General urine analysis: interpretation of results, norm and deviations
The content of the article:
- Indications for the appointment of a general urine test
- How to prepare for the study
- What does the general analysis of urine show?
-
Decoding a general urine test in adults
- number
- Colour
- Smell
- Frothiness
- Transparency
- Density
- Acidity
- Protein
- Sugar
- Bilirubin
- Ketone bodies
- Shaped cells
- Epithelial cells
- Cylinders
- Bacteria
- Fungi
- Salt
- Is it possible to decipher the urine test yourself?
Decoding a general urine test in adults requires the necessary qualifications, so doctors do not recommend doing an independent interpretation of the results. This laboratory study is highly informative with ease of conduct and is one of the most frequently prescribed.
General urine analysis - a study that is prescribed when examining a patient for most diseases
Urine, or urine, is a biological fluid that is produced by the kidneys during the process of filtering the blood flowing through them. It consists of 95-96% water and 4-5% of the products of protein metabolism (creatinine, uric acid, urea), mineral salts and other substances.
The diagnostic value of a general urine test is explained by the following factors:
- sampling of material for the study is simple and does not cause discomfort to the patient;
- speed and technical simplicity of implementation;
- urine analysis indicators correlate with blood test indicators, complementing each other;
- a complete general analysis of urine allows you to assess the functioning of many body systems;
- the results obtained in some cases allow the doctor to make a preliminary diagnosis.
Indications for the appointment of a general urine test
A general urine test is prescribed for all adults and children during dispensary observation; it is also included in the complex of basic examination of patients with a variety of diseases. It has the greatest informational content with the following pathologies:
- inflammatory diseases of the kidneys and urinary tract;
- urolithiasis disease;
- neoplasms of the genitourinary system;
- acute and chronic renal failure;
- type I and II diabetes mellitus;
- pancreatitis;
- diseases of the liver and biliary tract (hepatitis, cholangitis, cholelithiasis);
- hemolytic jaundice;
- poisoning with hemolytic poisons;
- condition after suffering streptococcal infection.
It is advisable that every healthy person should take a urine test once a year, since it gives enough information about the state of the body and allows you to diagnose some diseases at a latent stage, in the absence of any symptoms.
How to prepare for the study
The general analysis of urine not only reveals possible diseases of the genitourinary system, but also determines the state of many other systems, for example, the digestive and cardiovascular systems. However, in order for the parameters determined by it to be reliable, it is necessary to properly prepare.
One day before the study, it is necessary to stop eating foods that can affect the composition of urine. First of all, these are brightly colored foods (beets, carrots, caramel, lemonade), marinades, smoked meats, alcohol. In addition, you should stop taking any dietary supplements and vitamins, as well as diuretics (after consulting a doctor).
It is undesirable to take a urine test on the days of menstruation or any disease accompanied by an increase in body temperature, as well as within a week after bladder catheterization or cystoscopy. On the eve of the study, physical activity must be excluded.
The day before the urine test, you should stop physical activity and alcohol
It is necessary to take for analysis the morning urine obtained immediately after a night's sleep. To prevent the ingress of impurities into it, a thorough toilet of the external genital organs should be performed before collecting material for analysis. Use a sterile disposable plastic container or clean (sterilized) glass jar to collect urine. For the first 2-3 seconds, the patient urinates into the toilet in order to flush the urethra with a stream of urine, and then, without interrupting urination, puts a container under the stream and collects 150-200 ml of urine into it.
The collected material should be delivered to the laboratory as soon as possible; before the start of the study, it can be stored for no more than 1.5–2 hours at a temperature not exceeding 18 ° C. If the urine is stored longer or at a higher temperature, bacteria begin to multiply in it actively, and the result becomes unreliable.
In case of urgent need, a general urine test can be taken at any time of the day. If the result is required as soon as possible, then on the referral to the laboratory is written in Latin "Cito!", Which means "urgent". Since in such cases, as a rule, we are talking about emergency conditions, the laboratory assistant conducts a study of the delivered biological material immediately, out of the general queue.
What does the general analysis of urine show?
Before talking about how to decipher the results of the general analysis, you should list the parameters included in it. These include:
- organoleptic characteristics (color, smell, volume, transparency, foaminess);
- physical and chemical indicators (density, acidity);
- biochemical indicators (protein, sugar, urobilin, ketone bodies);
- microscopic examination of the sediment (erythrocytes, leukocytes, epithelial cells, cylinders, salt crystals, bacteria and fungi).
Only a doctor can assess the results obtained and their compliance with the norm, taking into account all the characteristics of the patient's condition. For example, in many diseases of the biliary tract and liver, the color of urine changes. However, it happens that the color remains normal, but it is still impossible to exclude one or another pathology of the hepatobiliary system for a number of other parameters.
Decoding a general urine test in adults
It is difficult to overestimate the importance of general urinalysis in clinical practice. For easier interpretation of its results, use the table.
| Index | Norm |
| Volume | 100-130 ml |
| Colour | Straw yellow |
| Smell | Specific, soft |
| Frothiness | When shaking urine, foam should be practically absent. |
| Transparency | Transparent |
| Density | 1,000-1,025 units |
| Acidity | 5 to 7.5 on the pH scale |
| Protein | Absent |
| Sugar | Absent |
| Bilirubin | Absent |
| Ketone bodies | Absent |
| Shaped cells (erythrocytes and leukocytes) |
Erythrocytes - no more than 2 in the field of view. Leukocytes - in men no more than 3, in women - 5 in the field of view. |
| Squamous epithelium | In women, in large numbers, in men, single cells |
| Transitional epithelium | Single cells in the field of view |
| Renal epithelium | Absent |
| Hyaline cylinders | Absent |
| Granular cylinders | Absent |
| Wax cylinders | Absent |
| Erythrocyte casts | Absent |
| Bacteria | Absent |
| Mushrooms | Absent |
| Salt | Absent or determined in small quantities |
number
A decrease in the amount of urine is observed with dehydration of the body, acute and chronic renal failure. With a large volume of urine (polyuria), diabetes mellitus or diabetes insipidus may be suspected.
Colour
A change in the color of urine can be due to various reasons:
- orange-red - in diseases of the hepatobiliary system, accompanied by an increase in the level of bilirubin in the blood (cholestasis, cirrhosis, hepatitis);
- the color of meat slops - indicates an impurity of blood (hematuria), is a sign of urolithiasis, tuberculosis or kidney cancer;
- reddish - often caused by the consumption of beets or foods containing a large amount of food colors, as well as certain drugs (amidopyrine, acetylsalicylic acid);
- black - a sign of alkaptanuria, a hereditary disease associated with a violation of tyrosine metabolism;
- grayish-white - with purulent inflammation of the kidneys or bladder;
- blue-green - associated with increased putrefactive processes in the intestines, accompanied by the formation of indoxylsulfuric acids, which are excreted by the kidneys and, decomposing in the urine, give it this color due to the formation of indigo;
- bright yellow-orange - taking vitamin B 2, Furadonin, Rifampicin, eating a lot of carrots;
- dark brown - Metronidazole therapy.
The color of urine depends on the existing diseases, dietary habits and drinking regime, as well as the medications used
Smell
Immediately after urinating, urine has a specific, mild odor. After a while, it intensifies, which is the norm. The appearance of other odors indicates pathologies:
- the smell of acetone - appears as a result of the formation of ketone bodies and is observed with decompensated diabetes mellitus, prolonged fasting, indomitable vomiting;
- the smell of feces - with infectious and inflammatory diseases of the urinary tract caused by E. coli;
- fetid odor - it is usually caused by a fistula between the bladder and intestines or a purulent cavity;
- musty or mousy odor - observed in phenylketonuria, a hereditary disease associated with a violation of the metabolism of phenylalanine;
- the smell of sweaty feet - isovalerian or glutaric acidemia (hereditary metabolic disorders);
- the smell of hops or cabbage - hop dryer disease (methionine malabsorption);
- the smell of maple syrup - with maple syrup disease (hereditary violation of the metabolism of branched-chain amino acids);
- rancid fishy smell - tyrosinemia (congenital metabolic disease);
- the smell of rotting fish - trimethylaminuria (a rare pathology associated with the accumulation of trimethylamine in the body).
Frothiness
Normally, when shaken, a small amount of unstable foam is formed on the surface of urine. The formation of abundant white foam is observed with proteinuria, yellow - with jaundice.
Transparency
Clouding of urine, the presence of threads and flakes in it is caused by the accumulation of salts, bacteria, corpuscles, mucus or pus in the urinary tract. Indicates an inflammatory process in the organs of the genitourinary system.
Density
Reduced density indicates kidney pathology and overhydration of the body. Increased is observed with dehydration, as well as in patients with diabetes.
Acidity
A deviation from the norm can be associated with the influence of both physiological and pathological factors. A decrease in pH less than 5 (shift towards the acidic side) is observed in the following cases:
- the predominance of meat dishes in the diet;
- hypoglycemic coma;
- acidosis, which develops against the background of heart or hepatic failure;
- acute nephritis;
- kidney tuberculosis;
- hypokalemia;
- gout;
- the introduction of large doses of ascorbic acid;
- corticotropic hormone therapy.
A shift in urine pH to the alkaline side (more than 7) can be caused by the following factors:
- the predominance of plant foods in the diet, adherence to a vegetarian diet;
- drinking large quantities of alkaline mineral waters;
- a state of alkalosis, which develops against the background of hyperventilation of the lungs or indomitable vomiting;
- exacerbation of chronic inflammatory diseases of the genitourinary system;
- chronic renal failure;
- hyperkalemia;
- intravenous administration of bicarbonates, sodium citrate.
Protein
The amount of protein in urine is called proteinuria. The reasons for its occurrence are:
- acute and chronic glomerulonephritis;
- amyloidosis of the kidneys;
- OPG-gestosis;
- collagenoses;
- diabetic nephroangiopathy;
- interstitial nephritis;
- purulent inflammatory processes of the urinary tract;
- tubulopathy;
- toxic kidney damage;
- severe cardiovascular insufficiency;
- feverish conditions.
Minor short-term proteinuria can be triggered by eating a large amount of protein foods, hypothermia or overheating, excessive physical exertion.
Sugar
The appearance of sugar in the urine (glucosuria) is observed in patients with uncompensated diabetes mellitus.
Sugar in urine is a sign of diabetes
Bilirubin
It is found in urine with liver diseases, as well as pathologies accompanied by significant destruction of erythrocytes (hemolytic anemia, sickle cell anemia, transfusion of incompatible blood, hemolytic poisoning, malaria).
Ketone bodies
They appear with decompensated diabetes mellitus, Itsenko-Cushing's disease, thyrotoxicosis, acute pancreatitis. Also, prolonged fasting, indomitable vomiting (early toxicosis of pregnant women, central vomiting with cerebral edema), alcohol intoxication, abuse of fatty foods can lead to their appearance.
Shaped cells
An increase in the number of erythrocytes in urine is observed with glomerulonephritis, urolithiasis, systemic lupus erythematosus, and poisoning.
Leukocyturia accompanies purulent-inflammatory diseases of the genitourinary system (pyelonephritis, cystitis, urethritis).
Epithelial cells
An increased content of squamous epithelial cells in the urine of men is observed with prostatitis and / or urethritis.
An increase in the number of cells of the transitional epithelium is associated with urolithiasis, tumors of the urinary tract, intoxication, acute inflammatory processes in the renal pelvis or in the bladder.
The appearance of renal epithelial cells in the urine is observed with circulatory failure, intoxication, nephritis. A very large number of renal epithelial cells are present in the urine of patients with nephrotic necrosis caused by poisoning with dichloroethane, antifreeze, and mercuric chloride.
Cylinders
What are cylinders? These are formations that are casts of the renal tubules and formed by various components of urine coagulated in an acidic environment. In alkaline urine, no casts are formed.
Depending on the composition, several types of cylinders are distinguished:
- hyaline - appear with some kidney diseases, heart failure and hyperthermia;
- granular - a sign of kidney pathology (pyelonephritis, glomerulonephritis, diabetic nephropathy), viral infections, lead poisoning;
- wax - with amyloidosis, chronic renal failure, nephrotic syndrome;
- erythrocytic - typical for glomerulonephritis, renal vein thrombosis, kidney infarction.
Bacteria
The appearance of bacteria in the urine (bacteriuria) is associated with an infectious inflammatory process in the organs of the genitourinary system or a violation of the rules for preparing and passing the test.
Fungi
Finding them speaks of a fungal infection. They often appear in the urine of people who have received a long course of antibiotic therapy or are suffering from immunodeficiency of various origins.
Salt
The appearance of salts in the urine may be associated with disorders of mineral metabolism, inflammation in the calyx-pelvic system, urolithiasis, gout, and dietary habits.
Salts in urine can be a sign of metabolic or eating habits
Is it possible to decipher the urine test yourself?
At first glance, it may seem that reading the result of a general urinalysis is not difficult if you have a decoding of the main indicators at hand. However, in practice, everything is much more complicated. It so happens that the existing deviations of indicators from the norm are not associated with pathology. For example, a decrease in urine density may be due to drinking plenty of fluids shortly before analysis, and a change in the color of urine - eating beet foods or taking medications (Furadonin, Furazolidone, vitamins).
On the other hand, a good urinalysis result also does not always indicate the absence of pathology; it must be correlated with blood tests, the general condition of the patient. In this regard, it is impossible to make a diagnosis based on the results of one study in most cases. As a rule, a deviation of certain indicators from the norm or, on the contrary, obtaining a normal result in the presence of clinical symptoms is the reason for an in-depth examination of the patient. The diagnosis is made on the basis of an assessment of the results of all studies, taking into account the clinical picture.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
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