Leukocytes in urine 1 4 what does it mean. General urine analysis. The norms of the general analysis of urine. General analysis of urine, transcript. Urine norms in adults, women and men. The norm of urine in children. Organized sediment is represented

Leukocytes, or white blood cells- protective cells that live in the human body, which are contained in small quantities in all natural fluids, including urine. Elevated leukocytes in the urine or leukocytosis is not an independent disease.

An increase in the level of leukocytes in the urine is a symptom of the disease

Norms of leukocytes in the urine

The allowable number of leukocytes in the urine of a patient depends on his age and gender.

In women during pregnancy, the normal rate can rise to 9-10 leukocyte cells per field of view.

Types of leukocyturia

An elevated level of white blood cells in the urine is called leukocyturia. According to the number of leukocytes, it is divided into 3 groups:

1. Minor: up to 25 white cells. Hue, smell and consistency of urine do not change. The urge to urinate becomes more frequent, discomfort may be observed in the process.
2. Moderate: 25 to 60 leukocytes. Urine changes color to dark orange, becomes cloudy, and may smell bad. Other symptoms: discomfort and pain when urinating, pain in the lower abdomen or lower back.
3. Piuria: more than 60 leukocytes in the field of view. Urine becomes cloudy, acquires an unpleasant odor, a precipitate appears in the form of flakes or threads. There is weakness, nausea and vomiting appear, the temperature may rise.

Leukocytes in urine under a microscope

In addition to numerical values, the analysis form often contains verbal designations for the number of leukocytes. What does this mean and how is it deciphered?

1. "Leukocytes 10-15", "...15-20", "...20-25", "...30-40", "...25-50": from 10 to 50 leukocytes are present in the urine. The value exceeds the norm for any age and gender.
2. "Accumulation of leukocytes": the collected material contains a large number of white bodies, which form a group or several groups in the field of view.
3. “Cover the entire field of view”, “Whole blood cells”: there are so many leukocytes and their clusters in the urine that it is not possible to calculate the exact number.

If the analysis shows the values ​​"0-2-3", "3-4", "4-5", "5-8", "7-10", this indicates the absence of an inflammatory process, or a slight inflammation in the body person.

Causes of an increase in leukocytes in the urine

An increase in the level of cells is influenced by both disorders in the body, diseases, and external factors.

In adult men and women

Why the level of leukocytes in the analysis of urine in adults increases is as follows:

• urolithiasis disease;
• cystitis, urethritis, pyelonephritis;
• glomerunonephritis;
• pyonephrosis and paranephritis;
• amyloidosis;
• inflammation of the appendix;
• tuberculosis of the kidneys;
• chronic allergies;
• dehydration and intoxication;
• diabetic nephropathy;
• lupus nephritis;
• inflammation of the mucous membranes of the genital organs;
• cysts and tumors of the urinary organs;
• taking medications: NSAIDs, antibiotics, diuretics.

There are also specific diseases depending on the gender of the patient:

1. In men: prostatitis, phimosis, balanoposthitis, adenoma and prostate cancer.
2. In women: vulvovaginitis, bartholinitis, adnexitis, thrush, preeclampsia.

With insufficient hygiene of the genitourinary organs and with the wrong technique for taking the material, high levels of white cells in the blood may turn out to be false positive.

Leukocyturia during pregnancy

Monitoring of urine parameters, including leukocytes, is mandatory during pregnancy

During pregnancy and after childbirth, the rate of leukocytes in the urine increases by 3-4 cells. Over 10 white cells in the field of view appear under such conditions:

• pyelonephritis, cystitis, nephritis, glomerulonephritis;
• thrush, vulvitis, vaginitis;
• helminthic invasions;
• urolithiasis disease;
• rheumatoid arthritis;
• neoplasms of the kidneys and genital organs;
• preeclampsia in late pregnancy.

Infections of the genitourinary system are dangerous for the fetus, therefore, when observing such symptoms, it is necessary to see a doctor.

Why is the content of leukocytes increased in a child

An increase in the number of leukocytes in the urine of a child occurs due to the following pathologies:

• diaper rash in the chest;
• kidney damage, including medication;
• pathology of the development of the genitourinary organs;
• reflux of urine into the ureters;
• urolithiasis disease;
• MPS inflammation: cystitis, urethritis, pyelonephritis;
• pinworm infection;
• vulvitis in girls;
• balanoposthitis in boys;
• chronic allergies;
• trauma to the organs of the genitourinary system.

The appearance of leukocyturia in children over 12 years of age occurs for the same reasons as in adults.

What to do with a high level of leukocytes in the urine?

An increased level of leukocytes in the urine is usually treated with medications, alternative recipes and changes in the patient's diet.

Preparations

Treatment of diseases that cause leukocyturia is carried out with the help of antibiotics of different groups, as well as symptomatic drugs.

The antibiotic Ampicillin is prescribed for the treatment of leukocyturia.

Folk remedies

Herbs, berries and seeds with a pronounced anti-inflammatory effect are used as folk methods for the treatment of leukocyturia.

Herbal tea

Add Knotweed to Herbal Tea and Take Before Meals

To prepare this drink you will need herbs:

• motherwort;
• field ivy.

Herbs must be crushed and mixed in equal proportions, and then diluted in a ratio of 1 tsp. mixture in 200 ml of water. The drink is infused for 10-15 minutes, after which it is taken before meals or during meals.

Also 1 tsp. mixtures can be added to a serving of soup or main course.

Birch juice

Birch sap contains natural antibiotics and trace elements that remove decay products of pathogenic microorganisms. It effectively relieves inflammation in the urinary tract and genital organs.

Treatment is with fresh juice taken in the morning on an empty stomach. 1 serving of juice is 100-200 ml.

green bean beans

Green bean beans, a strong antimicrobial agent, will help get rid of leukocyturia.

1. Wash and clean 100g beans.
2. Squeeze the juice out of them manually or with a juicer.
3. Drink on an empty stomach, 1 tsp. for the reception.

Treatment with bean juice lasts 1-2 weeks.

Cranberry tea with lemon balm

Cranberries, lemon balm and tea leaves have strong anti-inflammatory and diuretic effects. The drink is prepared like this:

1. 30 g of cranberries, peeled, washed, mashed in a deep container.
2. Add the resulting puree to the teapot, mix with 2 tbsp. l. tea leaves.
3. Pour the mixture with water, let it brew and use inside.

Lemon balm leaves are added to tea before ingestion. Also, the recipe can be supplemented with raspberry leaves or berries.

Wormwood infusion

Wormwood infusion will help to cope with infections in the body

Wormwood is an effective herb that fights inflammation and infections. The infusion is prepared as follows:

1. Rinse the grass, dry, finely chop.
2. Mix 3 tsp of wormwood with 0.5 l of boiling water, leave for 1 hour.

The infusion is taken orally, 15 drops before each meal.

Flax seed infusion

Flax cleanses the kidneys, fights infection, restores tissues and mucous membranes of the urinary organs. An infusion of it is made according to this recipe:

1. 30 g of dry flax seeds pour 200 ml of hot water.
2. Infuse the drink for 2-3 hours in a cold, dark place.
3. Dilute the mixture with 200 ml of cold water, use inside.

The drink is drunk 4-5 times a day, 50 ml at a time.

Bearberry infusion

Take bearberry infusion to treat urinary tract infections

Increase Vitamin B Foods to Normalize White Blood Cells

During treatment, the patient should drink plenty of clean water, compotes, herbal teas and fruit drinks. Avoid sugary and carbonated drinks.

Elevated levels of white blood cells in the urine- signals about inflammatory processes in the body. This condition is treated with antibacterial drugs - penicillins, nitrofurans, sulfalanamides and quinolines. Antiallergic, antifungal, anti-inflammatory, diuretics, as well as vitamins, probiotics and prebiotics in combination with corrected nutrition help get rid of unpleasant symptoms.

Leukocytes 1-1 in the urine are an overestimated indicator of the content of leukocyte cells in the patient's urine, which indicates the presence of certain diseases of the kidneys or the genitourinary system.

Leukocytes are white blood cells whose main function is to protect the body from infectious, viral attacks and foreign cells. Therefore, if the leukocytes in the urine are elevated, then this indicates an infectious disease or inflammatory processes.

Pathological manifestations

In some cases, a urine test for the number of leukocyte cells is prescribed by specialists if certain pathological processes in the body are suspected. White blood cells in the urine can be elevated with the following diseases:

1. Pyelonephritis is an infectious-inflammatory disease that affects the renal pelvis.
2. Cystitis is an inflammatory process localized in the area of ​​the mucous membrane of the bladder.
3. Nephritis is an inflammatory disease of the kidneys.
4. Urethritis is a pathological process of an inflammatory nature, localized in the region of the urethra.
5. Prostatitis is an inflammatory disease that affects the prostate gland.
6. Inflammatory processes in the genital area.
7. Glomerulonephritis in acute or chronic form is an immunoinflammatory process that affects the renal glomeruli.
8. Amyloidosis is the deposition of insoluble protein in the kidney tissues.
9. Renal tuberculosis - damage to the kidneys of an infectious nature.
10. Lupus nephritis is damage to the kidney tissue.
11. Urolithiasis - the deposition of salts in the kidneys and ureters.
12. Rejection of a kidney transplant.
13. Tumor neoplasms of a benign or malignant nature in the region of the kidneys, ureters or bladder.

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O indicates an increased content of leukocytes

In some cases, when conducting additional studies and diagnostic procedures, specialists fail to detect signs of the above diseases in patients. In this case, leukocytes in the urine can be significantly increased. What does this mean? Most often, such a clinical picture is observed with a latent form of the course of the disease, which is extremely dangerous for the patient's health, since it carries a potential threat to reduce renal function. Usually in such a situation, the patient is assigned additional urine tests, as well as the following diagnostic procedures:

1. Cystography.
2. Ultrasound examination of the urinary tract.
3. Radiography of the kidneys.
4. Ultrasound examination of the kidneys.
5. X-ray of the ureters.
6. CT scan.
7. Cystoscopy.
8. Magnetic resonance imaging.

With the help of the presented studies, the patient can be detected such pathological disorders as reflux - an obstacle to the outflow of urine. In the process of its stagnation, an accumulation of pathogens is observed, which leads to the development of an inflammatory process and explains the increase in leukocytes.

In addition, an increased content of leukocyte cells in the urine may be due to the presence of infectious diseases, sexually transmitted diseases (for example, balanoposthitis, vulvovaginitis, candidiasis, colpitis).

Normal value of indicators

Indicators of the normal content of leukocyte cells in the urine depend on factors such as the age category and gender of the patient. This indicator can also be influenced by some external factors, such as eating food or taking certain medications, psycho-emotional or physical activity. In women, white blood cells may increase in the first 2 trimesters of pregnancy or before the onset of menstruation. However, in most cases they give only minor changes.

The norm indicators are as follows:

1. The normal white blood cell count for men is 0-3.
2. The normal content of leukocyte cells in women is 0-6.
3. In children, leukocytes in the urine may be somewhat elevated. The norm for small patients is 0-8.

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Exceeding the above indicators (1-1) in medicine is called leukocyturia. An excessively high content of leukocyte cells in the urine is called pyuria. This condition is characterized by leukocyte counts of 2-3 and higher. With pyuria, in addition to leukocyte cells, purulent impurities, the appearance of specific flakes, and a change in color are observed in the urine. In most cases, pyuria indicates the development of purulent-inflammatory processes localized in the patient's genitourinary system.

How to prepare for the study

In order to obtain accurate results of a urine test for the content of leukocyte cells, it is necessary to properly prepare for the analysis. First of all, it is important to correctly collect material for laboratory research. For this, the following rules must be observed:

1. For the study, only morning urine obtained immediately after waking up is suitable.
2. Before collecting material for analysis, it is necessary to thoroughly wash yourself, always using soap or shower gel. Neglect of hygiene procedures can lead to the detection of an unacceptably large number of leukocyte cells in the urine.
3. Urine for research is collected in a specially prepared, sterile and dry glass or plastic container.
4. It is necessary to pass urine to the laboratory no later than 1.5 hours after its collection. Until then, the biological material is recommended to be stored in the refrigerator.
5. A few days before the test, you should refrain from carrying out physiotherapeutic procedures, radiographic and ultrasound examinations.
6. Antibiotics should be stopped 2 weeks before the study.

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It is worth emphasizing that compliance with the above simple rules will ensure reliable research results and eliminate the need for re-analysis.

Therapeutic measures

If during the study the patient was found to have leukocyturia or pyuria, he is assigned additional diagnostic procedures to determine the disease that provoked an increase in leukocyte cells. Only if the exact cause is identified, the specialist can prescribe the appropriate competent treatment to the patient, which is necessary to reduce the level of leukocytes to normal levels. In most cases, the patient is prescribed medication, which consists in taking antibacterial drugs and drinking plenty of fluids. A special diet may be recommended, based on the exclusion from the daily diet of spicy, salty, spicy, smoked and canned foods.

If the development of leukocyturia is associated with a disease such as cystitis, then taking healing baths from decoctions of chamomile or eucalyptus and following a special diet will help stabilize the situation.

If the leukocytes in the urine are elevated due to the development of renal tuberculosis, then the patient will need complex long-term treatment. Usually, adequate drug therapy is sufficient, but in especially complex and advanced cases, surgical intervention may be necessary.

With urolithiasis, the patient is prescribed a special drug treatment in conjunction with a diet. In some cases, it may be necessary to carry out a special operation, which consists in crushing salt deposits using ultrasound.

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Elevated white blood cells in the urine are an alarm signal indicating the presence of inflammatory processes or infectious diseases that affect the genitourinary system.

If the number of such cells in the urine exceeds the norm, additional studies are needed to determine the exact cause of the violation and determine the optimal therapeutic course.

Leukocyturia is a condition in which the content of leukocytes in the urine exceeds normal levels (ICD code 10 - N39.0). In connection with the anatomical and physiological features, women's norms differ from men's.

As you know, white blood cells perform a protective function in the body, so their number increases with urinary tract infections. You can detect their high level with the help of a general urine test and some additional samples.

Show all

1.

Classification

There are different types of leukocyturia:

1. 1 By origin (topographically): true leukocyturia (an increase in the number of white blood cells in the urine due to inflammation of the urinary tract or for other reasons), false (if the material for analysis is contaminated). The reasons for a false positive result may be non-compliance with personal hygiene, the use of dirty containers, infection of the genital organs.
2. 2 By sterility: bacterial (always associated with the presence of infection) and aseptic (autoimmune kidney damage in systemic lupus erythematosus, glomerulonephritis, allergic reactions, taking certain drugs, urolithiasis).
3. 3 According to the number of leukocytes detected: small (up to 40 in the field of view), moderate (40-100), significant (with the release of 100 or more cells, pyuria occurs). Pyuria is the discharge of pus in the urine, the number of white blood cells can reach 500 or more.
4. 4 According to the cellular composition: neutrophiluria, eosinophiluria, lymphocyturia and so on. For a qualitative determination of the elements, another study (urocytogram) is necessary, it allows to evaluate only the total number of leukocytes.

True leukocyturia can be of renal origin, when the inflammatory process is localized in the kidneys and leukocytes enter the urine from there. Other options are cystic and urethral leukocyturia.

It can be very difficult to assess the topographic affiliation of the infection; additional instrumental examinations, anamnesis and patient complaints help here. The appearance of cylinders in the urine, as a rule, is observed with pyelonephritis.

Sometimes a high cell count in the absence of bacteria in the urine can be mistakenly regarded as aseptic leukocyturia. It should be remembered that some types of infection cannot be detected by conventional, routine methods (, ureaplasma, Koch's wand).

2. Causes

An elevated level of leukocytes in the results of the analysis can be determined not only in infectious diseases of the urinary tract. The following are the most common pathologies not associated with kidney disease:

1. 1 Taking medications (cephalosporins, some antihypertensives, non-steroidal anti-inflammatory drugs, immunosuppressants).
2. 2 Inflammation of the genital organs (adnexitis, vaginitis, cervicitis in women, prostatitis in men).
3. 3 Inflammation of adjacent pelvic organs (appendicitis, hemorrhoid thrombosis).
4. 4 Damage to the urinary tract (kidney contusion, bladder rupture and other injuries).
5. 5 Pregnancy (distinguish between transient leukocyturia during pregnancy and an increase in the level of leukocytes due to urinary tract infection). Pyelonephritis often develops in late pregnancy.
6. 6 Oncological process.
7. 7 Allergic diseases (angioedema, urticaria, bronchial asthma).
8. 8 Acute poisoning, intoxication (intestinal infection, pneumonia, mushroom poisoning, salts of heavy metals, drugs, alcohol).
9. 9 Large loss of fluid (dehydration due to diarrhea, vomiting, drinking sea water, prolonged exposure to the sun and overheating can cause high leukocyturia).

Despite this, the leading causes still remain inflammatory diseases of the urinary system:

1. 1 Pyelonephritis (inflammation of the interstitium, calyces and pelvis of the kidney). In chronic pyelonephritis, leukocyturia is noted in 25% of cases.
2. 2 Cystitis and urethritis.
3. 3 Urolithiasis (ICD).
4. 4 Malignant diseases of the kidneys.
5. 5 Glomerulonephritis (immune lesion of the renal glomeruli).
6. 6 Paranephritis (inflammation of the perirenal tissue, a complication of pyelonephritis).
7. 7 Abscess of the kidney (limited accumulation of pus).
8. 8 Amyloidosis (deposition of a special amyloid protein with subsequent damage to the structure of the kidneys).
9. 9 Polycystic.
10. 10 Tuberculosis of the kidneys (with an increased content of lymphocytes in the urocytogram).
11. 11 Nephropathy (diabetic, lupus, pregnant).

2.1. Leukocytes in urine in children

The reasons for the high content of leukocytes in the results of a urine test in a child can be any of the pathologies listed above, but the likelihood of some of them is extremely low. For example, prostatitis, bladder cancer, adnexitis in childhood practically do not occur.

In children under one year old, the detection of a large number of leukocytes in the urine is more often associated with diaper rash, diathesis, allergic reactions to foods or milk formula, congenital malformations of the urinary tract and their subsequent infection.

After a year, babies often develop cystitis, pyelonephritis, vulvitis (in girls) and enterobiasis. In the older age group, the causes of such deviations in the test results are the same diseases, as well as glomerulonephritis, vesicoureteral reflux, trauma, appendicitis, and other conditions that occur in adults.

3. Diagnostics

3.1. General urine analysis

The most common analysis used in all clinics. In addition to determining the color, transparency, density, the presence of protein or sugar, it is also carried out (counting the number of epithelial cells, erythrocytes, leukocytes). If more than 6 leukocytes are found in women or more than 3 in men, they speak of leukocyturia. Children's norms are shown in the table above.

3.2. Nechiporenko test

Designed to determine the number of cells in 1 milliliter of an intermediate portion of morning urine. The detection of no more than 2 thousand leukocytes is considered the norm. The Nechiporenko test is able to detect an asymptomatic urinary tract infection.

3.3. Sample Ambourzhe

Urine for research is collected in the morning, 3 hours after the first urination. The day before the test, it is necessary to limit fluid intake; you can’t drink water at night before the test. The Amburge test shows the number of formed elements released per minute. The norm is not more than 2 thousand leukocytes.

3.4. Addis-Kakovsky test

The essence of the method is to collect all portions of urine allocated per day. Then, a small amount of material is taken from the resulting volume to determine the number of leukocytes, which is converted to a daily value. Normally, no more than 2 million cells are excreted per day.

3.5. Three glass sample

The purpose of the study is to identify in which part of the urinary tract the focus of infection is located. To do this, they collect: an increased content of leukocytes in the first indicates a pathological process in the lower urinary tract (urethra), in the second and third - inflammation in the bladder or kidneys. In men, prostatitis is possible.

4. Management of patients with leukocyturia

In most patients, the appearance of an excessive number of leukocytes in the urine is combined with any symptoms of diseases.

To clarify the diagnosis, it is important to pay attention to the number of other cellular elements in the urinary sediment (erythrocytes, granular and hyaline casts, epithelium), sugar and protein levels, color, density, and the presence of salts.

If necessary (the border between the norm and pathology, suspicion of an erroneous result), the doctor will prescribe a second urine test or additional samples.

Additional instrumental or laboratory diagnostic methods help to clarify the localization of the inflammatory process: ultrasound examination of the urinary system and pelvic organs, blood tests, urine culture. Important, this will help to avoid diagnostic errors and repeated trips to the clinic.

Pathology can occur anywhere in the urinary system, so it is believed that an increased content of leukocytes in the urine is a reliable sign of a pathological process.

Leukocytes in the urine is an important indicator that carries information about the state of the body. A general urinalysis is a laboratory test that is prescribed by doctors of any specialty. The study of urinary sediment allows you to identify various cells that are excreted from the body with urine. Among these elements, leukocytes are often detected, which indicate an inflammatory process. The norm of this indicator, the reasons for the appearance in the analyzes, allowing to clarify the diagnosis, in each case, you need to check with the doctor who recommended the examination.

Regulatory indicators

Urine is a liquid sterile medium in which various substances are dissolved. The kidneys continuously undergo processes of filtration, reabsorption and secretion, which ensure the removal of excess water and unnecessary compounds from the body.

Collecting in the renal pelvis, urine reflexively flows down the ureters to the bladder. From there, through the urethra (urethra), it is released outside during urination (miction).

In inflammatory processes of infectious and other origin, a large number of immune cells and, in particular, leukocytes, which perform a protective function, are concentrated at the site of injury.

Pathology can occur anywhere in the urinary system, so it is believed that an increased content is a reliable sign of a pathological process.

It is generally accepted such a norm of leukocytes in the urine of an adult and children:

• men - 2-3 uniform elements in the field of view (in p/z);
• women - up to 6 in p / s;
• girls - 6–10 in p / s;
• boys - up to 7 in p / s.

If the level of leukocytes in the urine is above 60 elements, then a conclusion is made about pyuria, that is, it has a purulent character.

It has been established that a slight excess of the content of leukocytes is permissible under certain conditions and is not a sign of a disease of the urinary system. The difference in indicators depends on the anatomical and physiological differences in the urogenital tract in men and women (the urethra is wide and short, the outlet is located close to the genital tract).

In children, in addition to morphological and gender differences, the number of formed elements in the urinary sediment depends on the functional maturity of the organs.

Causes of leukocyturia

The reasons why the levels of leukocyte cells in the urine increase can be pathological processes of both the urinary system organs and conditions caused by extrarenal factors.

Elevated leukocytes in the urine in an adult can be determined with the following lesions of the urinary system:

• pyelonephritis acute and chronic;
• urolithiasis disease;
• cystitis;
• urethritis;
• glomerulonephritis;
• nephritis of non-infectious origin (lupus, interstitial);
• kidney tuberculosis;
• nephrosclerosis;
• amyloidosis;
• tumor formations;
• infectious lesions of the ureters.

In addition, in women, the causes of leukocyturia can be

• gynecological infections (trichomoniasis, mycoplasmosis, chlamydia);
• vulvovaginitis;
• adnexitis - inflammation of the uterine appendages;
• bartholinitis - damage to the glands of the vestibule of the vagina.

In men, an increase in leukocytes in the urine sediment may be due to

• prostatitis;
• balanoposthitis - inflammation of the glands at the outer edge of the urethra;
• adenocarcinoma of the prostate;
• phimosis - narrowing of the foreskin;
• prostate adenoma;
• sexually transmitted infections.

White blood cells are found in the urine sediment due to such factors:

• excessive physical activity (especially static, due to weight lifting);
• fever;
• taking antibiotics (penicillins, aminoglycosides);
• treatment with non-steroidal anti-inflammatory drugs (Ketoprofen, Diclofenac, Indomethacin);
• the use of radiopaque substances;
• the use of iron preparations.

Often the results are distorted due to poor hygiene before urine collection and the use of a non-sterile container.

Tests to detect leukocyturia

The screening method that detects leukocytosis in the urine sediment is a general analysis. According to its results, organoleptic and physico-chemical properties are studied, and microscopy of the sediment obtained by centrifugation allows determining the cellular composition.

To clarify the diagnosis or identify hidden leukocyturia, specialists can use other laboratory methods and samples:

• research on Nechiporenko;
• test of Addis-Kakovsky;
• analysis according to Amburge;
• detection of "active" leukocytes;
• prednisone test.

An analysis according to Nechiporenko allows you to determine how elevated leukocytes, erythrocytes and cylinders. For the study, 1 ml of urine obtained from the average portion of morning urine is required.

Methods for determining the formed elements and cylinders of the urinary sediment according to Addis-Kakovsky are not used so often, since prolonged urine collection leads to the destruction of leukocytes. Within 12 hours, urine is collected in one container and delivered to the study. Laboratory assistants analyze the composition of the sediment and recalculate for 24 hours. The method is the most reliable and allows you to identify hidden inflammatory processes in the kidneys.

The Amburge analysis allows you to estimate the number of leukocytes and other elements excreted in the urine in 1 minute. A microscopy of the sediment obtained from a urine sample collected 3 hours after the first urination is carried out.

Identification of "active" or "live" leukocytes is indicated for pyelonephritis. With a decrease in the relative density of urine, "active" white blood cells that are released from the inflamed kidney can transform into Sternheimer-Malbin cells. If the density of the liquid increases, then they will again turn into "living" forms. For testing, distilled water and dye are added to the urinary sediment. Then microscopy is performed, where the percentage of "active" cells relative to the total number of leukocytes is calculated.

Sometimes kidney disease has an erased clinical picture, and laboratory results remain within the normal range. In order to detect leukocyturia, a prednisolone test is performed. Analyze the urinary sediment before the introduction of prednisolone and after (three times every hour). The test is considered positive when leukocytes appear, or if their concentrations are elevated.

The doctor should interpret the test results. But normally, their number should not interrupt the indicator of 5 leukocytes in any analysis.

Types of leukocyturia

In an adult, several types of leukocyturia are distinguished, which can be divided depending on the source of origin, association with infection and quantitative expression.

Thus, leukocyturia happens:

• true (explicit and hidden);
• asymptomatic;
• false;
• infectious and non-infectious;
• insignificant;
• moderate;
• expressed.

If leukocytes are reliably detected in the urine sediment by laboratory diagnostic methods, then a clear true leukocyturia is confirmed. If provoking methods (for example, a prednisolone test) were used to identify it, then it is considered hidden.

Asymptomatic leukocyturia is characterized by laboratory changes without an obvious clinical picture. This form can be detected in diseases with an erased course, in newborns, pregnant women, after physical exertion or taking medications.

Urine tests show false results if the inflammation is localized outside the organs of the urinary system. So, with diseases of the genital area, leukocytes from the genital tract enter the material for analysis.

With infectious leukocyturia, bacteria, erythrocytes and leukocyte cylinders can be simultaneously detected in the biomaterial. If white blood cells appear in large numbers due to non-infectious damage to the kidneys and other parts of the urinary system, for example, with lupus, then a conclusion is made about non-infectious leukocyturia. The number of leukocyte cells can be insignificant (10–15 per p/s), moderate (20–50 per p/s) and pronounced (60 or more per p/s).

What to do

If abnormalities are found in the results of the urine test, the doctor prescribes the following tests to obtain reliable data and clarify the localization of the pathological focus:

• repeated delivery of urine in compliance with the collection technique;
• daily collection of urine for analysis according to Addis-Kakovsky;
• urine culture to determine bacterial flora and sensitivity to antibiotics;
• carrying out a three-glass test.

The three-glass test is a simple method to determine the localization of the focus in the urinary system. For women, a two-glass test may be used. Urine is collected in three sterile containers. The first is filled with the anterior portion of urine, the second with the middle portion, and the third (in men) after prostate massage.

An increase in the content of formed elements in the first glass is a sign of inflammation in the urethra. Elevated white blood cells of the middle portion mean damage to the bladder or kidneys. A high content of leukocyte cells in the third glass is a sign of inflammatory damage to the prostate.

It is not advisable to start treating leukocyturia without finding out the cause, since it is only one of the manifestations of the disease. Therapy should be comprehensive and aimed at eliminating the underlying inflammatory process.

How to pass a urine test

The correct technique for collecting urine for analysis can significantly reduce the severity of leukocyturia or completely eliminate it. This requires a sterile container, which is desirable to purchase at a pharmacy.

The day before the analysis, you should reduce the amount of fluid you drink to 1.5 liters and exclude such foods and drinks from the diet:

• sorrel;
• spinach;
• spicy seasonings;
• poultry meat;
• offal;
• alcohol (red wine);
• chocolate and cocoa;
• coffee and strong tea.

Before the analysis, it is necessary to coordinate with the attending physician the temporary cancellation of certain antibacterial agents, hormones, NSAIDs. It is important to exclude heavy physical labor the day before.

For general analysis, the entire first morning urine is collected. Before micturition, the toilet of the genitals and perineum should be carefully carried out. Women with heavy vaginal discharge or menstruation should insert a cotton swab into the vagina.

Reliable results of additional laboratory diagnostics will help to cure inflammation of the urinary system in a timely manner.