Rules for the collection of urine according to Nechiporenko. The correct algorithm for collecting urine according to Zimnitsky

Urinalysis according to Zimnitsky - laboratory research, which makes it possible to evaluate such important features kidneys as osmotic dilution and concentration. The kidneys can excrete excess water from the body in the form of hypotonic urine, and also conserve water when water is deficient by excreting concentrated urine.

These processes help to maintain a constant level of osmotically active substances(Na, Cl ions, etc.) in the blood. The Zimnitsky test is characterized by high information content, simple technique and low cost, which allows it to be widely used in diagnostics.

Indications

Urinalysis according to Zimnitsky is prescribed for patients to evaluate if necessary. functional activity kidneys. The method provides information about pathological disorders on the early stages diseases, which allows to take therapeutic measures in time and prevent further development illness. Indications for this study include:

• chronic form glomerulonephritis;
• diabetes and diabetes insipidus;
• hypertonic disease;
• signs of kidney failure.

Algorithm for collecting urine for research

On the day of collection of the analysis, the usual regimen of drinking and eating is observed. If the patient is taking diuretics, then they are excluded for a while, after consulting with the doctor. It is not recommended to eat spicy and salty foods that cause thirst and thus can lead to excess drunk liquid.

On the eve of collecting urine for the study of the Zimnitsky sample, it is necessary to prepare a number of jars in advance. They must be clean and dry. Alternatively, you can buy special containers at the pharmacy. They are labeled with the name of the patient and the time interval for urine sampling.

Urinalysis according to Zimnitsky consists in collecting eight portions of urine throughout the day. At the same time, the following algorithm is followed:

1. At 6:00 the bladder is emptied into the toilet;
2. Before each subsequent urination, hygiene of the external genital organs is carried out;
3. Urine is collected for a certain period of time with an interval of 3 hours in jars. So, from 6:00 to 9:00, urine is collected in one jar, from 9:00 to 12:00 - in another, from 12:00 to 15:00 - in a third, etc. The last jar should contain urine collected from 3:00 to 6:00. Makes 8 servings in total;
4. In the absence of urination in the specified period of time, the jar is left empty;
5. During the day of sampling, the amount of fluid consumed is recorded, including that received as part of the first courses.

Filled jars are stored tightly closed in the refrigerator. The next morning, the collected urine test according to Zimnitsky, including empty containers, must be handed over to the laboratory.

Conducting an analysis

When the Zimnitsky sample enters the laboratory, it determines such indicators as volume and relative density or specific gravity. According to the rules, the study is carried out for each portion. The analysis technique is quite simple.

The volume of urine is measured using a graduated cylinder. Determine the volume of urine in each portion, as well as daytime (6:00–18:00), night (18:00–6:00) and daily diuresis.

Relative density is determined using a special hydrometer - urometer. For this, urine is transferred into a 100 ml cylinder. If foam has formed, it is removed with filter paper. The urometer is placed in the cylinder so that it does not touch its walls. When the oscillation of the instrument stops, record the value of the relative density along the lower meniscus.

All data obtained are transferred to the appropriate analysis form and transferred to the doctor or patient.

Decoding and norm of analysis

Deciphering the Zimnitsky test is carried out by the attending physician. This takes into account the results of taking general analysis urine, blood, as well as other prescribed tests and diagnostic methods.

Normally, the following readings should be obtained:

• daily diuresis 1500–2000 ml;
• the ratio of daytime and night diuresis 3:1;
• the relative density of urine should normally be 1010-1025 for daytime portions and not more than 1035 for the nighttime portion;
• the amount of urine excreted should be 65-80% of the amount of fluid consumed.

For children, the volume of daily diuresis and relative density depend on age and are generally somewhat lower than for adults. This is due to the lower reabsorption capacity. The lowest relative density of urine occurs in infants. The minimum value can be 1002. When deciphering the results of taking an analysis in children, this must be taken into account.

Deviations from the norm

If, as a result of decoding the analysis, deviations from the norm were revealed, then this indicates violations in the work of the kidneys or non-compliance with the correct urine collection algorithm.

The following deviations may be present:

1. Decreased relative density of urine. It is observed if in all portions the specific gravity does not exceed the value of 1010. This may be caused by the presence of such diseases in the patient: acute pyelonephritis, kidney failure, diabetes insipidus, heart failure. An increase in relative density is also characteristic when taking diuretics or following a diet that excludes the intake of salt and protein;
2. Increased relative density of urine. Most often due to the presence of large quantities protein and glucose. It is observed with dehydration of the body, toxicosis of pregnant women, diabetes mellitus, edema, glomerulonephritis. In children increased density urine happens with uric acid diathesis;
3. Nighttime urine output is equal to or greater than daytime urine output. Such a deviation indicates a violation of the ability of the kidneys to concentrate;
4. Daily diuresis is more than 2000 ml. characteristic of the decompensated diabetes or kidney failure;
5. The volume of excreted urine is less than 65% of the volume of fluid consumed. May be observed at initial stages glomerulonephritis and pyelonephritis, excessive sweating, limiting the amount of fluid consumed.

The kidneys remove water and substances dissolved in it from the body. To assess the work and functionality of the organs, the domestic therapist S.S. Zimnitsky proposed special sample, which is based on the analysis of the density of urine.

What it is?

The blood entering the kidneys is filtered by special tubules. Wherein excess fluid diffuses, and with it various amines, salts and other substances.

Primary filtration is replaced by secondary filtration, as a result of which they are absorbed from the urine back into the blood. useful compounds such as proteins and carbohydrates.

The essence of the Zimnitsky method is to determine the density of the fluid excreted from the body, its specific gravity. If the indicators are lower or higher than normal, then doctors talk about a change in the concentration of urine and a violation of the filtration function of the kidneys.

Deep biochemical analysis in this study do not perform, however, with a positive test result, additional measures are possible.

Why conduct a test according to Zimnitsky?

If a patient turns to a nephrologist with complaints of pain in the kidney area, then he without fail prescribe a urine test for sugar and protein. In addition, they carry out x-ray examination excretory organs for inflammation.

But there are times when these methods do not work. Those. pain syndrome present, but the cause of its occurrence is not known.

The physical characteristics of the output liquid (volume and density) will clarify the situation. The study of urine tests according to Zimnitsky is considered very informative, and it is prescribed for suspected pyelonephritis, renal failure, or heart disease.

The technique is not difficult, but the patient needs to collect urine every 3 hours for a whole day.

Algorithm for collecting urine according to Zimnitsky

Any medical analysis has an error. In addition, even when normal health observe changes in the concentration of organic and mineral compounds in the urine.

Therefore, in order to get the most reliable results, you need to exclude diuretics 1 day before sampling, which significantly affect physical characteristics excreted liquid.

The patient is also forbidden to eat foods that increase the feeling of thirst (salty and spicy), although the usual drinking regimen (1.5-2 liters per day) should not be changed.

How to collect a urine test according to Zimnitsky? First of all, prepare 8 containers. Special containers can be purchased at a pharmacy, but ordinary glass jars up to 0.5 liters are also suitable. They are numbered and signed so that there is no confusion in the laboratory. Urine is collected according to the following algorithm:

1. At 6 o'clock in the morning they are emptied into the toilet.
2. Every 3 hours, starting from 9.00, urine is collected in the appropriate jars.
3. Samples are stored in a refrigerator.

In total, you get 8 jars of urine collected at 9, 12, 15, 18, 21, 24, 3 and 6 hours. If the patient has no urge, then the container is simply left empty.

However, it is not thrown away, but, together with filled containers, is delivered to the laboratory for research. The specialists will necessary tests and decrypt the data in accordance with the average norms.

Norms of urine analysis according to Zimnitsky

The density of urine varies between 1.013-1.025. This means that in some jars the indicators will be higher, in others - lower. Generally considered normal following results:

• the daily volume of urine does not exceed 2 liters;
• in 2-3 containers the density is not less than 1.020;
• daily portions are 3-5 times more than nightly ones;
• the excreted fluid is 60-80% of the consumed;
• there are no indicators above 1.035.

When conducting a urine test according to Zimnitsky, the interpretation of the results will largely depend on compliance with the rules for sampling. If the patient drank too much water, then it will come out in excess of the norm. But the lack of fluid intake will also cause errors in the study. Therefore, on the day of sampling, it is necessary to concentrate on the task at hand so that the procedure does not have to be repeated.

Interpretation of urine tests according to Zimnitsky, table

So, the patient collected the material and sent it to the laboratory, the specialists conducted experiments and received certain information. What's next? Reveal the compliance of indicators of urinalysis according to the Zimnitsky norm. The table clearly demonstrates the diseases characteristic of various deviations.

The table displays a brief diagnostic information. A more detailed consideration of the causes of impaired urine density will help to understand the problem.

kidney failure

If a patient has been suffering from renal failure for several years, then the excretory organs simply lose their ability to perform their functions normally.

Associated symptoms are often a general deterioration in health and constant feeling thirst, which leads to increased fluid intake and, as a result, low urine density and a large daily excretion.

Kidney inflammation

Bilateral or unilateral inflammation of the kidneys also reduces the functionality of the organs due to the ongoing pathological hyperplasia.

Accompanied by pain in the lumbar region and elevated temperature, therefore, the Zimnitsky test is performed to clarify (confirm the diagnosis).

Additional biochemical analysis demonstrates increased concentration protein, which also indicates a violation of the filtration process.

Heart pathologies

The body is a whole. And if doctors diagnose a violation of the kidneys, then this fact provides grounds for checking cardiac activity. And often suspicions are confirmed on the electrocardiogram.

Congenital or acquired pathology of the heart leads to disruption of blood flow and a change in pressure in the vessels, which, of course, is also reflected in the filtration process: the volume and density of the excreted fluid are noticeably reduced, and at night a person is disturbed frequent urges to the toilet.

Diabetes

If the kidneys do not carry out sufficient reverse suction glucose, then doctors suspect. This disease is also characterized by thirst, increased appetite and other symptoms.

However key points high urine density and a large number of glycosylated hemoglobin in the blood.

diabetes insipidus

And poses a considerable danger. Essentially, this endocrine disruption, expressed in a deficiency of one of the hormones of the hypothalamus - vasopressin.

It is its deficiency that leads to excessive removal of fluid from the body, which is accompanied by a decrease in the density of urine. In addition, a person is very thirsty, and the urge to go to the toilet takes on a pathological character.

Glomerulonephritis

With glomerulonephritis, low permeability of the renal glomeruli is revealed. This naturally complicates the diffusion process, which is why the reverse absorption of compounds into the blood is disturbed - urine acquires a density of more than 1.035.

In addition, tests often show the presence of red blood cells and proteins in the samples.

Features during pregnancy

However, proteins in the urine are not necessarily a pathology. For example, during pregnancy, a woman's body suffers from toxicosis, which provokes a violation of protein filtration.

In addition, the growth of the fetus leads to an increase in pressure and functional load on the kidneys. After childbirth, the situation with excretory and other organs is normalized.

Blood diseases

Blood diseases are considered much more dangerous, accompanied by a change in the quality and quantity shaped elements- in particular, erythrocytes.

Excessively thick plasma, according to the law of diffusion, releases more components into the urine, so its density increases. If anemia is detected in a person, then, among other things, the kidneys suffer from oxygen starvation, which directly affects the functionality.

Conclusion

Urinalysis according to Zimnitsky is performed as primary diagnosis. The method is considered very informative, and positive result The sample gives grounds for a more detailed examination of the kidneys, heart and blood.

Often, the results of only a general urine test are not sufficiently informative for the correct diagnosis of any disease. In such cases, the doctor should prescribe specific urine tests or samples.

About analysis

To conduct it correctly, you need to fully adhere to all the recommendations of the attending physician regarding the collection of biomaterial, labeling of containers, storage conditions and the time of sending to the laboratory. It is often quite difficult to interpret the results, so only a specialist can do this. The Zimnitsky test is affordable way conducting a laboratory study, the purpose of which is to identify inflammation in the kidneys and organs urinary system. Such an analysis can reflect the functioning of the kidneys and show violations of their work.

In this article, we consider the Zimnitsky urine collection algorithm.

How to prepare for the collection of analysis?

The informativeness and accuracy of the readings of the result of the analysis according to Zimnitsky may be affected by some medications used by the patient, as well as food. Therefore, at least a day before the collection of urine, you need to follow a few simple recommendations:

• refusal to use diuretic drugs, both medicinal and herbal;
• compliance with the patient's usual diet and food intake (at the same time, one should limit oneself in the use of salty, spicy dishes that can provoke thirst, as well as products that can affect the color of urine, such as beets, etc.);
• limit excessive drinking.

The algorithm for collecting urine according to Zimnitsky is simple.

It should be remembered that if the patient has several urges to urinate in a certain time interval, it is necessary to collect the liquid in full, nothing can be poured out. If the container for sampling the biomaterial is already full in a given period of time, you need to take an additional container and be sure to indicate the time on it in accordance with the collection algorithm. If the patient does not feel any urge at any of the intervals, then the empty jar must also be sent for laboratory testing so that the volume of fluid can be correctly estimated.

During the day, all urine containers should be kept cold ( the best place- refrigerator), and the next morning the material must be brought to the laboratory, also adding notes on the amount of fluid taken by the patient during collection.

If the Zimnitsky urine collection algorithm is violated, then his technique will be incorrect, which will lead to an increase in the volume of biomaterial. This helps to reduce its density. Because of this, experts can get the wrong result and draw erroneous conclusions.

How to collect biomaterial?

To collect urine for the Zimnitsky test, specialists need to use special equipment. For the study you will need:

The Zimnitsky urine collection algorithm for adults is as follows:

1. You need to empty your bladder at six o'clock in the morning.
2. Throughout the day, every three hours it is necessary to empty into containers, that is, from nine in the morning of the first day to six in the morning of the second.
3. Store gradually filled jars in a closed form in the cold.
4. The next morning, the containers with the collected biomaterial must be delivered to the laboratory along with the notes in the notebook.

The Zimnitsky urine collection algorithm must be strictly observed.

Features of the Zimnitsky test

The method of diagnosis using the study of clearance (or depuration) is more reliable and reliable. Clearance is the clearance ratio, defined as the volume of blood plasma that can be cleared of a particular substance by the kidneys. It is due to such factors as the age of the patient, a certain substance that takes part in the filtration process, the concentration function of the kidneys. The algorithm for collecting urine according to Zimnitsky is of interest to many.

The following types of clearance are distinguished.

• Filtration - the amount of plasma that is completely cleared within one minute by means of glomerular filtration from an unreabsorbed substance. The same indicator is observed in creatinine, so it is most often used to measure the amount of filtration.
• Excretion - such a process in which the substance is excreted in full by excretion or filtration. To determine the amount of plasma that has passed through the kidney, diodrast is used - a special substance, the purification coefficient of which corresponds to the goals set.
• Reabsorption - such a process during which there is a complete reabsorption of filtered substances in renal tubules and excreted by glomerular filtration. To measure this value, substances are taken with a purification coefficient, zero(protein / glucose), since during their period high content in the blood, they can help evaluate tubular reabsorption performance. What else will help determine the Zimnitsky urinalysis collection algorithm?
• Mixed - the ability of a filtered substance to partially reabsorb, for example, urea. In this case, the coefficient will be determined as the difference between the concentration of a given substance in plasma and urine in one minute.

In order to conduct a differential diagnosis of kidney pathologies and evaluate the functioning of the glomeruli and tubules, urea and creatinine are most often used. If, in the presence of renal dysfunction, the concentration of the latter increases, this becomes a symptom of the onset of the development of renal failure. At the same time, creatinine concentration indicators increase much earlier than urea, therefore, in the diagnosis, it is the most indicative. The rules for collecting urine according to Zimnitsky and the algorithm should be told by the doctor.

Analysis results and their interpretation

The fact that the concentration function of the kidneys is normal is evidenced by the following results obtained during the analysis and their interpretation:

• the amount of urine collected during the day should be more than the volume of night urine in a ratio of three to one;
• the volume of urine per day should be included in at least seventy percent of the liquid consumed during the same time;
• the specific gravity coefficient should range from 1010 to 1035 liters in all sample containers;
• the amount of liquid allocated per day should be at least one and a half and not more than two thousand milliliters.

If the results of the biomaterial analysis deviate from normal indicators, there is reason to talk about impaired functioning of the kidneys, determined by any inflammatory process or pathologies endocrine system.

Below normal

For example, if the specific gravity coefficient is below a certain norm(hyposthenuria), it is necessary to diagnose a violation of the concentration function, which may be due to incorrect technique for collecting biomaterial, the use of diuretics (including herbal preparations with the same effect) or with the presence of the following pathologies:

• pyelonephritis in acute stage or inflammation of the pelvis;
• chronic renal failure, which has developed against the background of pyelonephritis and other diseases of the excretory system, if they have not been cured;
• diabetes, or diabetes insipidus;
• heart failure causing blood stasis.

The main thing is that during the analysis the Zimnitsky urine collection technique and the algorithm should be observed.

Above normal

In the event that the indicator of the specific gravity of urine exceeds the established limits of the norm, this serves as evidence of the content in the laboratory material of substances that have high density such as glucose or protein. As a result of deciphering such a result, the following possible pathologies can be identified:

• dysfunction of the endocrine system ( special case- diabetes);
• preeclampsia or toxicosis in pregnant women;
• acute inflammatory process.

Using the Zimnitsky test, it is also possible to estimate the amount of fluid released. If this volume is significantly higher than normal (polyuria), then this can signal diseases such as diabetes, diabetes, kidney failure. If the daily diuresis, on the contrary, is reduced (oliguria), then this indicates CRF on late stages or heart failure.

In some cases, nocturia can be detected in the transcript, that is, a significant increase in diuresis at night compared to daily amount urination. Such a deviation indicates that the development of heart failure occurs or the concentration function of the kidneys is impaired.

Testing for pregnant women

During pregnancy, the kidneys of a woman and her excretory system work even more intensely, since they contribute to the excretion of metabolic products of both the body of the pregnant woman and her fetus. Moreover, it further complicates normal selection urine and an ever-growing uterus, displacing and squeezing the kidneys. Analysis according to Zimnitsky makes it possible to most informatively and accurately assess the activity of the kidneys of a pregnant woman, to monitor their functioning, which makes it possible to prevent the appearance and development of pathology. The collection and delivery of biomaterial in this case correspond to general recommendations, the algorithm is the same.

Algorithm for collecting urine according to Zimnitsky in children

The main feature that distinguishes the Zimnitsky analysis from other urine studies is the emphasis on identifying the volume of urine excreted during the day, as well as determining the density of each portion, indicating the content of dissolved substances in it. Other indicators are not investigated by this sample.

To collect analysis from young children (babies), you can use containers specially designed for them (urinals). Before the child empties, you need to rinse his genitals very thoroughly and attach a container to them. It must be checked periodically and after each urination, drain the liquid into a container designed for this. All jars should then be sent to the laboratory, even if some of them are empty. If, for a certain time period, more urine was collected than can fit in a container, you need to take another container and mark a period of time on it. In addition, it is separately necessary to note the time and amount of liquid drunk by the child.

We reviewed the Zimnitsky urine collection algorithm. The manipulations are simple but effective.

1.1. Introduce yourself to the patient, explain the purpose and course of the procedure. Make sure the patient has informed consent for the upcoming procedure.

1.2. The night before, give out a container for collecting urine (labeled)

1.3. Explain the procedure for collecting urine.

1.3. Teach how to perform a hygienic wash the morning before the exam

1.4. Ask the patient to repeat all the information received

1. Urine collection technique

2.1 Treat hands in a hygienic way, dry.

2.2 Wear gloves

2.3 Teach the patient how to collect urine for examination:

- after washing:

- allocate the first stream of urine into the toilet (or vessel) at the expense of "1", "2";

- stop urination.

- excrete urine into a jar in an amount of at least 10 ml.

- delay urination, set aside a jar.

- Finish urinating into the toilet.

1. End of procedure

3.1 Close the jar with a lid

3.2 Remove gloves, place them in a container for disinfection

3.3 Treat hands in a hygienic way, dry.

3.4. Deliver urine to the laboratory no later than one hour after collection

3.5. Make an appropriate record of the results of the implementation in the medical documentation

What can be in the urine?

Quantity

Polyuria - an increase in daily diuresis.

Oliguria - a decrease in daily diuresis to 500 ml.

Anuria - daily diuresis is not more than 200 ml per day

Pollakiuria - frequent urination.

Olakisuria - infrequent urination.

Dysuria is painful urination.

Nocturia is an excess of nocturnal diuresis over daytime.

Enuresis is urinary incontinence.

The color of urine normally ranges from straw to saturated yellow, it is determined by the presence of dyes in it - urochromes, the concentration of which mainly determines the color intensity (urobilin, urozein, uroerythrin). Saturated yellow usually indicates a relative high density and concentration of urine. Colorless or pale urine low density and is released in large quantities.

Darkening of urine to a dark brown color is typical for patients with jaundice, often obstructive or parenchymal, for example, with hepatitis. This is due to the inability of the liver to destroy all mesobilinogen, which appears in large quantities in the urine and, turning into urobilin in the air, causes its darkening.

Red or pink-red color of urine, similar to meat slop, indicates the presence of blood in it ( gross hematuria); it can be observed in glomerulonephritis and other pathological conditions. Dark red urine occurs with hemoglobinuria due to transfusion of incompatible blood, hemolytic crisis, syndrome prolonged squeezing and others. In addition, red urine occurs with porphyria. The black color that appears when standing in the air is characteristic of alkaptonuria. At great content fatty urine may resemble diluted milk. The grayish-white color of urine may be due to the presence of pus in it ( pyuria). Green or Blue colour it can be noted with an increase in the processes of putrefaction in the intestines, when a large amount of indoxyl sulfuric acids appears in the urine, decomposing to form indigo; or due to the introduction of methylene blue into the body.

The smell of acetone - ketonuria

Smell of feces - E. coli infection

The smell is fetid - a fistula between urinary tract and purulent cavities and (or) intestines

Sweaty foot odor - glutaric acidemia (type II), isovaleric acidemia

Mousey (or musty) smell - phenylketonuria

Maple Syrup Smell - Maple Syrup Disease

Cabbage smell (hops smell) - methionine malabsorption (hop dryer disease)

The smell of rotting fish - trimethylaminuria

Rancid fishy smell - tyrosinemia

Swimming Pool Smell - Hawkinsinuria

The smell of ammonia - cystitis

Foaminess

When urine is agitated, foam forms on its surface. In normal urine, it is not abundant, transparent and unstable. The presence of protein in the urine leads to the formation of persistent, profuse foam. In patients with jaundice, the foam is usually yellow in color.

Transparency

Urine is normally clear. Turbidity can be caused by bacteria, red blood cells, cellular elements, salts, fat, mucus.

Physical and chemical research

Density. Normal density of urine is 1010-1024 g/l. Density can be increased by dehydration. Decreased density may indicate kidney failure.

Acidity. Typically, the pH of urine ranges from 5.0 to 7.0. The acidity of urine varies greatly depending on the food taken (for example, the intake of plant foods causes alkaline reaction urine), physical activity and other physiological and pathological factors. The acidity of urine can serve as a diagnostic sign.

Biochemical research

A deviation from the norm is the presence of protein in the urine at a concentration of more than 0.033 g / l - proteinuria.

Proteinuria is observed in violation of the permeability of the glomerular filter - glomerular proteinuria, in violation of the reabsorption of low molecular weight proteins by the epithelium of the tubules - tubular proteinuria in acute and chronic glomerulonephritis, renal amyloidosis, diabetic nephropathy, systemic diseases connective tissue. Tubular proteinuria may be due to interstitial nephritis, toxic damage to the tubular epithelium, and also occur with hereditary tubulopathies. In addition, the appearance of protein in the urine can occur with purulent inflammatory processes urinary tract, severe circulatory failure, nephropathy of pregnancy, fever. Also, brief episodes of mild proteinuria may occur with intense physical activity, a rapid change in body position, when the body is overheated or hypothermic, and after taking a significant amount of food rich in undenatured proteins.

microscopic examination

Organized Sediment

In the urine may be found:

flat epithelium (cells of the upper layer Bladder) is normally single in the field of view.

Cylindrical, or cubic epithelium (cells of the urinary tubules, pelvis, ureter). Normal - not detected, appears when inflammatory diseases. Same way transition epithelium - lines urinary tract, bladder. It is observed in cystitis, urethritis and other inflammatory diseases of the urinary system.

Erythrocytes. Increased content red blood cells in the urine, called microhematuria in case of a small amount erythrocytes and gross hematuria, in case of their significant content, is a pathology indicating kidney or bladder disease, or bleeding in some part of the urinary system. Normally, in women - singly in the preparation, in men - no.

Leukocytes. An increased amount of white blood cells in the urine is called leukocyturia. It indicates an inflammatory process.

Leukocyturia - up to 20 in the field of view, macroscopically urine is not changed.

Pyuria - more than 60 in the field of view, while macroscopically the urine is cloudy, yellow-green with a putrid odor.

unorganized sediment

In acidic urine are found:

Uric acid - crystals various forms(rhombic, hexagonal, in the form of barrels, bars, etc.), painted in red-brown or yellowish-brown color. Microscopic crystals in the urine sediment look like golden sand.

Urates - amorphous urate salts - small yellowish, often glued together grains. Microscopically, urates have the appearance of a dense brick-pink sediment.

Oxalates are colorless crystals in the form of postal envelopes - octahedrons.

Lime sulphate - thin, colorless needles or rosettes.

Cylindruria

Hyaline casts - Tamm-Horsfall mucoprotein, produced by tubular cells and coagulated in their lumen. Normally, single. Appear during exercise, fever, orthostatic proteinuria, nephrotic syndrome, various diseases kidneys.

Granular casts are regenerated and destroyed cells of the renal tubules on hyaline casts or aggregated serum proteins. Appear with severe degenerative lesions of the tubules.

Wax cylinders are protein coagulated in tubules with a wide lumen.

Epithelial casts - desquamated epithelium of the renal tubules.

Erythrocyte cylinders - erythrocytes, layered on the cylinders, often hyaline.