Leukocytes in urine in women and men: the norm, the reasons for the increase
The content of the article:
- Leukocytes in urine
- Leukocytes in the general analysis of urine
- Normal leukocyte counts in urine with different samples
- An increase in the number of leukocytes in the urine
- Causes of leukocyturia
- Symptoms accompanying leukocyturia
Leukocytes in urine analysis are one of the main indicators of the study. A pathology in which the number of leukocytes rises is called leukocyturia. Most often, this means that an inflammatory reaction develops in the body. How are leukocytes indicated in urine analysis, and what can deviations of their indicators from the norm indicate?
An increased content of leukocytes in the urine indicates the presence of inflammation.
Leukocytes in urine
Leukocytes are white blood cells involved in immune and inflammatory responses. Leukocytes are produced in the lymph nodes and red bone marrow. In the analysis of urine, there are different designations of these cells - LEU and WBC (white blood cells - white blood cells).
There are five types of leukocytes, each of which differs in its physical and functional characteristics:
- neutrophils - provide the body's main defense against bacteria, fungi and protozoa. Localized in the foci of inflammation, neutrophils surround and phagocytose bacterial agents and tissue degradation products with the help of lysosomal enzymes;
- lymphocytes - play a central role in immune responses, are responsible for acquired immunity, promote tissue regeneration;
- monocytes - have the highest ability to phagocytosis, absorb particles of foreign physical agents and foreign cells in the blood;
- eosinophils - carry out extracellular destruction of parasitic organisms, are able to phagocytose microbial cells, fight against particles that carry allergens in the focus of inflammation. When activated, eosinophils accumulate and release inflammatory mediators;
- basophils - secrete inflammatory mediators that increase vascular permeability, regulate blood coagulation and vascular permeability, play an important role in immediate allergic reactions.
Leaving the bloodstream, leukocytes penetrate into any organs and tissues. In healthy people, white cells enter the urine through the mucous membrane of the ureters and urinary bladder, the renal glomeruli and the tubular system in small quantities. With the development of an inflammatory reaction due to the destruction of the tubules and cell infiltration, conditions are created for the excessive release of leukocytes from the focus of inflammation into the urine. In this case, the presence of white blood cells is detected in the urine during laboratory tests.
Leukocytes in the general analysis of urine
General (clinical) analysis is one of the simplest and most accessible methods for determining the level of leukocytes in urine. When it is carried out, the obtained sample of the biomaterial is examined under a microscope.
Many factors can influence the composition of the urine and distort the test results. These include drinking and eating patterns, medication, physical and emotional stress. To get the most accurate result, you need to properly prepare for the analysis.
The day before the study, you should exclude significant physical activity, try to limit stress. Baths and saunas are contraindicated. Fatty and fried foods, as well as any foods that can change the color of urine (carrots, beets and other brightly colored vegetables and fruits, synthetic vitamins) should be excluded from the diet 1-2 days before the analysis. Also, do not consume alcohol, coffee, sugary and carbonated drinks. Taking any medication, if possible, should be suspended (in this regard, you should consult with your doctor). If you cannot take a break in taking, you need to draw up a complete list of drugs taken and inform the doctor about it, who gives a referral for analysis. Women who are menstruating are advised to postpone the urine test for a few days.
The material is collected on an empty stomach, at least 12 hours should pass from the last meal. For a general analysis, the first morning urine is required. To ensure that the biomaterial is not contaminated with secretions, thorough hygiene of the external genital organs must be carried out before urine collection. You should take care of the capacity in advance. It must be sterile, without residues of detergents. It is best to use special disposable containers that are sold at the pharmacy. Some laboratories issue such containers when registering for a study.
When collecting material, you need to flush a small amount of urine into the toilet, and then, without stopping urination, substitute a container and collect 100-150 ml, and the container should not touch the skin. This is done so that bacteria from the external genital organs do not get into the material. The collected urine for analysis can be stored in a cool place for no longer than 1.5–2 hours.
In the urine of a healthy person, leukocytes are found in an amount of no more than 10 per field of view. The norm of leukocytes in adults in a single portion of urine is no more than 7 in the field of view in men, and no more than 10 in women. To determine normal results in children, you can use the table of white blood cell counts in urine by age.
| Age | The number of leukocytes in the field of view in girls | The number of leukocytes in the field of view in boys |
| Newborn | 8-10 | 5-7 |
| Children 1 month to 1 year | 8-9 | 5-6 |
| 1 to 18 years old and older | 0-6 | 0-5 |
The level of white blood cells in urine can increase during teething in infants and children 5-6 years old.
Normal leukocyte counts in urine with different samples
Analysis of urine according to Nechiporenko is considered a more informative method for diagnosing kidney and urinary tract function. For the study, an average portion of urine collected in the morning is used. The norm of leukocytes is up to 2000 in 1 ml.
To detect latent leukocyturia, additional research methods are used - the Amburge and Addis-Kakovsky tests.
The Amburge test helps to determine the number of blood cells excreted in the urine in 1 minute. To obtain reliable data, 5-10 ml of urine collected in 3 hours is analyzed. Normal urine in the study according to Amburge contains up to 2000 leukocytes.
Addis-Kakovsky's samples are a method for the quantitative determination of formed elements in the daily volume of urine. In a healthy patient, no more than 2,000,000 leukocytes per day are excreted in the urine.
An increased content of leukocytes in the analysis of urine (especially in repeated ones) requires a detailed examination of the patient. Usually, additional studies are prescribed: ultrasound of the abdominal cavity and organs of the genitourinary system, chest x-ray, cystoscopy, excretory urography, general and biochemical blood tests, etc.
An increase in the number of leukocytes in the urine
An increase in leukocytes in the urine, i.e., leukocyturia, can be true and false. When true, white blood cells are formed in the urinary system, when false, the result of the analysis is affected by the pollution of the collected biomaterial with secretions from the external genital organs.
Depending on the presence of the pathogen, an infectious, or bacterial and non-infectious, or abacterial (sterile) leukocyturia is isolated. The latter is characterized by an increased number of leukocytes in the absence of bacteria in the urine.
When collecting urine for analysis, it is advisable to use special disposable containers
By the number of detected leukocytes, the following types of leukocyturia are distinguished:
- insignificant - up to 40 in the field of view;
- moderate - up to 100;
- significant - the entire field of vision is covered with leukocytes.
With 100 or more leukocytes in the field of view, they speak of pyuria - the discharge of pus in the urine. The number of leukocytes in this condition can reach 500 or more.
Depending on which types of white blood cells are predominant, leukocyturia is:
- neutrophilic - with inflammation of the kidneys, bladder, ureters or urethra, at the initial stage of acute glomerulonephritis, with pyelonephritis and tuberculosis;
- lymphocytic - with infectious lesions of the kidneys and urinary tract, autoimmune diseases;
- mononuclear - with interstitial nephritis, in the later stages of glomerulonephritis;
- eosinophilic - eosinophils are increased in cystitis and abacterial glomerulonephritis and indicate the addition of allergies to the inflammatory process.
Causes of leukocyturia
An increased content of leukocytes in urine is characteristic of the following diseases:
- pyelonephritis;
- glomerulonephritis;
- hydronephrosis;
- interstitial nephritis;
- rejection of a kidney transplant;
- kidney tuberculosis;
- cystitis;
- urethritis;
- urolithiasis disease;
- appendicitis;
- prostatitis;
- malignant tumors of the kidneys, bladder;
- inflammation of the uterine appendages and other diseases of the female reproductive system (vaginitis, candidiasis, vulvovaginitis);
- parasitic infections;
- intoxication;
- heart failure.
An increase in leukocytes can cause the intake of certain medications (antibiotics, diuretics, anti-tuberculosis drugs, immunosuppressants, drugs of the group of non-steroidal anti-inflammatory drugs).
An increase in leukocytes in urine in women is observed during pregnancy.
Symptoms accompanying leukocyturia
Depending on the accompanying symptoms, it can be assumed which pathology caused the increase in the level of leukocytes in the urine analysis.
One of the common causes of an increase in leukocytes in urine is chronic pyelonephritis.
The development of an infectious pathology of the urinary system is evidenced by:
- violation of urination;
- burning sensation, pain when urinating;
- painful sensations in the lower abdomen or in the lumbar region;
- strong smell of urine;
- discoloration of urine, the appearance of mucus, flakes, blood streaks;
- fever, symptoms of intoxication.
Kidney stone disease is accompanied by the following manifestations:
- clouding of urine (possibly the appearance of an admixture of blood, pus in it);
- sharp pain in the lower back with spread along the ureter;
- increased urination;
- violation of the outflow of urine;
- nausea, vomiting;
- temperature increase;
- increased blood pressure.
In acute pyelonephritis, leukocyturia is accompanied by:
- gradually increasing or acute pain in the lumbar region on one side;
- painful urination;
- discoloration and odor of urine;
- clouding of urine, the appearance of an admixture of pus in it;
- nausea, vomiting;
- chills, increased body temperature;
- joint pain.
Signs of chronic pyelonephritis:
- pyuria;
- regular and situational dull back pain of low intensity;
- cloudy urine;
- transient dysuria;
- muscle pain;
- weakness, decreased appetite.
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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