Phosphate salts. Phosphaturia or amorphous phosphates in the urine: causes of formation and methods for correcting the indicators of structureless salts in urine. Test preparation
By the composition of urine, one can judge which elements the body retains for its own purposes, and which it removes. This process is not always physiologically justified. In diseases of the urinary system, a violation of the filtration function is possible, followed by a loss of protein, red blood cells, and glucose.
An increase in the breakdown of biochemical compounds leads to the appearance of salts in the urine - oxalates, urates and phosphates. The appearance of phosphates in the urine always requires clarification of the cause. If salts in the urine test are a fickle phenomenon, then it can be associated with dietary excesses and the body's desire to remove an unnecessary amount of phosphorus.
Nutrition and amorphous phosphates in urine
If a unusual color detected for a urine sample, one of these conditions may be the cause. Once the cause is identified, it should be noted in the laboratory results. Some abnormal urine colors and their possible reasons.
- Red blood, laxatives such as senna, beets and rhubarb.
- Black - melanin in patients with melanoma.
- Brown - bilirubin in patients with obstructive jaundice.
- Green - drugs, chlorophyll in mouthwash.
Upon detection increased amount in several repeated studies, it is necessary to seriously think about the causes of the problem. Violations of phosphorus-calcium metabolism create favorable conditions for the multiplication of pathological bacteria in the urine, lead to urolithiasis. The presence of phosphate salts in the urine should be considered as a warning signal of future pathology.
Preanalytical variables that may affect culture and sensitivity testing include. A sample with a net catch in the middle of a stream is less likely to create contaminants compared to random urine. It has been recorded that pollution levels for women are twice as high as those for men. Each facility must determine its own level of contamination based on the patient population and authorized collection and transport methods. When there is a delay in transporting samples, samples that are not processed immediately, left unrefrigerated, or do not have a bacteriostatic preservative may contain bacterial growth causing colony counts that can be almost impossible to read.
- Container for collecting dirt.
- Outside sources bacterial infection include hands, skin and clothing.
- False-negative growth is observed in patients taking antibiotics.
How are phosphates formed?
Phosphates - chemical substances, which are formed in nature as a result of the reaction of phosphoric acid with alkaline solutions enter the body mainly with food. Phosphorus is a valuable element. Up to 85% of phosphates are in bone tissue, teeth. The rest is accounted for by:
- muscles (including myocardium);
- medulla;
- RNA and DNA of every cell.
For physiological action, phosphorus must necessarily be associated with calcium, only together they provide:
Interim samples provide the most valuable information for the concentration of a particular analyte. Some of the preanalytical variables that affect these tests are redundant for those used for urinalysis. Exist various factors, which can affect any of these analytes. The most common factors are preservatives, diet, and medications. More specifically, some of the drugs and foods that affect urine chemistry results are as follows.
An increase in sodium results can be caused by antibiotics, cough medicines, or laxatives. Increased measurements can be observed with diuretics, salicylates, or glucocorticoids. Creatinine is increased with hematamicin or chemotherapy agents heavy metals. Calcium shows an increase in antacids, anticonvulsants and some diuretics, while adrenocorticosteroids and oral contraceptives cause a decrease. On the total protein urine affect heavy physical exercises, dehydration, nutrition and emotional stress. It can be increased with acetaminophen, antibiotics, and radiopaque media. Glucose can be increased with lithium, estrogen, diuretics, chloramphenicol, and ascorbic acid. Uric acid is affected by high levels ascorbic acid, x-ray contrast media, alcohol, anti-inflammatory drugs, salicylate and warfarin. Bilirubin is reduced by mild and ascorbic acid and can be increased with antibiotics, diuretics, oral contraceptives, sulfonamides, and steroids. Amylase can be increased with aspirin, corticosteroids, codeine, and oral contraceptives. It can be reduced with heparin, methyldopa, and tricyclic antidepressants. Some of the common adjuvants are: water, bleach, eye drops and vinegar. Urinalysis and collection, transportation and storage of urine samples; Approved Manual - Second Edition.
- Decreased sodium results will be seen with diuretics.
- Diet can also affect potassium.
- Chloride is falsely reduced by androgens, estrogens, methyldopa, or cortisone.
- It is falsely increased by bicarbonates or corticosteroids.
- Microalbumin is affected by dehydration or strenuous exercise.
- Porphyrins are affected by morphine, oral contraceptives, and sulfonamides.
- Some of them also apply to porfibilinogen.
- Catecholamines are affected by chocolate, cocoa, coffee, tea, bananas and vanilla.
- They also suffer from stress and exercise.
- They can be increased with lithium, insulin, tetracycline, and nitroglycerin.
- Catecholamines can be reduced with salicylates and imipramine.
- Commercial adjuvants can be bought.
- A common intervention in urine drug testing is poppy seeds.
- They can cause false positive opiate screens.
- Samples must be cooled prior to testing.
- Analysis of urine and body fluids: color text and atlas.
- Handbook of Routine Urinalysis.
- the process of muscle contraction;
- protein synthesis and vital enzymes.
What are "amorphous phosphates"?
Amorphous (am) phosphates is a salt precipitate that does not form into crystals. They do not have a typical structure, but can form stones.
Phosphates are more common in children under five years of age and during pregnancy.
Urine clarity may be related to sample processing conditions. If the urine sample is old and unprotected, it may become cloudy from bacterial overgrowth. In turn, if the sample is stored in a refrigerator, amorphous urates or phosphates can cause temporary cloudiness. Amorphous urates are seen in acidic urine and amorphous phosphates are found in alkaline urine. Sample collection time and storage conditions should be reviewed to determine if cloudiness may be due to storage conditions.
Diet of pregnant women with phosphaturia
Other causes of cloudy patterns include talcum powder, mucus, crystals, white blood cells, epithelial cells, and fat. Clear tubes are best for examining urine clarity. Result reports should be standardized, with clear, hazy, cloudy, and hazy being the most commonly used descriptors. Specific gravity, or the amount of dissolved particles in a solution, is another measurement taken on urine. The specific gravity depends on the amount, quantity and weight of the dissolved substances in the sample.
If amorphous phosphates in the urine are determined in pregnant women and children, this means that the main reason is:
- immaturity of metabolic processes;
- temporary hormonal changes causing a decrease in the acidity of urine.
Amorphous phosphates accompany in urine alkaline reaction urine. It often occurs when:
- lack of animal protein in the diet (vegetarianism);
- drinking alkaline mineral water.
In the diet, protein norms must be observed for:
It serves as a measure of the ability of the kidneys to dilute and concentrate urine. Normal random urine has a specific gravity range of 001. Dehydration, sweating, diarrhea, radiopaque dyes, and antibiotics can produce high results because the ratio of solutes to low volumes of solute will be elevated. High fluid intake or diuretic intake can cause low measurements due to low quantity dissolved particles in a large volume of solute.
The pH test shows if the sample is acidic. Some crystals exist either in acidic or in alkaline environment. Some examples of these are oxalate crystals uric acid or calcium in acid urine and calcium carbonate or magnesium phosphate in alkaline urine. Diluted and alkaline urine can dissolve casts and cells. More low levels pH may be observed in uncontrolled diabetes or may reflect dietary high content meat or cranberries. Hunger and diarrhea can cause more acidic urine.
- adults - 1–1.2 g / kg of body weight;
- children - 3-4 g / kg.
Pathophysiological mechanisms of phosphorus metabolism disorders
The retention of phosphorus compounds in the blood occurs in primary departments(proximal) renal tubules. With urine, up to 12% of phosphates are excreted through filters. With a large amount, excretion is enhanced.
Hormones activate phosphate reabsorption:
Preventive measures are easy
Protein is a very important analyte measured in urine as it controls kidney function. A normal urine sample should not contain more than a trace amount of protein. Most reagent pads primarily measure albumin and, to a lesser extent, other proteins. Remainder disinfectants in contaminated urine containers may lead to false positive protein results. Similar false positives can be observed after strenuous exercise and in severe alkaline urine. High specific gravity urine samples may give results.
- pituitary somatotropic hormone;
- thyroxine;
- cholecalciferol.
Calcium retention is affected by:
- thyrocalcitonin;
- parathormone;
- calcitriol.
Accordingly, they contribute to the excretion of phosphorus into the urine (phosphaturia).
Why does phosphaturia occur?
The causes of phosphaturia can be physiological factors:
How to find out about phosphate stones?
Diluted samples, fever, mental stress, mucus, and exposure to extreme heat or cold can lead to salsagio protein results. Blood is another measurement at the level of the dipstick with urine, detection of intact red blood cells, free hemoglobin and myoglobin. A normal urine sample is usually negative for blood. False positive effects may be caused by the presence of chlorine bleach, the consumption of colored drugs by the patient, or a microbial peroxidase reaction from the presence of bacteria.
- a sharp decrease in the amount of protein food in the diet (vegetarianism), various restrictive diets;
- passion for seafood, fish;
- abuse of fast food, synthetic food additives, canned food;
- the state of pregnancy in women;
- deacidification gastric juice due to the use of a significant amount of water in the heat - when alkalized, phosphorus actively forms compounds with acidic residues, salt conglomerates or stones appear in the urine.
Learn more about education phosphate salts in the urine and danger to the expectant mother is possible.
False positive contaminants can also be introduced during collection, such as in samples submitted by women during menstruation. A normal urine sample is negative for nitrite. Some of the ways in which there may be positive results, include bacterial growth in samples that have not been properly stored, colored drugs and dyes. The conversion of nitrate to nitrite takes about 4 hours in the bladder. If this does not happen, the results may be negative for the presence of nitrite, which can be seen in randomly collected samples.
Pathological causes are observed with:
- poisoning with phosphorus compounds;
- fluid loss from frequent vomiting and diarrhea;
- de Toni-Debre-Fanconi disease ( congenital pathology renal tubules)
- acidosis of the renal tubules with inflammation;
- decrease in filtration rate and stagnation in the glomeruli of the kidneys (more salts are formed) in chronic renal failure;
- fluctuations in the content of phosphorus in the blood;
- urolithiasis;
- chronic or severe acute inflammation Bladder;
- hyperfunction of the parathyroid glands.
Causes of Phosphaturia Specific to Children
With phosphates in the urine found in the analysis of a child, first of all, the question arises to parents about proper nutrition. Perhaps children use a lot of:
Leukocyte esterase is an indicator of leukocytes. It is usually normal in normal specimens. False positive reactions may occur during collection Containers have been contaminated with chlorine bleach or other oxidizing detergents. Other factors that can lead to false positive results include formalin as a preservative and vaginal discharge. High specific gravity, some antibiotics such as tetracycline and a large number of glucose or ascorbic acid may cause false negative leukocyte esterase results.
- sweet soda;
- milk and fermented milk products(yogurt, cottage cheese);
- salinity and preservatives;
- fast food.
Until the age of five, phosphates form and are determined inconsistently. It is very important to notice regular phosphaturia in children in time. It may mean that:
- hereditary pathology - phosphate-diabetes;
- rickets.
Manifestations of rickets in children are found on the x-ray
Glucose, another urine test, is mainly used to monitor diabetes. Normal urine tests are negative for glucose. Some normal specimens have a small amount of glucose levels that are below the reagent band sensitivity level. leukocyte esterase, false positive glucose results are achieved when prefabricated devices are exposed to chlorine bleach or detergents. It has been noted that improper storage of reagent strips when exposed to air causes false positive results.
Treatment of this disease will require:
- special diet;
- taking vitamin D for replacement purposes;
- monitoring the presence of amorphous phosphates in the urine every 2 weeks.
What are the signs of phosphaturia?
Phosphorus in urine is determined only laboratory methods. But you can suspect phosphaturia by the following signs:
For reliable results, it is recommended
Over time, at room temperature, glucose will decrease due to glycolysis from bacteria. Tetracycline has been found to cause false negative glucose results, and refrigerated samples that cannot reach room temperature, may give false negative results because it interferes with the enzymatic reaction. Ketone bodies are by-product breakdown of fat. Normal urine tests are negative for ketones. An increase in ketones can be caused by hunger or alcoholism.
- urine becomes cloudy, small flakes are visible in the sediment;
- a person has intermittent dysuric phenomena (increased urge to urinate, cramps);
- in lumbar region possibly a feeling of heaviness or unilateral pain;
- pain is associated with physical activity, irradiation in the groin;
- gases accumulate in the intestines and bloating, spastic pains are observed;
- nausea occurs, vomiting is possible.
How to find out about phosphate stones?
The process of formation of stones in the urinary system is called urolithiasis. It precedes nephrolithiasis. Phosphate urolithiasis is suspected when detected in the analysis high concentration in the urine sediment of amorphous phosphates.
When conducting a general analysis, the nature of the salts must also be indicated in the conclusion. Yes, in acidic environment oxalates and urates are formed, and in alkaline - phosphates. They look under the microscope as small "heaps" or completely cover the entire field of view. For more detailed analysis the doctor prescribes the collection of daily urine.
The formation of large phosphate stones can be confirmed by renal ultrasonography.
How to collect urine for the determination of phosphates?
To perform a quantitative analysis for salts (not only phosphates, but also of other origin), daily urine is needed. To obtain reliable information, you will have to follow a few rules:
- a week before the collection, refuse to eat spicy foods, canned food, smoked meats, sweets, alcohol, carbonated drinks;
- prepare glass jar the desired volume, rinse it well and rinse with boiling water;
- start collecting material from 6 o'clock in the morning with a complete emptying of the bladder;
- before each urination, wash the external genitalia well with soap, make sure that soap solution did not hit the bank;
- store the container with urine in a dark, cool place in a closed state (but not in the refrigerator);
- the next day at 6 o'clock the collection stops;
- urine in a jar is gently shaken;
- pour about 100 ml of urine into another small sterile container (you can buy it at a pharmacy) and close it with a tight lid;
- on the reverse side directions to write the total volume of urine excreted per day;
- the jar must always be closed with a lid, since the substances contained in the urine are oxidized in the air;
- to the opening medical institution the analysis must be delivered to the laboratory; it is not recommended to store it even for several hours.
Do not forget to sign the container, put down the date
How to identify the relationship of phosphaturia with nutrition?
If phosphates appear in the urine in response to alkalization with food, then they can be eliminated with the help of a special diet. From the diet you need to exclude everything that contributes to the alkaline reaction:
- alcohol in any form, carbonated water;
- products from sour milk(cottage cheese, yogurt, curdled milk);
- all sweets and confectionery;
- fatty meat and fish;
- rich meat broths;
- salo;
- butter and animal fat;
- sausages;
- chips, crackers with added flavorings;
- reduce salt intake to 2 g per day, while taking into account salting during cooking.
Chips contain synthetic flavors, preservatives that increase appetite, negatively affecting the body
- for drinking - rosehip broth, weak coffee or tea, fresh unsweetened juices;
- the use of cereals for making cereals;
- legumes (peas, beans, lentils);
- boiled potatoes;
- squash vegetables (cucumbers, zucchini, pumpkin);
- carrot;
- bell pepper;
- meat and fish of low-fat varieties;
- eggs and cheese limited;
- increase the volume of consumed fruits and berries (apples, plums, grapes, currants, figs);
- eat a handful of nuts daily.
The duration of the diet is from one to two weeks. After that, you need to re-pass the analysis of daily urine. If phosphates are not found, then further control salt balance the patient will be able to use the restrictions of certain products. If phosphaturia is confirmed again, you should consult your doctor about the necessary measures.
How is the treatment carried out?
Phosphaturia therapy is considered as, chronic inflammation kidneys, urethra, bladder.
Patients convinced of the benefits of vegetarianism have to prove and justify the harm caused, explain why a transition to a varied diet is required.
Examination of the patient for hormones shows whether there is an effect of an altered balance. If hormonal changes are detected, then the endocrinologist prescribes maintenance replacement treatment.
With existing kidney diseases with symptoms of insufficient filtration, dialysis helps in therapy.
Babies may be associated with vitamin D deficiency. They are prescribed vitamin drops, walks in the sun.
For any reason, it is useful to observe drinking regime, the patient needs to flush out the accumulated salts from the urinary system. Therefore, it is recommended to drink up to 2.5 liters of water per day.
The detection of phosphates in a random analysis should not go unnoticed. To prevent subsequent diseases of the urinary organs, the patient must know what threatens him with salt in the urine. Doctor's advice, diet can get rid of serious problems in future.
A person bears some diseases for years, not even knowing about their existence. Truth, Attentive attitude to your well-being and health helps to recognize the danger in time. For example, the cloudy color of urine signals the presence of phosphates in its composition and, as a result, the development of a disease called phosphaturia.
It's time to get confused and panic, because not each of us clearly understands what phosphates and how exactly these substances affect the body. But, as you know, you need to know the enemy in person: for successful treatment disease, you need to collect as much information about it as possible.
Phosphates in the urine - dangerous or not
Phosphates are salts that are formed as a result of the interaction of phosphoric acid with bases. We encounter these substances every day: just look at the information contained in the packaging of one or another food product. E339 is the encrypted name of sodium phosphate, E341 is calcium phosphate, E450 is pyrophosphate ... Penetrating into the body, phosphates are broken down into several constituent elements, the main of which is phosphorus.
Like others minerals Phosphorus is of particular value to humans. So, enough This element ensures healthy activity of the muscles (including the heart), as well as the brain. Phosphorus is fundamental structural element phospholipid cells, and also takes part in all processes of multilevel metabolism and in the synthesis of molecules of some enzymes.
You should not be afraid of a deficiency of phosphorus in the body - in the course of research it was reliably established that together with food we get this substance in excess every day. Many of us can't always resist a sausage sandwich, hot dogs, canned food, and sweet soda. And meanwhile, all this food differs in the high content of phosphates. The harm of excessively incoming phosphates is obvious - on this basis, the processes of assimilation of such important substances for health as calcium, magnesium and iron are disrupted in the body.
In addition to eating foods rich in phosphates, The Medicine Lists other causes of phosphaturia:
- a sharp change in diet (strict long-term diet, vegetarianism);
- regular consumption of foods high level phosphorus content;
- disorder of the exchange of inorganic elements;
- pregnancy.
Features of the diagnosis of phosphaturia
To confirm or refute suspicions about phosphate salts in the urine, do general analysis urine. If the study shows that the acidity of urine is less than 7 units, this indicates the presence of a specific substance in its composition. Also, the patient may be prescribed a daily urine test for the presence of salts, which will allow the doctor to assess the quality of the urinary system as a whole. For the reliability of the results, 1-2 days before the proposed analysis, you can not train intensively, eat food with a pronounced taste (salty, spicy dishes), drink alcohol and smoke a lot.
Phosphaturia as a symptom
Confirmed laboratory analysis phosphaturia is often a guide to further investigation. The presence of phosphates and other salts in the urine may be a sign of a number of dangerous diseases. We list some of them:
Phosphate diabetes is a pathology caused by a genetic breakdown. The problem lies in the violation of the metabolism of enzymes, with the participation of which in renal tubules phosphates are absorbed. As a result of the disease, urine is saturated large quantity crystals while the blood loses them. The disease manifests itself from childhood and is expressed by curvature of the limbs and deformity of the joints.
- Syndrome de Tony-Debre-Fanconi. it congenital disease is inherited. Against the background of a decrease in the amount of phosphates, it develops like rickets.
- Hypophosphatemia. The disease develops when phosphates are not fully absorbed by the body. In most cases, the cause of this disorder lies in the abuse of alcohol and dysfunction of the gastrointestinal tract.
- Hyperphosphatemia. The main symptom of the disease is an excess of phosphates in the body.
- . The pathology is based on the formation of kidney stones due to the presence of phosphates and other salts in the urine.
Phosphate in urine during pregnancy
The appearance of salts in the urine of a pregnant woman is due to her position, and therefore is considered acceptable. The saturation of the urine of the expectant mother with phosphates occurs on the basis of an increase in the concentration of progesterone in the blood. This means that the woman's body is too relaxed at this time to filter, remove urine and prevent the formation of salt sediment in it. To ensure a more productive outflow of urine, expectant mother walk regularly and drink more water.Phosphaturia in children
This phenomenon is quite rare, and manifests itself in babies mainly up to 5 years. The presence of phosphate in infant urine indicates low acidity, which is formed if the child consumes a lot of fish, caviar, buckwheat, milk and other foods high in phosphorus. Crash in children's body occurs due to the imperfection of the regulatory processes on which the exchange depends inorganic substances. The appearance of phosphates in the urine of a baby can also be triggered by vomiting, high temperature and gastric lavage.
Development of symptoms of phosphaturia
On the initial stage the development of pathology, you can guess that something is wrong in the body, you can by suspicious turbidity of urine. If you do not seek clarification from the hospital in time, other signs of the disorder appear. The person may experience discomfort frequent urination, aching pain in the lumbar region, which increases several times after a power load, vomiting, nausea, colic, false calls to the toilet "in a small way."
How to solve a problem
As already noted, the presence of salts in the urine does not yet indicate serious illness for sure, but consultation with a competent specialist is needed in any case. the main task patient now - to immediately respond to this signal of the body, without waiting for the salt crystals to transform into a problem in the form phosphate stones in the kidneys.
Medical therapy for initial stage disease is not yet justified. Tablets are used in case of formation of kidney stones. The first thing to change in such a situation is to review and adjust your diet. It is best to discuss the specifics of the new diet with your doctor, since the diet for each patient will be individual. For example, a child who is found to have phosphate in their urine is likely to be given regular vitamin D supplementation and constant control salt content in urine.
Absolutely all people who are faced with such a phenomenon need to enrich their daily diet cereals and legumes, cereals from all kinds of cereals, lean meat and fish. At the same time, you can not get carried away with vegetables and sour berries. Drinking should be plentiful, but the water reserves in the body must be replenished by plain water forgetting for a while about coffee and strong tea.
The list of prohibited foods for phosphaturia includes alcoholic beverages, sweets and other sweets, pastries, smoked and salty dishes, "milk" with a high percentage fat content. Food should be divided into 5-6 small portions per day, and the total calorie content should be about 2500 kcal.
Prevention of the appearance of salts in the urine
So, summing up all of the above, we can confidently say that it will help to prevent the development of a disease associated with an increase in the concentration of phosphates in the urine. correct image life. To keep yourself out of trouble:
- eat properly and balanced, giving preference natural products;
- try to drink about 2.5 liters of water per day. In hot summer you need to drink even more;
- protect yourself from hypothermia;
- from time to time donate urine for analysis as part of general survey organism;
- do not neglect lower back pain if you do not know the cause of their origin. Go to the doctor right away;
- give up alcohol and cigarettes.
