How can I take a urine test?
Morning urine is usually taken for analysis. Before emptying the bladder, you must necessarily perform an intimate hygiene procedure using soap. The urine should be drained into a plastic container, which is sold in a pharmacy. Urinalysis is usually performed no later than an hour and a half after the collection of urine. Before taking a urinalysis, it is forbidden to take medications, since this can affect the results, and urine should not be left at sub-zero temperature.
Urinalysis by Nechiporenko
Analysis of urine by Nechiporenko allows to detect inflammatory processes occurring in the urinary tract and to determine the level of leukocytes, erythrocytes and cylinders. Normally, the following indicators are allowed: leukocytes - up to 2000 ml in males and up to 4000 ml in females; erythrocytes - up to 1000 ml; cylinders - up to 20 ml. Before you take the urine, you must first prepare a dry plastic container, which then need to collect about 200 ml of morning urine (a minimum of fifty to one hundred milliliters). The urine is analyzed as follows: the collected urine is shaken, then taken a little to a test tube that is centrifuged for several minutes, then the upper part of the urine is collected, and in the test tube, 1 milliliter of urine is left with the precipitate, which is thoroughly mixed and placed in a special chamber, leukocytes, erythrocytes and cylinders.
Urinalysis during pregnancy
At the onset of pregnancy, women have to take urine tests almost every week. The genitourinary system of a pregnant woman undergoes double the load, because during pregnancy not only does the uterus increase, but there is a compression on the kidneys, the bladder associated with the growth and location of the fetus. Therefore, the delivery of urinalysis during pregnancy is a mandatory regular procedure. For pregnant women, a small amount of protein in the urine may be the norm, although there is no protein in the urine in the usual state. If more than three hundred mg of protein is found in the urine of a pregnant woman, it can signal kidney pathologies, including chronic ones, that could become worse during pregnancy. In such cases, inpatient treatment is prescribed. Proteinuria (protein in the urine), which occurs at the 32nd week of pregnancy, can signal the development of nephropathy, accompanied by increased blood pressure, impaired functioning of the placenta. In the urine of pregnant women, various bacteria are often found. Bacteriuria can cause the development of pyelonephritis, which can cause a threat of premature birth. Of particular importance is the analysis of urine with asymptomatic bacteriuria, since only in this way can reveal hidden pathologies. In the urine of pregnant women there should be no leukocytes, and disorders of the genitourinary system can be indicated by an elevated level of salt content. If ketone bodies were detected in the urine of a pregnant woman, this may indicate the development of toxicosis. With a lack of potassium, as well as toxicosis in urine, the acidity level can be lowered. Urine analysis during pregnancy includes examination of color and transparency, density, epithelium, bilirubin, erythrocyte and cylinder contents. In case of receiving unfavorable results, additional urine tests are prescribed - according to Nechiporenko's method, as well as bacussia of urine, etc.
Microscopy of urinary sediment
Investigation of the constituent elements of urinary sediment is of great practical importance, including for establishing the level of localization of the pathological process in the urinary system. Elements of the urine sediment are divided into organic (cellular elements, cylinders) and inorganic (crystals of different salts).
Among organic elements of the urine sediment, epithelial cells, erythrocytes, leukocytes and cylinders are examined.
Epithelial cells differentiate according to the type of epithelium. Cells of flat epithelium originate from the lower parts of the urinary tract; increasing their content more than 1-2 in the field of vision, especially a large number of them indicates inflammatory processes in the bladder or urethra. The source of cells of the cylindrical epithelium is the renal pelvis and ureter; an increase in their number is observed with pyelonephritis and urethritis. The cells of the renal tubular epithelium are rounded, their detection in complexes with the cylinders or in large groups testifies to their renal origin. This type of cells is found in various kidney diseases (tubulointerstitial nephritis, chronic glomerulonephritis, including lupus).
Erythrocytes are found in the urine sediment of healthy individuals in an amount of 0-1 in the field of vision.
The presence of a macromemuria in a patient is judged by a characteristic change in the color of urine; to distinguish it with myoglobinuria and hemoglobinuria, there are special tests ("Hematuria").
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Leukocyturia - an increase in the content of leukocytes in the urinary sediment (the norm is 0-1 in the field of view of the microscope in men and up to 5-6 in women). Differential diagnostic tests to determine the leukocyte population of the urinary sediment are used to accurately determine the source of leukocyturia.
Isolate infectious leukocyturia, characteristic of many infectious and inflammatory diseases of the urinary system (including pyelonephritis). About the infectious nature of leukocyturia can be tentatively judged by the detection in the urinary sediment of bacteria - bacteriuria (more than 1x10 5 / ml of urine). During the sowing, urine often results in false negative results due to the fact that even the insignificant violations of the rules for sampling and storage of samples affect the accuracy of this method. Aseptic leukocyturia, characteristic of many forms of chronic glomerulonephritis, analgesic nephropathy; sometimes observed in amyloidosis.
Cylinders are formed by the connection of the Tamm-Horsfall Uromucoid (protein secreted by the epitheliocytes of the ascending knee of the Henle loop), plasma proteins that have passed through the glomerulus membrane and specific constituents (cells, fat particles).
- Hyaline cylinders consist only of protein molecules, they are found in various kidney diseases and normal (not more than 100 in 1 ml of urine).
- Waxy cylinders consist of plasma proteins and act as a sign of chronic nephropathy.
- Cellular cylinders (erythrocyte, leukocyte) always have a renal origin and indicate a lesion of the kidney parenchyma.
- Fatty cylinders are found with significant proteinuria, including nephrotic syndrome.
- Grainy cylinders are a sign of kidney disease.
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Inorganic elements of urine sediment consist of crystals of different salts
Detection of uric acid crystals, calcium oxalate, amorphous urates and phosphates, as well as triphosphate in the urine is not a sign of kidney damage, urine analysis and clinical data should be taken into account.
The presence in the urine of crystals of cholesterol, cystine, tyrosine and leucine always indicates the defeat of the kidneys. Cholesterol crystalluria is observed in patients with nephrotic syndrome; crystals of tyrosine and leucine indicate prognostically unfavorable liver damage.
In the urinary sediment, bacteria, fungi, protozoa and parasites are also found. Bacteriuria is most significant in combination with leukocyturia; to clarify its genesis, it is advisable to conduct a bacteriological study of urine. Of the fungi in the urinary sediment are most often found representatives of the genus Candida, especially in patients with diabetes mellitus or receiving immunosuppressive therapy. Sometimes amoebae are found; In the presence of dysuria, this indicates a genito-urinary amoebiasis. Detection of eggs Schistosoma haematobium indicates the invasion of the urinary tract.
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