How to collect a general urine test. The result of a general urine test
Urinalysis refers to clinical laboratory studies. Doctors prescribe it to absolutely all patients, regardless of the diagnosis. General urine analysis in children is one of the main for diagnosis, because they are complex tests are assigned extremely rarely, only when necessary.
General urine analysis. Decryption Norm
This study allows to evaluate the physical and chemical properties, as well as the microscopy of the collected material, i.e. the presence of formed elements (leukocytes, erythrocytes) and protein in it. Microscopic examination in the urine can detect renal epithelium, mucus and bacteria, usually they are found in pathological conditions. Normally, healthy people should not have protein (for women, the allowable rate is 0.033 ppm), white blood cells can be present up to 4-6 in the field of view. The result of the general analysis of urine can tell about the condition of the patient, indicate kidney disease or the presence of diabetes. To begin, remember how the urine is formed.Then we will talk about each indicator of this analysis in more detail. Consider the norm and pathology.
How does the formation of urine
Urine is formed and excreted as a result of the vital activity of the human body. It is produced in the kidneys and consists of soluble organic and inorganic substances, which are formed as a result of filtration of blood plasma in the glomeruli and tubules.
In the glomerular capillaries under the influence of blood pressure, ultrafiltration of the protein-free part of the plasma occurs, thus forming the primary urine. It contains all plasma elements, with the exception of proteins. Further, this filtrate enters the renal tubules, 99% of it is reabsorbed (absorbed) back into the blood. The non-absorbed final glomerular filtrate is urine, which contains 96% of water and 4% of metabolic products.
How to collect a general urine test
For a reliable assessment of the result of the study, only morning urine is suitable; it is more saturated. The result of a general analysis of urine depends largely on the correctly collected material.The analysis must be delivered to the laboratory no later than 2 hours from the moment of collection. If you are assigned a general urine test, how to collect it should tell a medical professional. The rules for collecting this analysis are simple and can be summarized as follows:
- Before passing the analysis it is imperative to wash the external genitalia of both women and men.
- The beginning of urination is done in the toilet, the average jet is collected in a container for urine analysis. Finish urinating again in the toilet.
- A special container purchased at a pharmacy is best for analysis, but you can also use dry clean glassware with a wide neck.
- If the patient had a cystoscopy procedure the day before, then it is better to postpone the delivery of this analysis for 5-7 days.
- Some medications may distort the true results of the study, so it is best to pass all tests before starting treatment. Alcohol should also not be taken before testing.
- The required amount of urine for analysis is at least 120 ml.
- Overcooling of the material during transportation is not allowed, since it may precipitate salts. The result of the analysis in this case may be incorrectly interpreted and regarded as pathology.
Sometimes information on how to properly collect a urine test is located on the stands near the test rooms.
What to do if the patient cannot collect urine by himself
In some conditions, the patient cannot independently collect material for analysis. This happens, for example, in acute urinary retention. How to collect a general urine test in this case? Then urine is excreted with a catheter. This is done in the hospital. The procedure is performed by a qualified nurse.
Acute urinary retention is possible in men more often, the cause can be: acute prostatitis, phimosis, adenoma, oncology of the prostate gland. Sometimes it serves as a symptom of diseases of the central nervous system, for example, with a brain tumor or trauma.
How to collect urine in an infant
Collecting this analysis for very young children is sometimes difficult. How to collect a general urine test for babies? For them there are special adhesive bags with velcro, which can be purchased at the pharmacy. For a small child, a sufficient volume of urine is about 10 ml for analysis.
How to evaluate the results of a general urine test? Decoding this analysis is not difficult. Normally, there should be no protein, erythrocytes, renal epithelium, sugar and acetone. Only single leukocytes and squamous epithelium, which are determined by microscopy, are allowed. About all this in more detail.
Physical properties include:
- specific gravity (relative density);
All these indicators are included in the general analysis of urine. Norm and pathology will be described below.
The color of normal urine is straw yellow due to the presence of urochrome (urinary pigment) in it. The color may change as a result of taking medications, such as iron, some antibiotics, phenazopyridine, warfarin, etc. When you take these drugs, urine may turn reddish. The same shade may have urine and pathology: gross hematuria or hemoglobinuria, as well as as a result of chronic lead intoxication.
Dark yellow color, often with a greenish or greenish-brown tinge, urine has, if along with it there is a selection of bile pigments.This happens with mechanical and parenchymal jaundice. In the case of obstructive jaundice, the urine is greenish-yellow, and in the case of parenchymal urine, it has a greenish-brown color, but these differences are not always distinct. In jaundice hemolytic urine has no pathological staining.
Greenish-yellow color occurs when purulent inflammatory processes occurring in the urinary system. This color is due to the huge number of leukocytes (pus) in the urine. Often, microscopy of such urine leukocytes completely cover all fields of view.
Gray or dirty brown speaks of pyuria in the case of alkaline urine.
Black color refers to hemoglobinuria, it happens with hemolytic anemia or alkaptonuria (homogentisic acid secretion) or with melanoma and melanosarcoma (melanin secretion during tumor processes).
Whitish urine may be present if phosphates (salts) are present in it, as well as in lipuria - the release of fat, this may occur, for example, during invasion of the parasite of filaria (filamentary nematodes that parasitize in human lymphoid or connective tissue).
Urine can also have a significant increase in intensity.coloring in case of heart failure (congestive kidney) or in case of dehydration of the body due to vomiting, diarrhea or burns. Usually the color intensity varies in parallel with the density. Increases with its increase and decreases with a decrease. Urine of patients with diabetes mellitus is an exception, in this case the increase in relative density occurs due to the presence of sugar in it, but as a result of polyuria, the urine remains pale.
Freshly urine of a healthy person has no unpleasant smell. The presence of such a smell may indicate a particular pathology:
- ammonia smell can come from cystitis;
- when gangrenous or neoplastic processes of the bladder urine may have a putrid odor;
- fecal odor has urine in the presence of cystic rectal fistula;
- the smell of apples indicates the presence of acetone in the urine;
- eating horseradish, asparagus or garlic can give the urine a fetid odor.
The relative density (OD) or specific gravity of the urine of healthy people ranges from 1010 to 1025. A single measurement of OD has no diagnostic value and, as it is raised or lowered, requires additional study, for example, a Zimnitsky test may be assigned.
The increase in OP occurs in the following situations:
- inadequate fluid intake or dehydration;
- small diuresis, for example, with an increase in edema in diseases of the kidneys and heart, during pregnancy;
- with diabetes.
The decrease in OP can be observed in the following situations:
- polyuria with heavy drinking or taking diuretics;
- in case of renal failure caused by pyelonephritis, amyloid-shriveled kidney, nephrosclerosis, etc .;
- observance of protein-free diet or long fasting;
- diabetes insipidus.
Chemical urine test
The general urinalysis includes chemical research, it is the reaction of urine, protein, urobilin, bile acids and pigments, hemoglobinuria (free hemoglobin). But some of these indicators are done only on prescription, for example, the determination of free hemoglobin and bile pigments.
The indicator "reaction of urine" is included in the general urinalysis. The pH range varies from 5 to 7, which corresponds to a weakly acidic and acidic reaction.
Urine acidity may increase in the following situations:
- prolonged fasting;
- hard physical work;
- acute febrile processes;
- renal failure;
- kidney tuberculosis.
Alkaline urine can be in the following situations:
- when taking an alkaline drink, for example, mineral water;
- after vomiting;
- with cystitis;
- due to resorption of exudates or transudates;
- with hematuria.
A protein test is necessarily included in the urinalysis. Norm - is the absence of protein in the urine of men, women are allowed 0,033 ppm. High protein content is a pathology.
The presence of protein in the urine is called proteinuria. It can be physiological and pathological.
Physiological proteinuria is sometimes observed after ingestion of a significant amount of foods containing undenatured protein (raw eggs and milk), as well as during high exertion, strong psycho-emotional experiences, after taking a cold bath and during epileptic seizures.
Pathological proteinuria is observed in inflammatory diseases of the urinary system, intoxication of various origins, etc.
Microscopic examination of urine
Microscopic examination of urine can detect leukocytes, erythrocytes, epithelium (flat and renal), cylinders, salts, bacteria, mucus.
The presence in the urine of the renal epithelium and cylinders says kidney disease.
A large number of leukocytes and erythrocytes can be caused both by diseases of the bladder, and to have renal origin.
Salts (phosphates or urates) may appear in the urine after eating certain foods.
Bacteria in the fresh urine should not be. Their appearance may be associated with a bacterial infection of the bladder. If urine costs more than 2 hours, then bacteria may also appear in it (this is not a sign of disease).
General analysis of the urine of the child
How to read a common baby urine test? Decoding it is no different from an adult. All criteria for this analysis are the same. The only difference is the collection of urine. How to collect a general urine test for a small child? This was discussed above, for this purpose, special mochesborniki for infants. If for an adult the minimum volume for this analysis is 120 ml, then for children under one year about 10 ml will suffice. A larger volume for such children is problematic to collect.
Urinalysis in children can be appointed almost from birth.
Biochemical examination of urine
If necessary, the doctor may prescribe a biochemical examination of urine. Such a study is assigned to both children and adults. Biochemical analysis of urine can be performed for the presence of Bens-Jones protein, chloride content or calcium determination (this study is more often carried out in children), diastase quantitative determination (in case of pancreitis and pancreatic necrosis).