What indicators are included in the general analysis of urine. Standardized technology for clinical laboratory analysis of urine. General urinalysis. B.8 Ketone bodies

Urine is biological fluid, which is produced by the kidneys and excreted from the body through the urinary tract. Its production and excretion is an important mechanism that helps maintain a normal internal environment.

Urinalysis helps to identify hidden pathologies in the body and serious illnesses requiring immediate treatment. In addition, urine analysis is also carried out in order to determine the effectiveness of the treatment.

If a person wants to be sure and check for the presence of the drug in their urine, she should go to a specialized drug detection and treatment laboratory and get professional information where she can perform a more sensitive and specific test than a home test.

Ensuring the quality of the implementation of urinalysis technology

There are also substances that, when added to a urine sample, falsify the result. If there is suspicion that there may be an operation to mask the result, it should also be checked in a specialized laboratory. Hematuria is not a pleasant sight, and is often the reason for a quick visit to the doctor. This may indicate developing pathology urinary tract or offensive systemic disease. See what blood in your urine might look like.

Types of analyzes

Conditionally, everything can be divided into 2 groups:

specific;
non-specific.

The first group includes tests that help determine whether a person is using alcohol or drugs. They are aimed at identifying specific substances. The second group includes studies that indicate pathological processes in the body. But what kind of urine tests are carried out for one purpose or another, you will now find out.

A.5 Storage of the urine sample

Causes of hematuria. . This applies to all causes of hematuria that are not related to the kidneys, but from the blood itself, medications taken, and poor control of heart disease. This can happen if you are taking anticoagulant therapy due to heart disease and an overdose. Similarly, with hypertension - if it is poorly treated and poorly controlled. Blood is also the first symptom of development hemorrhagic disease based on coagulopathy or abnormal peripheral blood.

This group includes all pathologies that are closely associated with glomerulonephritis, especially inflammation. kidney blood it is also a symptom of kidney cancer, active tuberculosis, or kidney damage. It often happens that violations connective tissue or rheumatic diseases first manifest through nephropathy and hematuria.

Specific urine tests

AT this group can be attributed the following tests urine:

general (clinical);
according to Nechiporenko;
according to Zimnitsky;
for glucose;
for protein;
Reberg's test;
on the uric acid;
to determine the level of hCG;
Sulkovich test;
bacteriological culture.

It is prescribed to absolutely all people, regardless of their age, gender and existing diseases. This study requires biological material (urine) collected in the morning. This analysis allows you to determine the level:

Quality assurance programs

Causes in this group are strongly dependent on the urinary tract. kidney stones are the most common cause of extrahepatic hematuria. Stones in the ureter or bladder can damage the epithelium urinary tract and cause bleeding. Quite often it happens that bleeding from the urinary tract means the development Bladder or urethra. In men, hematuria may be the first symptom of cancer. prostate, but in women it may simply be meningitis or other bleeding from the genital tract, which requires a gynecological diagnosis.

leukocytes;
erythrocytes;
cylinders;
salts;
squirrel;
bacteria;
mucus, etc.

At the same time, during the study, the color of the collected biological material, its smell, transparency, specific gravity and the presence of sediment are taken into account.

At healthy person urine is yellow, clear and without a strong odor. It contains no impurities or sediment. Deviation from the norm indicates development various diseases. In the presence of sediment in the urine, its microscopy is also performed.

Any bleeding from the urinary tract should be diagnosed as soon as possible, preferably in a hospital setting. Hematuria can be very serious - most of them are non-lethal inflammatory conditions that can be quickly treated with pharmacotherapy, but sometimes hematuria can be a serious pathology that requires prompt therapeutic treatment.

If the hematopoietic episode was one and did not recur, there is probably no cause for concern, but this situation also requires initiation diagnostic procedure, starting with a general urine test and its culture, which tests general state urinary tract and kidneys.

Urine analysis according to Nechiporenko is carried out in humans different ages. Most often it is prescribed when clinical trial urine gave poor or questionable results, as well as if there are suspicions of the development of infectious and inflammatory processes in the body.

This analysis allows you to determine the presence of diseases such as pyelonephritis, cystitis and urethritis. For the study, an average portion of morning urine is required. The Nechiporenko test does not require special preparation. The only thing that a person should do before collecting urine is to hold hygiene procedure for washing the external genitalia.

The presence of bacteria in the urine may be due to an abnormal urine collection technique. However, if the result shows that the number of bacteria in it may indicate inflammatory disease additional microbiological tests should be performed as soon as possible and the patient should be given antimicrobial therapy.

Requirements for the mode of work and rest, diet and restrictions in preparing the patient for the collection of urine for urinalysis

Inflammation of the bladder or urethra. . These are some of the most common nephrological and urological practice and do not require specialized tests to diagnose the cause of the disease, in combination with the symptoms reported by the patient, the diagnosis by the physician does not require additional confirmation by other diagnostic tests.

An analysis according to Zimnitsky is prescribed to determine the concentration and excretory functions of the kidneys. 8 Servings Required for Lab Testing biological material, which is collected according to a specific hourly schedule.

With the help of this analysis, the amount of urine excreted and its density are determined. Deviations from the norm indicate the development of various diseases. The Zimnitsky test is prescribed for both adults and children.
In the course of cystitis or urethra, body temperature and urological symptoms may be referred to as "dysuria", which includes pain, puffiness, and discomfort during urination. There may also be painful pressure in the bladder and menstruation that does not relieve symptoms.

What is associated with urinary tract infections? . Since the bacteria themselves are proteinaceous organisms, a urinalysis will show the presence of protein in the urine. In addition, each infection of the body predisposes to the appearance of proteinuria, which is a condition characteristic of this type of situation.

Urinalysis for glucose is done to detect pathological processes accompanied by violation carbohydrate metabolism in the body. These include:

diabetes;
inflammation of the pancreas;
adrenal diseases.

For the delivery of this analysis, daily or single urine is required. Its results can be strongly influenced by active physical exercise or the use of alcoholic beverages the day before, for this reason they should be excluded.

In addition to the presence of bacteria, leukocytes or leukocytes, which are also mediators of inflammation, called bladder antibodies to fight developing infection. Can bacterial infection occur in the urine despite the absence of infection? Asymptomatic bacteriuria, the presence of bacteria in a urine sample with no symptoms reported by the patient, requires another urine sample to finally check if the previous sample was accidentally contaminated.

Despite this, bacteria are still present in the urine, doctors believe that the body can cope with the infection and not use antibiotics. The opposite situation is observed in pregnant women and patients before planned urological procedures - in these people, asymptomatic bacteriuria is an obvious indication for antibiotics.

A test to determine the level of protein in the urine is necessary to assess the condition of the kidneys. In the absence of pathological processes in the body, this substance is not detected in urine. The presence of protein in the urine indicates the development of acute and chronic infectious diseases. He also talks about intoxication of the body and other pathologies of the urinary system.

Urinary tract infection is an indicator for conducting a urine culture, that is, for placing it on special bacteriological plates for growing any bacteria and for carrying out the appropriate antibiotic therapy. Collection of urine is slightly more difficult than in the case general examination. What does the procedure look like and what happens to the diluted bacteria?

Taking urine from urine requires the person who performs it to be very careful. Urine cannot strike bacteria from any other place on the body or from environment so as not to interfere with the reading of the result. Urine is collected in a sterile container, which is opened only at the beginning of the collection. At present, urine collection containers have already prepared a bacteriological medium, which is placed inside the urine container immediately after it has been filled.

The Rehberg test is another test that helps determine kidney dysfunction associated with creatinine production. This substance is a kind of energy source for the heart and muscles.

A low level of creatinine indicates the development of various diseases that lead to a violation of the functionality of the kidneys. Most often, this urine test is prescribed to diagnose heart pathologies, diseases. thyroid gland and diseases of other internal organs.

External quality assessment

Slightly more hygienic hygiene should be used during urine collection than during general examination urine collection. This rule applies to washing hands before the procedure, as well as washing the urethra. Men should pay attention to the removal of accumulated secretion under foreskin. Women should thoroughly clean the urethral and vaginal area from front to back, i.e. from the urethra to the anus, inadvertently transfer bacteria that are around the mouth gastrointestinal tract rather than causing them to be misidentified.

A uric acid test is prescribed for suspected diseases such as:

gout;
urolithiasis;
mumps;
pancreatitis;
kidney failure.

This analysis does not require special training. For its implementation, a single portion of urine is needed.

A urine test to determine the level of hCG is prescribed to determine pregnancy for early dates. During the formation of the fetus, the level of hCG increases significantly. This is related to getting into female body a certain hormone that the fetus produces. This study requires a single portion of urine collected in the morning.

Once the bacteria are grown on the substrate, a microbiological identification is made. When a microbe can determine the type and type of bacteria it is dealing with, next step will make a so-called "antibiogram" - a study whose purpose is to determine which chemotherapy of a given bacterium is resistant and susceptible to it. This is a very important test that is usually performed with every bacteriological test. Allows you to specify which drugs should be administered to the patient to neutralize the bacteria.

If a patient has already started on an antibiotic that does not respond to the test according to the test, the treatment will not stop, but the antibiotic cycle continues and the second therapeutic drug capable of fighting advanced medicine added to the treatment plan. already an infection.

The Sulkovich analysis is carried out to diagnose diseases in which calcium salts accumulate in the body. For this study, the delivery of a single portion of morning urine is required. 8 hours before collecting urine, you can not eat, drink tea, coffee and smoke. Immediately before collecting urine, it is required to take a hygienic shower. If this analysis is carried out in a child, then he cannot be fed for 6 hours before the test.

Under what conditions do you have a urinalysis?

A general urinalysis has all the necessary advantages of the most effective test- it is simple, fast, non-invasive and cheap. Unfortunately not clear. Deviations from certain norms may point to various pathologies not only the urinary tract, but the whole body. What diseases can be diagnosed by observing general analysis urine?

This is the main group of conditions that can be diagnosed based on a general urine test. Urine is actually blood that has been filtered, depleted and purified by the kidneys - what we find in it will be directly responsible for the function of the kidneys. If a patient's symptoms are described by a doctor, they will likely have a urinalysis, possibly with some pathology related to the functioning or construction of the kidneys.

Bacteriological culture is carried out in order to identify inflammatory and infectious processes in the body, as well as determining the type of bacteria that provoked them. This analysis helps to develop an accurate regimen for treating a patient with antibiotics.

To put it another way, if the blood is not clearing the elements in the blood well, this will be a sign of an ongoing kidney disease or that there is so much substance in the blood that the kidneys cannot clear the blood. in general. The most important element renal pathology is the presence of protein molecules in the urine. Depending on its morphology, this may indicate nephropathy, different types inflammation of the kidneys or serious damage.

In case of cystitis or urethritis, urinalysis is optional diagnostic component. First of all, it confirms the proposed diagnosis and, in addition, excludes kidney disease which can present similarly to urinary tract infections.

Nonspecific urine tests

If we talk about what non-specific urine tests are, then in our country only two methods are used:

immunochromatographic;
chemical-toxicological.

Immunochromatographic analysis requires the collection of urine in a dry container in an amount of not more than 50 ml. The study of biological material is carried out immediately after its collection using a special test strip, which reacts with urine and gives the results of the study in 10-15 minutes.

Types of urine tests in children

To check the diagnosis, the doctor orders another test called a urine culture. It consists in placing special plates, called substrates, in the patient's urine, where there are places prepared for breeding possible bacteria. If they are not in the urine, the substrate will remain clean. If present, they will overlap with growing bacterial colonies.

Study of urine in a simple way can also serve as an illustration of liver function. This is an organ that is also responsible for filtering the blood, but it deals with substances other than the kidneys. The parameters that are checked during a urinalysis are the presence of urobilinogen and bilirubin, which is a substance of the liver. Their presence in the urine may indicate jaundice or a disease process occurring inside the liver or inside the gallbladder.

If the test showed positive results, then the specialists immediately draw up a protocol and send it to the appropriate authorities.

Identify drugs with non-specific methods research is practically impossible, since they evaporate quickly and do not contribute to the formation of sediment.

The chemical-toxicological method requires the collection of urine in a sterile container with a volume of at least 30 ml.

Urinalysis according to Zimnitsky

The presence of protein in the urine is normal for some clinical conditions that are not pathological for the body. In such situations, there is a "trace" of the protein in the urine. In situations where the amount of protein can be measured and expressed in milligrams per deciliter, it is obvious to the physician that there are some abnormalities in the kidney that require further diagnosis.

Protein in the urine can be both a symptom of an illness and also a trigger. This is because the protein molecules are too large to squeeze through the glomerular filter membranes, thereby causing their own presence in the glomeruli, damaging them and leading to progressive degeneration unrelated to current process disease, which was the direct cause of proteinuria.

This analysis allows you to reliably establish the fact of consumption narcotic substances, but only if the person has been using drugs for less than 72 hours. This analysis is not an express method.

At some point in life. After all, even a child knows that the results of the study help to identify certain diseases or control their condition. Therefore, urine is an important "tool" for clinical diagnosis human health.

However, the information obtained from the analysis may depend on how the material was collected. What types of urine tests and their characteristics exist, we will consider in this article. In addition, we will find out how to properly collect and transport material for research.

What is it for?

First of all, let's determine why you need to take urine for analysis to the laboratory:

To check for diseases or urinary tract infections. Symptoms in this case can be very different: bad pain when urinating, blood impurities, pain in the side and others.
To control the condition of various diseases such as diabetes, kidney stones, urinary tract infections, high blood pressure or certain kidney and liver diseases.
For a regular physical examination, a urinalysis is also performed, the types of which are determined by the doctor.

How to prepare?

Before passing urine for analysis, you should not eat foods that can color it. Namely: blackberries, beets, rhubarb and others.
Do not conduct intensive training before the study.
It is important for women to tell their doctor about menstrual cycles. If necessary, the specialist will postpone the urine test for several days. The types and methods of conducting such a study are assigned individually.
Your doctor may also ask you not to take medicines that affect the color of your urine (usually B vitamins, Rifampicin, and Phenytoin) for a while.
If you are taking diuretics, be sure to tell your doctor. Because they can significantly affect the results of research.

Now let's take a closer look at how urine is analyzed, what types and methods of collection are.

Express test

by the most fast way check urine is a rapid test. It is carried out as part of routine examinations (in the office family doctor or when admitted to hospital) or when patients have pain in the abdomen, stomach or back. You can make such an analysis using a special strip with small colored fields, which must be immersed in a vessel for a few seconds. Then the doctor compares the color of the urine with the color of the fields and determines its condition. Only a specialist can determine what concentration of the liquid indicates its deviation from the norm.

The test will help identify the following problems:

high protein level, which becomes a sign of nephritis (inflammation of the kidneys);
detection of sugar and ketone in the urine is a sign high content blood sugar;
leukocytes and nitrites indicate the appearance of a bacterial infection.

It is important to note that this analysis is not always reliable, so it is best to test in a laboratory.

Clinical (general) research

This type analysis is part of a routine examination or performed before admission to the hospital. It is mainly used to find the cause of diseases of the liver, kidneys, urinary tract infections and bleeding in urinary system. It can also be used to check for an incorrect rapid test result. Complete Analysis carried out in the laboratory, as a rule, in 3 stages:

Evaluation of the color and concentration of urine (physical indicators).
The study chemical composition fluid, which includes several additional tests for pH, protein, glucose, ketones, blood, bilirubin, nitrite, urobilinogen, and
Specialists diagnose types of urine tests for bacteria under a microscope.

The results of the conducted research also help to identify the following problems:

high blood cholesterol;
detection of urinary reflux will indicate the development of renal diseases;
in addition, quantitative urine tests can be performed to help diagnose a variety of specific disorders such as endocrine disorders, bladder cancer, osteoporosis, and porphyria (a group of disorders caused by chemical imbalances).

If the doctor revealed any abnormalities during a clinical study, then he recommends to the patient such types of urine tests for infections: Nechiporenko analysis and Zimnitsky analysis.

Analysis according to Nechiporenko

These are laboratory tests that are carried out to determine the content of blood cells, erythrocytes and cylinders in 1 ml in order to assess the condition of the urinary tract and kidneys. This type of analysis is prescribed for the following indications:

hidden hematuria (blood in the urine);
monitoring the effectiveness of treatment;
latent inflammation in the kidneys and urinary tract.

The Nechiporenko analysis is more specific than other types of urine tests. How to collect material, consider below:

the day before, you should refrain from drinking alcohol, vegetables and fruits that change the color of urine;
before collection, you need to purchase hygiene procedures;
in a prepared clean and dry container, no more than 20-30 ml of morning urine should be collected;
it must be brought to the laboratory within 2 hours.

Normal indicators:

leukocytes - 2000 in 1 ml of urine;
erythrocytes - 1000;
cylinders - 20.

Urinalysis according to Zimnitsky

This type of research is unique. It helps to assess the condition of the kidneys and identify early stage insufficiency of these organs, as well as to monitor the dynamics of the course of the disease.

Indications for this type of study:

chronic glomerulonephritis;
diabetes;
signs of kidney failure;
hypertensive heart disease;
chronic pyelonephritis (inflammation of the kidneys).

Of course, urine tests, types, methods of collection for each diagnosis are different. It is necessary to collect material for research on Zimnitsky very carefully. You must prepare eight clean jars and label each one with the number of urinations (1, 2, 3, and so on). It is necessary to start collecting at 6.00 in the morning, and then every three hours. Remember that it is strictly forbidden to drain urine into one container. Refrigerate containers prior to transport to the laboratory. Try to keep your usual routine and diet on this day. Do not forget about hygiene rules so that they do not get into the jars harmful bacteria and microbes.

The results of the study in case of deviation from the norm:

a decrease in the relative per serving (below 1020 g / l) indicates renal and heart failure, exacerbation of pyelonephritis;
high density (over 1035 g/l) can occur with accelerated decay of red blood cells, chronic or acute glomerulonephritis and also in diabetes.

Analysis according to Kakovsky-Addis. Amburge method

As a rule, these types of urine tests are performed in children, since they are convenient to use even for babies under 3 years old. Prescribed to patients when abnormalities are detected in general test, if there are suspicions of the appearance of diseases of the kidneys and urinary tract, as well as for detailed control over the course of an already identified disease.

The results of the studies help to identify the occurrence of inflammatory processes (cystitis, glomerulonephritis and pyelonephritis), as well as to monitor the functioning of the kidneys and urinary tract.

Collect material for analysis in two ways:

within 12 hours;
throughout the day.

What is seeding?

What else is a urine test? The types and methods of research are discussed in detail in our article. Sowing is carried out in order to see if there are microbes or harmful bacteria, as well as to determine their type.

In the laboratory, a jar of urine is placed in a container. Then small plates with growth medium for microorganisms are placed in the sample and tightly closed. Next, the container is placed in an incubator for 2 days. If there are fungi or bacteria in the urine, they will noticeably grow during this time.

If during the study, microbes were found, then the patient is determined the type of antibiotics needed to combat them.

Urinalysis according to Sulkovich

This type of study is used as a screening test for early diagnosis endocrine diseases and disorders of calcium metabolism. For more accurate results doctors recommend not eating dairy and meat products, fruits and vegetables, and do not drink tea and coffee. Try to include in the diet only cereals cooked in water.

you can not eat food for 8 hours, children - 6 hours;
monitor the hygiene of the genital organs so that germs do not get into the urine sample;
the material should be collected in a sterile container and taken to the hospital.

AT laboratory conditions specialists will add the Sulkovich reagent to the urine, which will help determine the amount of calcium and bilirubin.

Daily Analysis

This test consists in collecting urine during the day in the following sequence:

the first sample after awakening is not used, but the time of urination is noted;
after that, each drop of material is collected in a jar;
when you have emptied your bladder within 24 hours, you need to take a special container from the doctor, in which a substance has already been placed to prevent the growth of bacteria, and pour all the collected liquid into it;
Keep the jar in the refrigerator during collection.

Diagnostic results show how much certain substances (such as proteins, hormones, salts and other metabolic products) are excreted from the body. If experts have found too little metabolic creatinine in the urine, then there is a suspicion of a decrease in the efficiency of the kidneys. High level protein can be caused by heart failure, diabetes, urinary tract infection, kidney disease. Some disorders endocrine system increase the amount of hormones and their metabolic products in the urine.

Pregnancy test

Of course, these types of urine tests are carried out in women. If your menstrual cycle does not start, with the help of tests it is possible to check whether you are pregnant. Most studies can determine this as early as the tenth day of conception. However, they are not always reliable. You can buy tests at any pharmacy.

These types of urine tests are carried out during pregnancy, as a rule, in the morning, after waking up. You will find exact instructions in the leaflet. Collect after urination a small amount of morning urine into the container and dip the test stick into it for a few seconds. After five minutes, it will show if you are pregnant or not.

It is important to note that test results can sometimes be false. This happens when a woman spends it too early, takes specific medications or drinking too much liquid before the test. Only a doctor can tell you for sure whether you are pregnant or not.

Types of urine tests in children

Doctors can different reasons Schedule a urine test for your child. As a rule, this preventive goals, the occurrence of deviations in the general analysis of urine or the control of an already detected disease.

Consider the main types of urine tests in children:

General (clinical) examination of urine.
Nechiporenko test.
Analysis according to Zimnitsky.
Diagnosis according to Kakovsky-Addis.
Amburge method.
Bacteriological culture of urine.
Raeberg's test.

Types of urine tests during pregnancy

From the moment a pregnant woman is registered with a gynecologist, she will be recommended to take a general urine test throughout the entire period of gestation. If any deviations from the norm are found in this study the doctor will advise you to conduct a urine test according to Nechiporenko or Zimnitsky, as well as bacteriological research to detect infections.

Such control will help the specialist assess the condition of the bladder, determine kidney disease, the appearance of diabetes and gestational diabetes, which can develop at the twentieth week of pregnancy. A high protein level will indicate inflammation of the urinary tract. Elevated Levels ketones show that a woman's body is dehydrated. It is not recommended for pregnant women to conduct a urine test on their own. All actions should be discussed with the doctor.

Conclusion

Summing up, we can conclude:

urine analysis, types and methods of collection are completely different, and they should be carried out only on the recommendation of a doctor;
some studies can be done independently, such as a rapid test and a pregnancy test;
other types of diagnosis are carried out exclusively in the laboratory to detect any deviations;
To reduce the chance of urine contamination with bacteria, maintain good hygiene.