One of the most common tests at any age is a complete urinalysis (CUA). The norm in children and adults indicates the satisfactory functioning of the urinary system and the absence of pathologies, disorders in the body. Depending on age, reference values may differ significantly. The OAM norm in children is an indicator of full development, the formation of internal organs and systems.
Laboratory study of urine
In most cases, the doctor issues a referral for this analysis along with a general blood test. The research is carried out at different age periods. In practice, younger children have to be tested more often than adults and adolescents.
Even the most minor changes in the body can be identified by decoding OAM in children. The norm at the same time of all indicatorsindicates that there is no cause for concern, while a violation of at least one of the criteria indicates the need for more detailed screening, diagnosis and, possibly, treatment. A general analysis of urine is an indispensable stage of the examination, which is often prescribed by pediatricians for preventive purposes. Knowing the norm of OAM in children, you can get a lot of information about the state of he alth of the child, determine the further direction in the diagnosis.
Unlike a blood test, a urine test is the simplest and painless method of examination that objectively demonstrates whether systems and vital internal organs are functioning stably.
Quality collection of urine and its timely delivery for study play a huge role in laboratory diagnostics. To a greater extent, the reliability of the results depends not only on the competence of he alth workers, but also on whether the elementary rules for collecting biomaterial by parents are observed. Upon completion of the study, it is necessary to decipher OAM in children. About the norm, excess or decrease in indicators, the conclusion is made by the attending physician.
When you need to take a general urine test
Indication for this analysis can be an examination both for preventive purposes and for suspected diseases of the genitourinary system, stomach, pancreas, liver, cardiovascular system. In the absence of complaints and normal he alth, it is recommended to take a urine test at least once a year.
The OAM norm in children at 3 years old and, for example, 15 years old is significantly different. For babies, an analysis is prescribed, as a rule, for the purpose of conducting a routine examination. In infants, it is necessarily carried out at the age of 1, 3 and 12 months. Urinalysis, carried out immediately after birth, helps to identify congenital anomalies in the intrauterine development of the bladder, kidneys, and to determine abnormalities in the structure of the genitourinary system, which is especially important to know in the first months of life. Since infants are unable to say what is bothering them, deciphering OAM in children can provide answers to a number of questions of interest.
In addition, the study of urine is the easiest way to detect inflammatory diseases of the kidneys, liver, ureters, biliary tract. Urinalysis values can be important in making diagnoses such as cholecystitis, cystitis, urolithiasis and even oncology.
This type of laboratory test is often prescribed for respiratory diseases, during the treatment of viral or bacterial pathologies. The study is prescribed for a protracted course of the disease, accompanied by characteristic symptoms, persistent fever. If a cold does not recede for a month or more, a sick child must be sent for OAM. The norm in children will say that the therapy is chosen correctly, but the body needs some time to fully recover. Otherwise, you will need to urgently change the tactics of treatment or undergo a second examination.
In case of bacterial diseases of the upperrespiratory tract (tonsillitis or scarlet fever), it is advisable to pass a general urine test again a week after discharge. It will also make sure that the disease has receded.
Preventive examination
As already noted, the most common indication for a general urine test is routine diagnostics. In infants, it is carried out immediately after birth in order to detect congenital pathologies, at the age of one, three months and a year, and then annually. In children under one year old, the decoding of OAM (urinalysis) is of particular importance, because during this period it is extremely important to monitor the he alth of the baby. This will help to prevent the development of serious diseases in a timely manner, the most common of which in infants are urinary tract infections, cystitis, urethritis.
In addition to a scheduled preventive examination, such a diagnosis would be appropriate against the background of long-term infectious and inflammatory processes in the body. In addition, a general urine test is prescribed to identify the dynamics of recovery, the effectiveness of the therapy.
How to properly collect biomaterial?
To get the most correct and reliable data, you need to follow certain rules in the process of collecting urine for research:
- Before starting the procedure, you need to wash the child with warm water without soap.
- You need to collect urine on an empty stomach in the morning, as soon as the baby wakes up.
- Special attention should be paid to the dishes for collecting biomaterial - urinemust be placed in a sterilized glass or plastic container. The pharmacy sells special containers for this purpose.
- After collection, urine can be stored for no more than three hours, preferably in a cool place.
Thus, having received the biomaterial, it is necessary to transport it to the laboratory as soon as possible.
Difficulties in collecting urine from babies
This used to be a real problem, because babies have absolutely no control over their urination. To get the biomaterial, the parents had to "on duty" with the baby without a diaper with a sterile container. However, today it is much easier to collect baby urine. In any pharmacy you can find a miniature disposable device - a urinal. It is a small sterile package that is attached to the outside of the child's genitals. The urinal is suitable for use by both girls and boys.
The package is easily fixed on the skin with adhesive tape, which is located at the edges of the hole. There is no need to wait for the act of urination. Having fixed the urinal, the child can put on a diaper, and after a while check whether the baby has urinated or not yet. As soon as the material for research is collected, it is poured into a sterile dish.
Older children have much easier urine collection. If the child already knows how to control the process of urination, it is necessary to take care of the cleanliness of the pot in advance. As soon as the baby urinates into it, you can pour urine intospecial container.
Basic indicators of the norm
Primary decoding analysis in children (OAM) takes place in the laboratory. Specialists study the provided biomaterial according to various criteria. Each of the indicators has reference values. With a slight deviation from the OAM norm in a child under one year old and older babies, the doctor may prescribe an additional examination.
So, for example, to determine the quality of urine, its color is important. This criterion depends on the presence of coloring pigments. The color of urine may be more pronounced with excess nutrition, taking medications. In a he althy child, straw-yellow urine is considered normal, and in older children, amber-yellow. Transparency also matters. This indicator indicates the presence of sediment in the urine. Normally, it should be transparent. Slight turbidity is allowed if the biomaterial was delivered to the laboratory 5 or more hours after collection.
The second fundamentally important indicator is the smell, despite the fact that information about it is not indicated in the OAM results. Normally, in children of 3 years of age, the aroma of urine becomes the same as in an adult. Urine has an unusual aroma, slightly reminiscent of the smell of meat broth, while in a he althy person it should not be sharp.
The next criterion is density. It depends on the chemical composition of urine. To a greater extent, the specific gravity of urine indicates the filtration function of the kidneys. With increased density of urine, dehydration is suspected. This indicator of OAM in children should normallybe within the following limits:
- in the first days after birth - 1008-1018 mg/l;
- up to six months of age - 1002-1003 mg/l;
- from six months to three years - 1006-1009 mg/l;
- three to five years - 1010-1019 mg/l;
- at seven years old - 1008-1021 mg/l;
- after 10 years – 1011-1025 mg/l.
Interestingly, with excessive consumption of protein foods, urine density increases, and with excessive consumption of fiber, it decreases.
When studying the urine of an adult or a child, such a parameter as acidity is taken into account. It indicates the percentage of alkali and acid in urine. This criterion is not stable, as it constantly changes depending on the diet. The pH level is considered to be within the range of 5-7 units.
Chemical composition and other characteristics
Such a reference value of TAM, as specific gravity, allows you to assess the state of he alth of the child. However, this parameter is not constant and should change in children with age. Normally, OAM in both children and adults demonstrates the absence of a number of substances in the chemical composition of urine. So, for example, in a he althy child, they are not found in the urine:
- Proteins are organic substances made up of amino acids. Their presence in the urine indicates an inflammatory process in the urinary system. The exception is the results of the analysis of the urine of newborns - in infants of the first days of life, a slight presence of protein (up to 5 mg / l) is allowed.
- Glucose is a simple carbohydrate. If hegets into the urine, which means that its concentration in the blood is overestimated. In infants, glucose may appear in urine collected after feeding.
- Bilirubin is one of the elements in bile. It should not be in urine, just like urobilinogen, a component formed from bilirubin.
- Ketone bodies are the toxic by-products of fat and carbohydrate metabolism. Ketone bodies can appear in the urine with a diet rich in proteins and fats and deficient in carbohydrates. The presence in the urine of indican, a substance derived from indoxyl, is not allowed.
In the urine of a he althy child, a small amount of cells of the upper epithelial layer may occur. They enter the sample from the outer surface of the epidermis during the collection of biomaterial. The presence of mucus and cylinders in the urine (these are microscopic particles of the cavity of the renal tubules) indicates poor functioning of the kidneys, which do not fully perform their filtration functions.
Urine in a he althy child is an absolutely sterile biological fluid. Pathogenic microorganisms may be present in diseases of the genitourinary system or non-compliance with hygiene measures when collecting urine. Most often, E. coli, Klebsiella, Proteus, Enterococcus and lactobacilli are found in the analyzes.
Inflammatory and infectious processes in the kidneys, bladder and urinary tract can be indicated by red and white blood cells - erythrocytes and leukocytes. Normally, they should not be in the urine, but in children under one year old, OAM maythere are a small number of them.
Oxalates, phosphates, urates are s alt crystals, the percentage of which directly depends on the diet of the child and the degree of his physical activity. When deciphering OAM in children, the doctor must take this factor into account.
Deviation from the norm of organoleptic parameters
Not always the excess or decrease of normal parameters indicates pathology. Urine is a biological fluid that contains various organic compounds. Urine is based on water, which contains several hundred microcomponents, while most of them do not have specific characteristics.
During the day, 30-50 g of dry substances (s alts and urea) are excreted through the genitourinary system of a child, about 70-80 g of adult - about 70-80 g. organism. Organoleptic parameters, including shade, smell, degree of transparency and quantitative indicator of urine, can indicate a number of disorders in the urinary system.
As already noted, first of all, laboratory specialists pay attention to the color of urine. Normally, it should be light yellow or straw. If the urine is dark yellow, suggest dehydration or heart problems. An almost brown shade of urine may indicate a malfunction in the liver, structural disorders of the gallbladder. A reddish color, reminiscent of meat slops, is usually observed with hematuria. Suchthe phenomenon occurs against the background of infectious and inflammatory diseases of the kidneys, trauma to the lumbar region, the presence of stones or sand in the urinary tract.
Turbid urine also suggests the course of a pathological process in the kidneys or bladder. Transparency decreases with an increase in the content of blood cells and urea, as well as when epithelial cells enter during the collection of biomaterial.
If the urine has a pronounced pungent odor, the child may be suffering from dehydration. The pungent smell of urine can be a symptom of diabetes. If the liquid smells like acetone, inflammation in the bladder is diagnosed. The smell of rot indicates a bacterial infection of the urinary tract, for confirmation of which, in addition to UAM, children are given a urine culture.
Daily Volume
An insufficient amount of fluid released during the day can also be a cause for concern. The norm of urine volume depends on the age of the child and is calculated according to the following formula: 100 x (L-1) + 600, where L is the number of years.
An increase in daily urine output is not considered pathological if it is caused by the use of diuretic drinks, watermelon, etc. Restriction in water intake, increased sweating, vomiting or diarrhea lead to a reduction in natural diuresis. In premature babies, reduced diuresis is considered normal, but if the baby does not urinate for 12-18 hours, anuria is diagnosed.
Diseases of the kidneys and urinary tract in children
Ohthese pathologies are most often evidenced by blood elements, cylinders and s alts in urine. Biomaterial samples are examined under a microscope. If a pathology is suspected, a general blood test (CBC) is performed in parallel. Deciphering OAM in children (the norm of various indicators may differ depending on the age and gender of the child) includes the definition of basic elements:
- erythrocytes;
- leukocytes;
- bacteria;
- s alts.
When erythrocytes appear in the urine, such kidney diseases in a child as pyelonephritis, glomerulonephritis, cystitis are suggested. The concentration of red blood cells sometimes increases with viral diseases and severe chemical intoxication of the body. A small number of red blood cells can be observed during physical overexertion.
Normally, children should not have leukocytes in OAM. Their appearance also indicates renal dysfunction, an inflammatory or purulent process. If leukocytes are detected in the urine of girls, it is recommended to take the test again, since white blood cells could accidentally get into the urine from the surface of the labia.
Bacteria, as already noted, appear in urine for one of two reasons: infection of the urinary tract or improper collection of urine. The s alt content increases with an unbalanced diet, consisting mainly of fatty and sweet foods. An excess level of oxalates, urates, phosphates in the urine is a favorable condition for the development of urolithiasis.
Other study parameters
In addition to the above criteria, inIn the process of studying the biomaterial, other characteristics of urine are also evaluated. In particular, physicians are interested in density and acid-base balance - these indicators are also noted in the analysis results. OAM in children allows you to determine the functionality and coherence of the renal system, its ability to filter, dissolve various compounds. Decreased urine density is observed with dehydration. If the specific gravity of the urine is elevated, one of the following may be present:
- liver failure;
- nephrotic syndrome;
- diabetes mellitus;
- arrhythmia.
Children whose pH level does not reach five units suffer from hyperacidity. Such test results are found in babies with hereditary diabetes mellitus, as well as in those children who consume a lot of meat products. A pH value above 7 indicates low acidity in the body and, as a result, serious pathologies of the urinary system, infection of the kidneys. A similar problem occurs in adult patients who adhere to vegetarian dietary principles.
Ketone bodies identified in the urine require special attention - these are the breakdown products of fats and carbohydrates. An increase in their concentration contributes to a deficiency of glucose in the body. Most often, ketonuria is diagnosed in children under the age of five years and leads to the development of acetonemic syndrome. When deciphering OAM in children under one year old, ketonuria is extremely rare.
What to do in case of deviations fromnormal?
Panic and make hasty decisions is not worth it. After receiving the results of a general urine test, it is necessary to consult with a pediatrician. Not all deviations from normal indicators are a cause for concern. First of all, it is impossible to 100% exclude the distortion of the results of a laboratory study. In addition, the cause of errors may be taking medications or vitamins, a sharp change in the climatic zone, severe overvoltage and other circumstances.
To make a diagnosis and prescribe treatment, not only the results of the analysis are important, but also the clinical picture, the patient's complaints, and atypical manifestations. If a specialist suspects a serious illness, then to confirm the diagnosis, he may prescribe a second study in order to exclude the possibility of errors in the laboratory conclusion and confirm his assumptions.
