Complete urinalysis, or UAM, is a typical laboratory test. The patient receives a referral to it during inpatient or outpatient treatment, as well as during a routine medical examination. Correct interpretation of indicators helps the doctor in making a diagnosis. A general analysis of urine allows you to evaluate how physiological processes proceed in the body, detect inflammatory processes in the ureter, kidneys, as well as make a diagnosis and prescribe the necessary therapeutic treatment.
Preparations
The results will depend on careful preparation, on the basis of which, if necessary, the doctor will prescribe the appropriate therapy.
Every patient should know how to properly pass a general urine test. To get reliable results, you need to prepare for it:
- one day before urine collection go todiet food;
- do not drink alcohol;
- if possible, refuse to take medications and vitamin complexes;
- exclude from the diet foods that affect the color of urine;
- reduce physical activity;
- refuse from procedures that lead to dehydration of the body (visiting baths and saunas).
During menstruation, it is not recommended to take tests, as red blood cell counts may be too high.
Before the procedure for collecting urine, it is very important for both women and men to thoroughly wash the genitals. Otherwise, mucus may enter the container, and the accuracy of the analysis results will be impaired. Of the detergents, it is advisable to use only baby soap. Women should wash from front to back.
Urine analysis: how to collect it correctly?
Biomaterial is collected immediately after sleep, in the morning, since at this time the urine contains all the substances that the body has excreted during the night. The results obtained in this case will most fully reflect the state of he alth of the patient. On the eve of the pharmacy, you need to purchase a special jar for collecting urine, pour boiling water over it. For analysis, take the average portion of the allocated urine. Do not immediately collect urine in a container. The first few seconds of urination should be performed in the toilet, then in a jar and the rest again in the toilet.
Research will require no more than 100 ml of urine. Close the jar with a lid and place in the refrigerator. After collection within 1-2 hours, it must be handed over to the laboratory. It is not recommended to freeze it, it is necessary to transport it at a positive temperature, without shaking. Violation of the recommendations may lead to erroneous results.
What not to do when collecting urine?
Not recommended for adult urinalysis:
- Collect urine in untreated container: pot, plastic bag.
- Submit urine that has been stored for more than three hours to the laboratory.
- Use a catheter to collect samples when not needed. Its use is possible in bedridden patients, as well as patients with certain oncological diseases. All these cases are coordinated with the attending physician.
- To be tested during inflammation of the genitourinary system, vagina and dermis near the urethra.
- Collect urine immediately after a bowel movement, intercourse, during menstruation.
Indications for analysis
Complete urinalysis in adults and children is a standard procedure for diagnosis and he alth checks. It is carried out in the following cases:
- annual medical examination;
- with unsatisfactory functioning of the urinary system and kidneys;
- visiting a doctor with diseases of internal organs;
- research before any operation;
- diagnosis of prostate diseases;
- after suffering a sore throat and scarlet fever;
- examinations to control ongoing therapy.
By deciphering the generalurine analysis, the doctor can diagnose diseases of the bladder, various kidney diseases, ailments with the prostate gland, pathologies of internal organs when there are no obvious symptoms of the disease.
Physical indicators of OAM
These include:
- Density. It is determined using a special device called a urometer. It is placed in a container with urine and indicators are determined on a scale. For adults (men and women), the specific gravity rate is 1010–1025 g / l. Density above the norm is possible when there is a large amount of sugar, protein, s alts and bacteria in the urine. Low rates are typical when taking fluids in large volumes during the day.
- Color. His laboratory assistant determines by eye. The use of certain products changes the color of urine, but this phenomenon is not considered a pathology. Urine may be light yellow, pink, red, brown, straw yellow.
- Smell. It is determined by the olfactory organs and should not be sharp. With various diseases, the smell of urine changes. It smells like ammonia in diabetics and rotten meat in bladder cancer.
- Transparency. Determinedvisually. Normally, urine is transparent and retains this property for several hours after collection. It forms a precipitate only during long-term storage, which makes it difficult to determine the result. Urine becomes cloudy if it contains mucus, s alts, white blood cells, bacteria, or a large amount of epithelium. The transparency of the biomaterial largely depends on how urine was collected for general analysis and how it was stored.
- Acidity. To determine it, indicator paper is used. It is lowered into a test tube and the resulting color is compared with the standard. The norm for urine is an acidic reaction. Decreased acidity occurs in people who consume a large amount of plant foods, as well as in certain kidney diseases, hormonal disorders and a lack of trace elements. Increased acidity is present with dehydration, diabetes, fasting, urinary tract infections, debilitating diets.
It is normally light yellow. Colorless urine indicates dehydration, dark urine indicates severe damage to the urinary system. It can be pyelonephritis, kidney stones or oncology. The color of meat slops indicates jade, and the milky color indicates a violation of the outflow of lymph. With hepatitis, there is a failure in the exchange of bilirubin, and the urine becomes dark in color.
Each indicator is entered by the laboratory assistant in the research form.
Transcript of results
Deciphering the results of a general urine test in adults is carried out according to the content of organic substances in the test material.
Most often, urine is tested for its protein and glucose content. Sometimes the doctor prescribes an extended analysis, where he requires to indicate the presence of ketone bodies, bile pigments and bilirubin. The listed substances are not present in the urine of a he althy person.
- Protein. Its appearance in urine in the form of traces is normal. This may be due to eating s alty or spicy foods before taking the test. Protein in the urinealso appears after physical or emotional stress.
- Glucose - high content indicates a large intake of carbohydrates on the eve of the delivery of biomaterial or acute pancreatitis, diabetes mellitus, pheochromocytoma, nephrotic syndrome. Normally, it should not be present.
- Urobilin - is a consequence of liver failure, sepsis, intestinal inflammation.
- Ketone bodies - their detection in the urine indicates a violation of metabolic processes in the body: thyrotoxicosis, diabetes, alcohol intoxication.
- Bilirubin - appears as a result of liver damage, severe toxic poisoning, hemolytic disease.
- Hemoglobin - indicates a significant destruction of red blood cells. In urine, it is detected with myocardial infarction, kidney injury, malaria, burns, intravenous blood infusions.
- Leukocytes - with inflammation of the urinary tract, leukocytouria is observed.
- Erythrocytes - a high level indicates bleeding. In addition, the cause may be chronic glomerulonephritis, cystitis, urolithiasis. An increased level of red blood cells is also detected when passing a general urine test during menstruation.
Study of urinary sediment
Urine is centrifuged to detect sediment. It is placed on a glass slide and examined under a microscope. For standard analysis, determine and count the number of the following inclusions:
- Epithelium. It is flat, renal and transitional. Flat epithelium should not exceed 3-5 pieces. bigits quantity is observed in women who neglect the toilet of the genitals. In this case, the analysis has to be retaken. The presence of the renal epithelium signals the pathology of the kidneys, and the transitional epithelium in the urine is the norm.
- Mucus - should not be present in urine.
- Bacteria - their presence indicates abnormalities in the body: urinary tract infection.
- S alt crystals - for a he althy person, the content of oxalates, urates and tripelphosphates is considered normal.
- Leukocytes - for men, the largest number should not exceed three cells, and for women - five. If, when deciphering the general analysis of urine, the indicators are higher than normal, then this is a sign of an inflammatory process in the kidneys, bladder, prostate or urethra. Often, an increased content of mucus and leukocytes occurs due to a poorly performed toilet, before collecting urine, genital organs.
- Erythrocytes - a high level in the urine indicates a pathology of the urinary system and kidneys, possibly bleeding. For men, they should be in a single quantity, and for women - no more than three.
- Cylinders - their presence occurs in renal pathology. With high pressure, pyelonephritis, hyaline casts may be present. The presence in the urine of granular, waxy, erythrocyte, epithelial cylinders indicate pathological changes in the body.
Before collecting the analysis, the patient needs to be familiarized with how to take a general urine test. Obtaining unreliable results may depend on violationstorage container with collected material. It must be remembered that room temperature promotes the development of microorganisms, you can not put a jar in sunlight.
OAM during pregnancy
In OAM, chemical, physical properties are examined and microscopic examination is carried out. The first includes:
- acidity;
- bilirubin;
- protein;
- glucose;
- urobilinogen;
- ketone bodies.
Study of physical properties:
- transparency;
- density;
- colors.
Microscopic examination:
- erythrocytes;
- leukocytes;
- s alt;
- epithelium;
- mushrooms;
- cylinders;
- bacteria.
Before each visit to the antenatal clinic, a woman carrying a child takes a general urine test:
- in the first three months - once every four weeks;
- in the second and at the beginning of the third trimester - once every two weeks;
- starting at 35 weeks - every seven days.
In order for the doctor not to make mistakes when making a diagnosis, the procedure must be treated responsibly. Every pregnant woman should pay attention to the diet before donating the biomaterial. Refuse fatty and sweet foods, as well as foods that can change the color of urine. How to pass a general urine test, the attending doctor will tell.
Research purpose
During pregnancy, the kidneys have a double burden. They bring productsexchange not only of the mother, but also of the fetus. The ever-increasing uterus presses on all the organs of the abdominal cavity, and the kidneys and bladder are no exception. This can cause stagnation of urine, swelling of the kidneys, and infection. Due to the restructuring of the body's work, a woman's immunity is significantly weakened, which can also provoke an infectious process in the bladder and kidneys or exacerbate chronic pathologies of the urinary system.
In addition, a general urine test helps the doctor not to miss such a disease as preeclampsia. It is very dangerous for the fetus and mother. OAM is often given to women in an interesting position due to:
- early diagnosis of pathological changes in the urinary system and other internal organs;
- monitoring the he alth status of a woman in labor;
- monitoring the course of an existing disease and evaluating the effectiveness of ongoing treatment.
In deciphering the results of a general urine test, a pregnant woman should not have:
- Protein - proteinuria. Its detection can be caused by stress, physical activity, eating protein foods. Pathological proteinuria signals the emerging preeclampsia.
- Ketone bodies. Their detection indicates anemia, early toxicosis or diabetes mellitus.
- Glucose - glucosuria is possible with gestational diabetes.
- Bilirubin, the detection of which indicates the presence of obstructive jaundice or hepatitis of viral origin.
- Fungi, bacteria. Bacteriuria signals pyelonephritis or lack ofintimate hygiene.
- Cylinders, their detection indicates a kidney disease. All other indicators must be within the acceptable range. If any abnormalities are detected, hospital treatment or additional examinations are recommended.
Change results
Distortion of the results of a general urine test is observed in case of violations committed during the preparation and collection of biomaterial:
- Mucus and leukocytes found in excess of allowable values indicate poorly washed external genitalia in both men and women, before collecting urine.
- A large number of microorganisms is associated with errors in nutrition or the use of non-sterile containers for collecting urine, storing it at room temperature, which provokes the active reproduction of bacteria, as well as the lack of hygiene procedures.
- If there is no evidence of bleeding, an elevated red blood cell count indicates that urine was collected during menstruation.
In addition, the decoding of the general urine test in adults and children will be unreliable if the storage conditions of the container with biomaterial are violated. For example, ultraviolet rays have a destructive effect on bilirubin. Urine that has been stored for a long time (more than two hours) will be unsuitable for research.
It is important to remember that the accuracy of determining certain indicators, for example, color, density, reaction, depends on the assessment of the work of organs and systems, the detection of infectious or inflammatoryprocesses. And in order for the doctor not to make a mistake in making a diagnosis, based on the results of laboratory data, the individual needs to know how to pass a general urine test correctly. This will serve as an additional guarantee against incorrect diagnosis, and, accordingly, treatment.
