excretion.
Indications for the appointment of a urine test:

Diseases of the urinary system;
Screening examination during medical examinations;
Assessment of the course of the disease, control of the development of complications and the effectiveness of the treatment;
Persons who have had streptococcal infection (tonsillitis, scarlet fever) are recommended to have a urine test 1-2 weeks after recovery.
Healthy children are encouraged to perform this test 1-2 times a year.
Urine collection rules

For the results of the analysis of urine to be reliable, it is necessary to collect it correctly. Only morning urine is suitable for analysis.

First, we prepare the container. Wash a small jar with a wide neck and dry it. You can also use special bags-urinals (put on the genitals, glued, put on a diaper on top), they are sold in the pharmacy.

The child's genitals must be clean, the baby must be washed in preparation for urine collection - do not overdo it, wash it as you usually do. Do not use potassium permanganate, herbal infusions, or other antiseptics.

It is quite difficult to catch the moment of urination in a child under one year old, but many parents know the signs by which one can determine that the child wants to write - the baby is worried, screams, or, conversely, freezes. All that remains is to bring the urine bag under the stream. It is preferable to collect the middle portion of urine.

You cannot pour urine from the pot, no matter how well it is washed, it is better to put a clean container in the pot to collect urine. You cannot squeeze urine out of a diaper or diaper, or even sterile gauze - all this distorts the analysis results.

If the child does not want to "pass urine for analysis" in any way, stimulate him to urinate by stroking his abdomen clockwise, or by the noise of pouring water.

In older children, urine is collected in the same way as in adults: wash, collect the middle portion of urine in a clean, dry dish.

Decoding urine analysis

When conducting a general analysis, the amount of the collected morning urine portion has no practical value (well, unless you bring 1 ml of course). The normal amount of urine excreted during the day is highly dependent on age. The amount of urine excreted during the day in children can be approximately calculated using the formula:
600 + 100 (A - 1) = ml of urine in 24 hours, where A is the number of years of the child.

Diuresis increases with the intake of large amounts of liquid, the consumption of foods that increase the excretion of urine (melon, watermelon), decreases with restriction of fluid intake, increased sweating, vomiting, diarrhea, and in premature babies. Oliguria or anuria in newborns can be suspected if dry diapers are present for 12 to 18 hours.

The main indicators studied in urine:

1. The clarity of urine is determined by examining the urine in transmitted light. Normal urine is clear. Turbid urine can be with pyelonephritis or cystitis if it contains a large amount of mucus, cells, bacteria and / or salts.

2. Color of urine. Normally, young children have straw-yellow urine. At an older age, it becomes amber yellow. Children with pyelonephritis may have a more intense color of urine because this condition often causes a decrease in urine volume due to fever, vomiting, loose stools, and increased sweating. The color of urine may change with certain medications and foods. Rhubarb produces a greenish tint to urine. When taking riboflavin (vitamin B2), the urine becomes intense yellow. The urine darkens on standing if the child receives nitrofuran preparations (furagin, furadonin, etc.).

3. Reaction of urine. In a healthy child, the normal reaction of urine is slightly acidic, and it can change depending on the nature of the food. An alkaline reaction is observed when eating plant foods, and an acidic reaction is observed when eating meat. A child's ability to excrete both acidic and alkaline urine can be a confirmation of the normal functioning of his kidneys. Acidic urine (pH 5.5) is often observed in acute diseases of various origins, and neutral and alkaline (pH 5.5) in urinary tract and kidney infections due to the decomposition of urea by bacteria with the formation of ammonia.

4. Relative density (specific gravity). The specific gravity is determined by the content of solutes in the urine, primarily salts and urea. Under normal conditions, the relative density of urine during the day varies from 1008 to 1025, depending on the nature of the food, the amount of fluid drunk and excreted, and the child's age. This indicator characterizes the work of the kidneys for the dilution and concentration of urine. In chronic pyelonephritis, the specific gravity of urine may remain low and monotonous during the day, which will indicate a violation of the kidneys.

5. Protein in urine (proteinuria). Healthy children do not have protein in urine when it is determined by conventional methods. Sensitive studies show that protein is excreted in the urine and in single portions its concentration is not more than 0.033 g / l. In a child with pyelonephritis, protein may be present in the urine, reflecting damage to kidney tissue (renal proteinuria). Protein can enter the urine from the mucous membranes of the urinary tract or vagina - this is extrarenal proteinuria.

6. Leukocytes in urine (leukocyturia, pyuria or pus in urine). Pus in the urine comes from the bursting small pustules that form in the kidney or urinary tract during inflammation. It mainly consists of white blood cells - leukocytes. Leukocytes "eat" microbes (this process is called phagocytosis) and save a person. An increase in the number of leukocytes in the urine indicates an inflammatory process in the kidneys or urinary tract. In the urine of a healthy child, when examined in the field of view of a microscope, single leukocytes can be found.

The detection of more than 5-7 leukocytes in the urine in boys and 8-10 in girls may indicate an inflammatory process in the urinary tract and kidneys. However, leukocytes can enter the urine from the external genital organs, which is possible in boys with narrowing and inflammation of the foreskin (phimosis with balanoposthitis), and in girls with inflammation of the external genital organs (vulvovaginitis). Inflammation of the external genital organs is manifested by local redness, leucorrhoea and other secretions that stain linen. Suspicion of this process can be resolved by the doctor when examining the external genital organs. If necessary, a urologist is involved in the examination of boys (elimination of phimosis), and girls - a gynecologist, who conducts not only an examination, but also a special study (a smear from the vaginal mucosa) and treatment of vulvovaginitis. With prolonged leukocyturia, the doctor also excludes renal and urinary tract tuberculosis.

7. Erythrocytes (red blood cells). Erythrocytes in the urine of a healthy child are absent or are found in a single number (1-2 in the field of view of the microscope). When red blood cells appear in the urine in excess of the norm, they speak of "hematuria" (blood in the urine). The term "gross hematuria" is used when blood is secreted in such an amount that the color of urine changes, it becomes dark red, the color of "meat slops" or "strong coffee". With "microhematuria", the color of urine does not change, and erythrocytes are detected by examining urine under a microscope. More than 100 congenital and acquired diseases can cause hematuria. Pyelonephritis, cystitis and reflux are on this list. Parents can help the doctor decipher the reasons that change the color of urine, since some food plants (beets, blueberries, etc.) or medications can stain it.

8. Cylinders in urine. The cylinders are casts of the renal tubules, the base of which is coagulated protein, so they appear in the urine with protein. Another condition for the formation of cylinders is the presence of an acidic urine reaction. They do not form in alkaline urine or dissolve quickly.

9. Salts. By the presence of salts in the general analysis of urine, one can judge its colloidal state, acidity and other properties. Depending on the acidity of urine, various salts can precipitate: in an acidic environment - uric acid, uric acid and calcium phosphate, calcium sulfate, calcium oxalate; in alkaline urine - triple phosphates, ammonium urate, amorphous phosphates, calcium carbonate and calcium oxalate. The amount of excreted salts can be determined only in daily urine. Uric acid precipitate is observed with excessive consumption of meat, strenuous exercise, fever, fasting, or taking hormones (prednisolone).

Oxalates are present in the urine of children who eat foods high in oxalic acid - coffee, tea, nuts, strawberries, black currants, spinach, rhubarb, lettuce. Oxalate crystals can appear with prolonged standing of urine. Triple phosphates and amorphous phosphates are often found in urine sediment in pyelonephritis and cystitis. For this reason, the presence of salts in the urine does not allow the conclusion about the violation of salt metabolism.

The doctor, not the parents, should deal with the decoding of the urine test.

Clinical blood test in a child. What to look for and decryption:

Hemoglobin (Hb) is a protein that transports oxygen to tissues and carbon dioxide to the lungs.

Red blood cells (RBC - Red Blood Cells) are the main blood cells, the "containers" of hemoglobin. The size of the containers is determined by the "Average amount of hemoglobin in one erythrocyte" parameter. Color indicator - the ratio of the obtained values ​​of the amount of hemoglobin and erythrocytes to normal.

Hematocrit (Hct, PCV - Packed Cell Volume) - characterizes the ratio of plasma volumes and formed elements (blood density)

Reticulocytes - young erythrocytes are always present in the blood, the amount depends on the body's need for new erythrocytes.

Platelets - the main cells of blood coagulation, are not of interest in the treatment of acute respiratory infections.

Thickening of the blood (lack of fluid) is manifested by an increase in hematocrit and the amount of hemoglobin in the blood.

Leukocytes (WBC - White Blood Cells) are uniform blood cells that represent the immune system. The study of leukocytes allows you to understand the cause of the disease (bacterial, viral or allergic)

An important feature of the child's body is that the number of leukocytes in a child is, on average, much higher than that of an adult (since the immune system is just being formed).

Leukocytosis - an increase in the level of leukocytes above normal. It occurs during acute (especially bacterial) infections, purulent inflammatory processes, oxygen deficiency, etc.

Leukopenia - a decrease in the level of leukocytes below normal. It occurs with viral infections, with severe toxic and infectious conditions, accompanied by bone marrow suppression, with some bacterial diseases, radiation sickness, etc.

Leukocytes are divided into the following 9 types:

Neutrophils (myelocytes, metamyelocytes, stab, segmented) - 4 types;

Eosinophils;

Basophils;

Lymphocytes;

Monocytes;

Plasma cells.

The ratio of different types of leukocytes (in%) forms a leukocyte formula.

Neutrophils - are especially active against bacteria. The more pronounced the bacterial inflammatory process, the greater their ratio in the formula. Matured neutrophils are called. segmented (a kind of special forces), immature - stab, young - metamyelocytes, and the smallest - myelocytes.

The more active the fight in bacteria, the more stab neutrophils in the blood ("all to the front"). Metamyelocytes and myelocytes appear only in the most critical cases, when the body is struggling with its last strength.

Basophils - have nothing to do with acute respiratory infections (normally no more than 1%)

Lymphocytes - participate in immune, are responsible for general and local immunity (detection, recognition and destruction of antigens, synthesis of antibodies, etc.). The main and most common type of leukocyte in the blood. Lymphocytosis is primarily a symptom of a viral infection.

Monocytes - are engaged in phagocytosis (absorption and digestion of bacteria, dead cells, etc.). Lives in the blood for about 30 hours, after which it passes into tissues, where it matures to a macrophage (from ancient Greek - a big devourer).

Plasma cells - are responsible for the formation of antibodies (normally 1 in 200-400 leukocytes in children, absent in adults). The number increases primarily with viral infections with damage to lymphoid tissue (infectious mononucleosis, measles, rubella, chickenpox, etc.)

The sedimentation rate of erythrocytes, ESR - the size of the column of settled erythrocytes per hour (mm / h). An increase in ESR indicates an inflammatory process in the body (in children, it is normal from 2 to 10 mm / h)

How is a complete blood count performed?
A general blood test does not require special preparation. As a rule, the analysis is carried out in the morning, on an empty stomach (or 2 hours after a meal). Blood for general analysis is taken from a finger (usually from a ring finger) using a special sterile instrument - a scarifier. With a quick movement of the hand, the doctor makes a small puncture of the skin of the finger, from which a drop of blood soon appears. The blood is collected with a small pipette into a vessel that resembles a thin tube. Less commonly, blood for a general blood test is taken from a vein.

Biochemical analysis of blood in children. What to look for, decryption.

As a rule, the decoding of a biochemical blood test of a child includes eight main indicators.
blood sugar (glucose) and calcium levels;
kidney function test;
balance of electrolytes and body fluids.
When is this analysis done?

This set of indicators is often determined to assess the general condition of the body or for diagnostic purposes. It should also be performed in patients admitted to the emergency department, as it allows you to quickly get information about the possible cause of the problem and provide adequate assistance.

Decoding a biochemical blood test of a child:

Glucose is a sugar that constantly circulates in the blood and is needed to provide the body with energy. Deviations of this indicator from the norm indicate the presence of diabetes or hypoglycemia (low sugar level).

Calcium - plays an important role in the processes of muscle contraction, transmission of nerve impulses, hormone secretion. A decrease or increase in calcium levels may indicate hormonal imbalances or problems with the liver, bone, or pancreas.

Sodium, potassium, carbonates and chlorides (electrolytes) help maintain the fluid balance in organisms, as well as the acid-base environment. They are important for the regulation of heart rate, muscle and brain function. The deviation of electrolyte levels from the norm occurs with the development of heart disease, kidney disease, or severe dehydration.

Urea in the blood and creatinine are end products of metabolism and are excreted from the body through the kidneys. An increase in their concentration is a signal of possible problems in the functioning of the kidneys.
Preparation for analysis

In case of urgent need, the analysis of basic biochemical parameters can be performed without preliminary preparation. But in order for the results to give more objective information, the child should refrain from eating and drinking 8-12 hours before the analysis. When going to the doctor, choose clothes for your child that will not obstruct access to the ulnar vein.
Procedure

Blood sampling is carried out from the cubital vein by trained health professionals. In infants, blood for biochemical analysis is taken from the heel using a thin needle. The place where the needle is inserted is treated with an antiseptic. The section of the arm above the vein is compressed in order to increase the pressure in the vein and achieve strong filling. Then a needle is inserted into the vein, through which the blood enters a special vessel or test tube.

At the end of the blood collection procedure, the pressure bandage is removed. The needle is removed after the required volume of blood has been collected. A piece of cotton wool is applied to the puncture site in order to stop the bleeding. The procedure takes no more than a few minutes.

Taking blood from a vein causes temporary inconvenience, the child will feel an unpleasant injection, but there is no strong pain during this procedure. Most children are afraid of this procedure. Help them. Explain the course of the analysis and its purpose, explain why the doctor performs this analysis and how the child's well-being will improve after undergoing the correct treatment. Let him ask any questions that interest him to the medical staff. Help your child relax during the procedure. The tension makes it more painful. Take your attention away from the needle, especially when inserting it into a vein.

In modern medical institutions, a biochemical blood test is performed using special equipment. It allows you to get the result within an hour, but usually there is no need for such a rush and you will have to wait about a day. If deviations from the norm in the analysis results are detected, a re-examination is prescribed.

In general, the analysis of blood biochemical parameters is a safe procedure, but in some cases minor complications may arise:
fainting or dizziness;
hematomas (accumulations of blood under the skin in the area of ​​a puncture of a vein).

Order of tables:
1. Clinical blood test in children
2. The main indicators of the biochemical blood test in children
3. The main indicators of biochemical analysis of urine in children

The color of human urine does not always remain the same: it depends on several factors that affect the human body.

What is the color of urine?

Normally, the options for the shades of human urine may be different. A healthy person can have a pale or yellow bright color of urine. The shade depends on the amount in the urine urochrome , that is, the pigment, which determines how concentrated the urine will be. This pigment is produced by the breakdown of the one that carries oxygen in.

The color also depends on age: in a child, urine is lighter, in an adult - a more saturated color of urine. In infants, urine is light yellow in color, and in a newborn baby, urine is an almost colorless liquid.

What color of urine a person has depends on the activity of metabolism, as well as on how much fluid the body removes. If a person drinks a lot of fluids, the color of the urine will be clear. Therefore, the more concentrated the urine, the more intense its color. If the body is severely dehydrated, the urine may be amber-colored.

Why does the color of urine change?

Thus, the healthy color of the urine may vary. Changes in the color of the urine of a healthy person, as a rule, are temporary, and manifests itself as a result of the use of drugs, certain foods or dyes. If there is a suspicion of the development of a pathological condition, you should ask your doctor about the normal color of urine in an adult. After all, serious changes in the color of urine may indicate the development of infectious diseases and other serious ailments. However, the person himself is able to determine what color healthy urine is by comparing all changes with the usual shade of urine.

With genitourinary infections, in addition to a change in the color of urine, a person may experience other symptoms, although often such diseases go away without other signs. However, with a urinary tract infection, there may also be a constant urge to urinate, abdominal pain, burning sensation during urination , chills , , weakness ... The urine may not only have a discoloration, but also a pungent odor.

Attention should be paid to those changes in the color of urine that are visible to the naked eye.

Reddish urine in both men and women is not always indicative of serious health problems. The red color of urine is mainly associated with the presence of red blood cells in it. This bleeding usually disappears quickly, so red urine is only temporary. However, if a reddish color appears constantly, then this symptom indicates a serious illness. In medicine, urine of a reddish color, which appears due to the ingress of blood into it, is called hematuria ... This symptom can accompany diseases of the prostate gland in men, the appearance of stones in the kidneys or in the bladder, and oncological diseases of the genitourinary system.

It should be noted that the reddish color of urine is often associated with the food that a person ate. Beetroot, blackberry, and rhubarb dishes can turn urine pink. The urine also turns red under the influence of a number of toxins, in particular, due to poisoning with mercury and lead.

Sometimes the urine turns orange. Often women are seriously worried about why the orange color of urine during pregnancy appears from time to time. In fact, this symptom is often caused by the most common causes. This shade may appear after the use of certain foods, food additives. These are, first of all, carrot dishes, which contain a large amount of carotene ... Orange urine is observed in those who take more amounts. Why bright orange urine appears in a person during the treatment of certain diseases, explains the intake of certain medications. They are separate, phenazopyridine and others. It should be noted that the orange color of urine may also indicate dehydration, since in this case the urine becomes more concentrated.

If a woman's urine color changes during pregnancy, then both physiological reasons and the development of some pathologies can explain this. A change in the color of urine during pregnancy occurs if the expectant mother suffers from a strong disorder in the early stages of pregnancy, as a result of which dehydration is noted. Also, the reasons for the change in the color of urine in pregnant women are often associated with the dietary habits of the expectant mother's drinking regimen. But if a woman has the slightest suspicion that changes in the color of urine are associated with diseases, she should immediately consult a doctor who will prescribe the necessary laboratory tests.

If a person has a blue and green color of urine, then such manifestations can also be associated with the intake of drugs and certain foods. For example, the greenish color of urine appears after eating asparagus. Blue and yellow-green urine appears after drug treatment urised , tagamet , also after taking some multivitamin complexes.

In rare cases, blue urine is observed in children who suffer familial hypercalcemia ... This is a hereditary disease in which the level of calcium in the blood is increased.

The dark color of urine with a smell in men and women occurs both against the background of the use of certain foods (legumes, rhubarb), and as a result of taking a number of medications. Urine that is dark brown or dark orange in color appears after taking antimalarial drugs, after treatment with certain drugs used to treat urinary infections, and after taking drugs that contain hay, cascara, and metoclopramide.

What does darkening of urine mean, you should definitely figure it out if a person suffers from liver ailments. Darkening of urine occurs when, hepatitis ... Also, urine can acquire a dark brown tint when acute glomerulonephritis when the kidneys do not remove toxins and excess fluid in a sufficient volume.

This symptom cannot be ignored for expectant mothers. If your urine turns brown or dark red during pregnancy, you should definitely see a doctor, as it may be bleeding.

In addition, brown urine during pregnancy sometimes indicates liver or kidney problems. Also, red-brown urine can be a sign of infectious diseases. To diagnose and determine exactly why brown urine in women who are expecting a baby can be tested. It should be understood that an uncharacteristic color of urine during pregnancy can be both a sign of a disease and an absolutely normal physiological phenomenon. Therefore, it is better for the expectant mother to always tell the doctor about her observations and suspicions.

Sometimes a person may be concerned about why a cloudy color of urine is found under certain circumstances. Cloudy white urine can be a sign of urinary tract infections. If fatty degeneration of the kidney occurs, pus and fats appear in the urine. As a result, the urine becomes whitish in color.

If the transparency of the urine is cloudy, and at the same time there are impurities of mucus in it, then we can talk about the development of diseases of the kidneys, bladder, urinary tract. Sometimes the transparency of urine is incomplete with the progression of a woman or a man. Also, a woman's slightly cloudy urine can come out after intercourse if all the rules of personal hygiene have not been followed.

It should be noted that in some cases, clouding of urine is possible under normal health conditions, for example, after visiting a sauna, in very hot weather, with excessive consumption of protein products. If the influence of these factors is eliminated, then gradually the state will normalize and complete transparency is noted. If a person turns to a doctor with this symptom, and subsequently it is found that the urine test for transparency is normal, it means that it was just about turbidity under the influence of physiological factors.

Sometimes brown urine appears in older men. If this phenomenon is observed regularly, it is necessary to consult a urologist, since often brown urine in men indicates development.

How to normalize urine color?

If you suspect that the change in the color of urine is pathological, it is necessary to contact a specialist who deals with the treatment of urinary tract pathologies. At the doctor's appointment, it is important to tell him in detail about the medicines that have been used recently, about the peculiarities of nutrition, as well as answer in detail other questions of the specialist.

The doctor conducts a physical examination, prescribes laboratory tests of urine and other tests, depending on the characteristics of the manifestation of the symptom.

If there is a violation of the color of urine, then the cause of this phenomenon is initially determined, and only after that a treatment regimen for the underlying disease is prescribed.

It is also important to pay attention to some of the features of the lifestyle. It is undesirable to allow dehydration of the body. If the urine turns dark, it is important to replenish the lost fluid by adjusting the drinking regimen. The development of diseases that cause the manifestation of this symptom should be prevented. In particular, sufficient fluid intake, regular urination after the first urge appears, and proper hygiene of the genitals will help prevent the development of urinary tract infections. To prevent the appearance of kidney stones, it is important to limit the amount of protein foods and salt in the diet.

In addition, smoking cessation, protection from the effects of toxic chemicals, and a healthy and active life should be mentioned as prevention methods.

The red color of urine often indicates the presence of red blood cells in the composition, which is called hematuria. Among the reasons for the unnatural color, there are also those that do not pose a danger to the functioning of the body. Since such manifestations can be a signal that an infection has entered the body or the development of a disease, you should consult a doctor for advice.

Redness of urine in a child can occur from the use of coloring products, but it is worse if it is blood impurity.

Reasons for changing the color of urine in a child to red

Reddish urine may appear due to the ingestion of products that contain dyes of natural or synthetic origin. Medicines, such as vitamin complexes, also affect the color. Color changes can occur due to excessive excretion of sodium and potassium salts with urine, due to acute inflammatory or infectious processes, the formation of stones in the kidneys, ureter or bladder. Urinary trauma, bleeding disorders, and excessive exercise can affect the color of your urine.

In a newborn

If the newborn has reddish urine, this is not a sign of concern. A similar color appears due to the peculiarities of nutrition, namely, feeding with the liquid secreted from the mammary glands of the mother in the first time after childbirth (colostrum). Since there is practically no water in the colostrum, sodium and potassium salts are excreted in the baby along with urine, as a result of which red urine appears. This feature is called uric acid infarction. In addition to the reddish color of the urine, small brick-colored crystals appear, similar to salt crystals. Similar symptoms disappear after a week.

In a baby

Red urine occurs in infants after adding foods denser than breast milk or formula milk to the diet. Beets, peppers, and blueberries contain strong natural food colors that can cause color changes in urine. Poisoning the body with poisonous substances and taking medications can also have an effect. In addition to the above non-dangerous reasons, the color of urine in an unnatural color in children under one year old may indicate that blood has entered the urine. Such manifestations should alert parents and become a reason for contacting a specialist.

In older children

Redness of urine in preschoolers can also be caused by taking some pills.

As in infants, a change in the color of urine in older children (after 2 years) may be associated with the presence in the diet of beets, rhubarb, berries, red pepper in large quantities. Excessive physical activity, all kinds of injuries and infections of the urinary system also have an effect on the color of the child's urine. Color change also occurs due to the intake of the following drugs:

• "Amidopyrine" - a remedy that relieves inflammation, with a pronounced analgesic, antipyretic, anti-inflammatory effect;
• "Thioridazine" is an antipsychotic drug with a moderate positive effect on the patient's affective sphere;
• "Propofol" is a short-acting sleeping pill.

If a child's urine in a given age group turns red, synthetic dyes can be added to non-hazardous reasons, which are present in many confectionery and sugary drinks that children may have begun to consume at that age. Vitamins with mineral complexes can also affect the color, since many parents do not consider them serious drugs and give them to children without consulting a doctor.

Burgundy urine, as a rule, speaks of kidney stones or vascular injuries.

Red urine in a child indicates the presence of a significant amount of blood in the urine. The reasons include the presence of stones in the kidneys that damage blood vessels during movement, the appearance of neoplasms, and trauma to the urinary tract. In the case of severe bleeding due to severe vascular damage, the urine becomes a dark red color, reminiscent of blood.

Red urine occurs with excessive hematolysis - the destruction of red blood cells with the release of hemoglobin into the environment. The process of hematolysis occurs continuously in the human body, but the presence of a large amount of free hemoglobin in the blood is dangerous because it can lead to acute renal failure.

If a child has dark urine after taking medications and certain foods, then there is no cause for concern. If these reasons are excluded, then you need to pass dark urine for analysis and consult a doctor to exclude pathology of the kidneys, liver and other organ systems

A healthy baby has clear, straw-colored urine. But when parents notice that her shade has changed, they begin to panic. The reasons why urine changes color are different, from consuming coloring products to taking medication. But dark urine in a child (especially in babies under one year old) should alert loved ones - it is often a symptom of a pathological process.

Having discovered a darkening of urine in a baby, you do not need to ignore this phenomenon or panic. To begin with, it is worth excluding all harmless reasons affecting the color of urine, observing the child and only after that rush to the doctor.

Normal urine color in children

Normally, urine in babies is of different shades: from light yellow to darker due to the increased concentration of salts and pigments. In children under one year old (babies) fed only with mother's milk or formula, the urine is almost transparent.

With the growth and development of the baby, the color of his urine becomes richer. Parents should also remember that the morning urine will always be darker as it is more concentrated.

Causes of darkening urine

The child's body is formed gradually, and all his organs and systems are especially vulnerable. This is why babies are so sensitive to fluid loss, temperature changes and other factors. All of them often lead to the fact that the urine of the crumbs changes color.

If the child's urine becomes dark or has acquired any other color, natural causes must first be ruled out.

First of all, the introduction of some products into the baby's diet affects the color of urine:

• beef and some types of fish;
• herbal decoctions and infusions of buckthorn or cassia;
• vegetables and fruits (beets, carrots, rhubarb stalks and black berries - blueberries, blackberries).

The color of urine changes if the child drank soda with artificial colors the day before, as well as when the body is dehydrated. Parents should always remember about the increased mobility of their babies. When running, jumping and frolicking, the child sweats and loses fluid. And if the baby drinks little at the same time, there is a high risk of dehydration. The same thing happens when a child has a fever due to illness.

Urine changes color after taking certain medications:

• vitamins;
• antibiotics (metronidazole);
• antimicrobial agents (nitrofuran group).

Information about such properties of the drug is indicated in the instructions. But this phenomenon should not cause alarm, because after the course of treatment, the situation will return to normal.

Yellow-orange urine

The causes of bright orange urine are usually as follows:

• dehydration;
• taking multivitamin complexes;
• taking drugs of the phenothiazine subgroup or rifampicin;
• eating carrots and other foods with orange pigments in large quantities.

If you stop using coloring products, the color of urine will return to the same color within 24 hours. The same is true for medicinal and multivitamin products: after a course of treatment or early withdrawal of the drug, the child's urine returns to normal.

Dark brown urine

Most often, a child has dark urine against a background of dehydration. It develops not only due to insufficient fluid intake, but also due to such dangerous conditions:

• vomit;
• high temperature;
• pathology of the heart.

The urine darkens after laxatives and antimalarial drugs, legumes, rhubarb, beef, aloe. In addition, drinking large amounts of strong black tea can also affect the color of the urine.

In other cases, dark urine indicates the development of a pathological process:

• liver disease (hepatic or obstructive jaundice);
• kidney damage (glomerulonephritis);
• gallbladder problems;
• poisoning with chemical compounds.

Dark urine (beer-colored) is a sign of an increased concentration of bilirubin in the blood (due to jaundice). This pigment, excreted with urine, stains it in a pronounced brown color. With obstructive jaundice, due to a violation of the outflow, bile enters the bloodstream, and then into the urine. Urine darkens and sometimes turns green. In parenchymal jaundice, bilirubin is released from the destroyed liver cells, while urine

In rare cases, a child has absolutely black urine. This is a sign of alkaptonuria.

Pathology is inherited and congenital. As a rule, other symptoms are noted with black urine: age spots on the skin, weakening of the musculoskeletal system, numerous calculi in the kidneys and almost instant darkening of urine when it interacts with air.

If the urine turns black, you should suspect melanosarcoma. With this pathology, the pigment melanin is released into the urine. You need to see a doctor immediately, because the disease is life-threatening.

Red urine

The most common cause of this condition is food rich in red pigments: beets, rhubarb, red berries. In this case, the urine remains clear, and the baby does not have any other alarming symptoms. A day after the removal of coloring products from the diet, the color of urine is restored.

Also medications can cause: laxatives, metronidazole, ibuprofen, rifampicin. In other cases, red urine is a signal of pathology.

The urine turns red due to blood entering it. As a result, the urine becomes cloudy, with a dirty tint (even blood clots are likely).

Often the blood in the urine comes from the kidneys. This phenomenon is provoked by glomerulonephritis, urolithiasis or kidney tumor. Against the background of such diseases, the crumbs also show other symptoms.

Also, urine can turn red due to the destruction of blood cells or muscles. Because of these processes, huge volumes of hemoglobin or myoglobin get into urine.

Alarming symptoms

Caring parents should be concerned about the following symptoms in their baby:

• pain in the abdomen, back, muscles and painful urination;
• excessively cloudy urine, especially with a pungent odor;
• frequent or too rare emptying of the bladder;
• high fever, weakness, lethargy and lack of appetite;
• yellowness of the skin, whites of the eyes, itching and discolored feces.

If the baby has such symptoms, you should immediately consult a doctor. You should not brush it off and ignore the darkening of urine in a child (especially in babies under one year old, whose, because such a phenomenon is not always harmless.

Usually, a biochemical blood test and an ultrasound scan are prescribed. After identifying the reasons why the urine has changed color, the doctor prescribes treatment. If the urine has darkened due to dehydration, the water balance is restored. With hepatitis, hepatoprotectors, enzymes are prescribed, a supportive diet is prescribed. For nephrological problems, antibiotics, diuretics and other drugs are used based on the severity of the child's illness and the presence of complications.

Urine tests are routine examinations, and when contacting a pediatrician for any reason (including a preventive examination or examination to obtain a certificate in a pool, music, sports school, etc.), at least a general urine test is mandatory. If changes are found in the analysis, additional studies are assigned. But what exactly do the results of urine tests mean, what is their norm and what do the deviations mean?

We have already written about. Now let's talk about the interpretation of urine tests in children.

General urine analysis

There are a number of indicators that can detect impaired renal function. They are collectively called general urinalysis.

In the table below, you can see a child's normal CBC readings.

Index	Abbreviation on letterhead from an electronic analyzer	Normal intervals
Colour	Color	Light yellow (straw yellow, s / f) to yellow
Transparency	Clarity	Transparent
Volume	V	Doesn't matter (how many passed)
Specific gravity	SG	up to 2 years old: 1012-10222-3 years old: 1010-1017 over 5 years old: 1012-1025 teens: 1010-1040
Glucose	GLU	Negative / Negative
Bilirubin	BIL	Negative / Negative
Acetone	KET	Negative / Negative
acid-base reaction	pH	4.5-8.0
Protein	PRO	Negative / Negative
Urobilinogen	UBG	Up to 17 μmol / L (umo / L)
Leukocytes	LEU	Boys: 0-1-2 FV / Negative Girls: 0-2 to 8-10 FV / Negative
Erythrocytes	BLD	0-1 / Negative
Cylinders	Usually attributed by hand (cyl.)	No
Epithelium	(Ep. Or ep. Cl.)	Single, up to 10 in FZ
Salt	(the name of the salts is attributed by hand - phosphates, etc.)	No
Slime		No
Bacteria	NIT	No

Deviations from the norm and their meaning

Color changes:

1. Dark yellow color (hyperchromuria) - concentrated urine. Physiological hyperchromuria is observed in the summer and in general with increased sweating, against the background of drinking a small amount of liquid. Dark coloration of urine is also possible when eating carrots. Pathological hyperchromuria occurs with dehydration (diarrhea, fever, vomiting) and starvation (including a lack of breast milk), with, heart.
2. Very pale, colorless urine (hypochromuria) - is noted against the background of copious drinking and the use of foods with a diuretic effect. Pathological hypochromuria also occurs with diabetes insipidus, nephrosclerosis and some others.
3. Orange color - when eating foods rich in beta-carotene (carrots, persimmons, apricots and other brightly colored orange and yellow-orange fruits and vegetables); while taking riboflavin, multivitamins and vitamin C.
4. Pink and red color of urine - most often indicates the presence of blood in the urine (cystitis, glomerulonephritis,). In addition, red urine occurs with severe toxicosis, hereditary porphyrinuria, taking certain medications (sulfazole, red streptocid, amidopyrine).
5. The brown color is due to the presence of bilirubin and bile pigments (urobilinogen, urobilinoids, stercobilinogen) or split erythrocytes in the urine. It is noted in liver diseases (when bile cannot flow from the gallbladder into the intestines), hemolytic anemias.
6. Milky white color - in the presence of fats () or lymph (and tumors of the urinary system) in the urine.
7. Green, blue color - with severe jaundice, intake of methylene blue.
8. Brown and black-brown color - with melanosis (excessive accumulation), alkaptonuria (hereditary metabolic disease), naphthol poisoning.

Transparency changes

Turbid urine is noted with a high content of leukocytes, mucus (inflammation of the kidneys or urinary organs). In the presence of salts, urine does not become cloudy immediately, but after settling.

Specific gravity

The specific gravity will be increased with the release of concentrated urine (dehydration, fever, limited fluid intake) and decreased with the release of dilute urine (heavy drinking, diabetes, polyuria with kidney damage).

Glucose

Sugar in urine (glucosuria) is detected if a large amount of refined carbohydrates is consumed on the eve of the test; in premature babies - due to the immaturity of the renal tubules. Glucosuria can be a consequence of hyperglycemia (increased blood glucose levels) against the background of diabetes mellitus, hereditary disorders of sugar metabolism (galactosemia). In addition, glucosuria is possible at normal blood glucose levels, for example, it is noted in a number of renal diseases, accompanied by impaired renal tubular function (Fanconi syndrome).

Acetone (ketone bodies)

In children, ketone bodies are often found in urine (in wide circles they are simply called "acetone").

Ketonuria (- acetone, acetoacetic and beta-hydroxybutyric acids) is observed in severe disorders of carbohydrate, fat and protein metabolism. In children, carbohydrate metabolism is easily disturbed, therefore ketones are found quite often:

• during fasting (in newborns - with undernourishment);
• with an unbalanced diet (in children with a tendency to acetone crisis, acetonuria can lead to even small errors in the diet, especially against the background of infectious diseases);
• in case of poisoning;
• against the background of fever;
• with acute infections (, etc.);
• in children with neuro-arthritic diathesis - against the background of stress (even in the case of positive emotions), nervous overexcitation, overwork.

Changes in acid-base reaction

The reaction of urine is highly dependent on nutrition: the more protein, the lower the pH. Acidic urine (pH<4) может свидетельствовать о рахите в период разгара, отмечается при сахарном диабете, лихорадке и некоторых других состояниях. Щелочная реакция с pH>8 is often noted in cases of urinary tract infection, poisoning with salts of heavy metals, sulfonamides. If the urine reaction is always alkaline, tubular abnormalities (renal acidosis) must be ruled out.

Protein

The appearance of protein in the urine is called proteinuria. Single low amounts of protein can be found in practically healthy children after physical exertion or with fever against the background of an acute infectious disease. But even a single detection of protein traces requires a repetition of the analysis or additional examination to exclude renal pathology. Persistent proteinuria is observed in kidney disease: from trace amounts of protein in the background to massive proteinuria in nephrotic syndrome.

Bilirubin and bile pigments

And an increased content of urobilinogen is noted in liver diseases and hemolytic jaundice. With physiological jaundice of newborns, the concentration of urobilinogen in the urine increases slightly. The complete absence of urobilinogen occurs in young children (up to 3-6 months), and later indicates a mechanical obstacle to the release of bile into the intestines (obstructive jaundice).

Leukocytes

An increased content of leukocytes characterizes an infection of the kidneys or urinary organs and is found in urethritis, pyelonephritis, renal tuberculosis, kidney abscess.

The borderline values ​​of leukocytes in girls (from 4-5 to 10) often occur with errors in the collection of tests (the toilet of the external genital organs was not carried out, or urine was collected from the first portion).

It should be taken into account that in girls, leukocytes can enter the urine not only from the urinary tract, but also from the vagina with other inflammatory gynecological diseases; and in boys - with phimosis.

Erythrocytes

An increase in the number of red blood cells - blood in the urine or hematuria. When there are a lot of red blood cells, they change the color of urine (the color of meat slops, pink, red), and then they talk about gross hematuria. Single erythrocytes are not visible to the eye and are determined only microscopically (microhematuria).

Hematuria appears with various kidney diseases:

• glomerulonephritis, interstitial nephritis, pyelonephritis;
• tumors of the kidneys and bladder;
• urolithiasis disease;
• hemorrhagic cystitis;
• urethritis;
• trauma to the urinary organs;
• kidney tuberculosis.

Single erythrocytes, up to 5-10 in the field of view, are often observed in dysmetabolic nephropathy. Hematuria also occurs in diseases of the blood system in children (hemorrhagic diathesis), with renal syndrome.

When interpreting the results of urine tests of adolescent girls, it is necessary to find out if the test was taken against the background of menstruation, when blood could enter the urine from the vagina.

Cylinders

Several types of cylinders are excreted in the urine: hyaline, erythrocytic and leukocytic, epithelial, granular, fatty and waxy.

1. Hyaline can be found in healthy children with physical activity, dehydration.
2. Erythrocyte casts indicate the presence, but are also noted in heart attack and kidney injury.
3. Leukocyte casts in combination with other signs of urinary tract infection indicate pyelonephritis.
4. Epithelial casts are found when the renal tubules are affected.
5. Granular and fatty casts are secreted in nephrotic syndrome.
6. Waxy are found when.

Epithelium

Several types of epithelium can be found in the child's urine: flat, transitional and renal. Squamous and transitional epithelium is almost always present in small amounts, its amount increases with inflammation of the urinary tract or damage to their mucous membrane with solid salt crystals. The renal epithelium, if it is occasionally found in urine in a single amount, with other normal indicators, is also considered a normal variant, but if protein, casts or leukocytes with erythrocytes are found simultaneously with the renal epithelium, then this confirms the diagnosis of kidney disease.

Salt

Normally, there should be no salts in the urine, but they can sometimes appear after eating certain foods (uric acid - with an excess of meat in the child's diet, oxalates - after consuming cocoa, chocolate, etc.). If salts are found periodically in urine tests, then this makes the diagnosis of dysmetabolic nephropathy likely. The constant detection of a large amount of salts requires a detailed examination of the child (to exclude urolithiasis and other kidney pathology). In infections of the kidneys and urinary tract, triple phosphates and amorphous phosphates are often present in the urine.

Slime

Mucus in combination with epithelial cells indicates damage to the mucous membrane of the urinary tract by the inflammatory process or by salt crystals.

Bacteria

Urine collected during normal urination is not sterile. But the number of bacteria in it is not high and they are not determined in a conventional study. If the results indicate the presence of bacteria (from + to ++++), it is recommended to continue the examination of the child with a urine test for sterility.

Cumulative samples

In case of questionable results of urine tests (traces of protein, borderline values ​​of leukocyturia, etc.) and suspicion of kidney or urinary tract disease, as well as for routine examination of children with pre-existing diseases of the kidneys and urinary organs, cumulative samples are used. Cumulative samples include samples from Addis-Kakovsky, Amburzhe and Nechiporenko. They make it possible to detect leukocytes and red blood cells in urine, even if they are not always present, but only periodically during the day.

Rates of accumulative urine samples in children

Exceeding normal values ​​indicates diseases of the kidneys or urinary organs.

Zimnitsky test

A urine test according to Zimnitsky is prescribed to assess kidney function. Only 3 indicators are examined on it: the specific gravity of urine and its fluctuations during the day, daily diuresis (amount of urine per day) and the ratio between night and daytime diuresis.

Research standards for Zimnitsky for children

Deviations from the norm:

Hypoisostenuria - a decrease in the difference between the maximum and minimum specific gravity (range is equal to or less than 7 units) - indicates a decrease in the concentration capacity of the kidneys. It is noted in acute and chronic pyelonephritis, renal failure.

An increase in the daily amount of urine (polyuria) is possible against the background of the initial stage of renal failure, as well as with extrarenal diseases (diabetes mellitus and diabetes insipidus, etc.), against the background of abundant fluid intake.

A decrease in the daily amount of urine is observed in the late stages of renal failure, with glomerulonephritis, HFRS, nephrotic syndrome, heart disease, etc.

Erasing the difference between daytime and nighttime diuresis occurs with the initial degree of renal failure, and with severe renal dysfunction, nighttime diuresis prevails over daytime (nocturia).

Three-glass and two-glass samples

These samples are used to roughly determine the localization of the inflammatory process or the source of blood in the urine. The number of corpuscles (erythrocytes and leukocytes) in the norm in each portion should be the same as in the general analysis of urine. With a three-glass test, an increase in the level of cells in the first portion indicates the localization of the painful process in the external genital organs or the initial part of the urethra; if the indicators are increased in the second portion, it is assumed that the urethra is damaged; with changes in the third portion, inflammation of the bladder is likely. When pathological changes are found in three portions at once, this may indicate diseases of the kidneys, ureters, and bladder.