Update: December 2018
Urine is a human waste product. Its formation occurs in the kidneys; it is a complex and lengthy process. Excess water, waste (uric acid, urea), ions (sodium, potassium, chlorine), vitamins and hormones are removed from the body with this fluid.
A general urine test plays a big role for a doctor; it helps determine kidney function, and also allows one to judge the state of the gastrointestinal tract, cardiovascular system, and others.
Urine collection rules
Human urine is normally sterile; bacteria can only enter it when passing through the urinary tract or from dirty dishes. Collecting this biological fluid is a very intimate process that is carried out independently; children or seriously ill people usually need help. How to properly collect urine?
- material is collected in the morning, immediately after sleep, on an empty stomach;
- it is recommended that the previous urination was at least 5-6 hours ago;
- before urinating, the patient must toilet the external genitalia (women wash the perineal area with soap and water, and men wash the head of the penis and the external opening of the urethra);
- Sample collection is prohibited during menstruation;
- an average portion of urine is collected, its volume is approximately 50-100 ml;
- the first drops are flushed into the toilet, as they contain epithelium that has peeled off from the mucous membrane;
- the material is taken into a dry, clean, transparent container with a wide neck and a tight lid;
- urine should not be taken from a duck, urinal, chamber pot, etc.;
- collection dishes must be thoroughly washed and rinsed free of detergents, as they can affect the analysis results;
- the collected liquid must be immediately delivered to the laboratory; its shelf life is no more than one and a half hours;
- On the eve of the examination, it is undesirable to eat vegetables and fruits containing pigments (carrots, beets), as well as alcohol and chocolate.
Indications for the purpose of the study
- inflammatory processes in the genitourinary system (glomerulonephritis, interstitial nephritis, cystitis,);
- spicy and
- some neoplasms (myeloma, melanoma, pituitary tumor);
- obstructive jaundice (, acute cholangitis);
- sugar and ;
- acute pancreatitis.
Usually, an ultrasound of the kidneys is also prescribed at the same time (see).
Table of norms for general urine analysis
| INDEX |
ON AN ELECTRONIC ANALYSIS FORM |
NORM |
| Color | Yellow (all shades, from straw yellow to yellow) | |
| Smell | Not harsh | |
| Appearance | Transparent | |
| Relative density or specific gravity | Adults – 1010-1025 (in morning urine – 1018-1026)
|
|
| Acid-base reaction | pH |
|
| Protein |
|
|
| Glucose |
|
|
| Ketone bodies or acetone | KET |
|
| Leukocytes |
for girls: Negative or 0-2 and up to 8-10 in PZ |
|
| Urobilinogen |
Up to 17 µmol/l (umo/L) |
|
| Red blood cells |
in adults 0-1-2-3 in the field of view |
|
| Epithelial cells (squamous epithelium) | ep. or ep. class | |
| Cylinders (hyaline casts) | cyl | |
| Bilirubin | BIL | Absent/Negative |
| Bacteria | ||
| Salt crystals | the names of the salts are written by hand | |
| Mushrooms | — | |
| Slime | — |
Interpretation of a general urine test
Daily diuresis
This is the amount of urine excreted per day. It depends on the volume of fluid drunk and moisture loss through the lungs, skin and intestines. Normal daily urine volume at different ages:
Disorders of daily diuresis:
| Pathological syndrome | What is its essence | What diseases does it occur in? |
Polyuria |
Increase in excreted fluid over 2000 ml per day |
|
Oliguria |
Reducing urine volume to 300-600 ml |
|
Anuria |
Reduced urine output to 50 ml or its complete absence |
|
Ishuria |
Urine is retained in the bladder or spontaneous urination is impossible |
|
How many times a person urinates per day also plays an important role. Normally, this number is 4-5 times a day.
A change in the frequency of urination occurs in the following cases:
- pollakiuria (more than 5 times a day) - happens if you drink a lot of water, as well as with inflammation of the genitourinary system;
- olakiuria (less than 3 times a day) – this condition is possible due to insufficient water intake or neuro-reflex disorders;
- dysuria (see) - occurs with cystitis, urethritis, pyelonephritis, etc. (see,).
Transparency
Urine should be clear, if it is cloudy, then it is possible:
- The presence of protein in the urine - amyloidosis, pyelonephritis, glomerulonephritis
- The presence of red blood cells - kidney cancer, urolithiasis, prostatitis, pyelonephritis, glomerulonephritis
- Bacteria in urine - cystitis, pyelonephritis
- Presence of leukocytes – pyelonephritis, cystitis
- Epithelium in urine - pyelonephritis
- Precipitation of salts (phosphates, urates, oxalates)
Color
The color of the liquid we secrete is provided by the pigment urochrome (a product of bilirubin metabolism). A change in the color of the material may indicate various pathologies; it is also observed when consuming certain foods and medications:
- reddish, red, the color of “meat slop”- indicates the presence of red blood cells (hematuria), that is, blood in the urine (urolithiasis, cystitis, glomerulonephritis), as well as in hereditary porphyrinuria, lead intoxication, severe toxicosis, taking anti-tuberculosis drugs (rifampicin), phenacetin, iron supplements, sulfazole, red streptocide, amidopyrine.
- dark yellow with a brownish or greenish tint– release of bile pigments during mechanical (bile stagnates and does not flow from the gallbladder into the intestine), hemolytic anemia.
- dark yellow - concentrated urine, usually occurs with low fluid intake, increased sweating, and also when eating carrots. With (vomiting, diarrhea, high temperature), as well as with fasting, in children with a lack of breast milk, with heart and liver diseases.
- greenish yellow– an abundance of pus (pyuria);
- dirty brown– pyuria with an alkaline reaction;
- black and brown-black– release of hemoglobin in hemolytic anemia (hemoglobinuria), melanin in melanoma, melanosarcoma, Marchiafava-Micheli disease, naphthol poisoning
- white, whitish– large amounts of phosphates (phosphaturia), fats (lipuria) or lymph (tumors of the urinary system or renal tuberculosis).
- clear, pale urine– harmless reasons: taking diuretics and products (see), drinking plenty of fluids. Pathological causes - diabetes insipidus, impaired concentrating function of the kidneys;
- pink – the presence of phenolphthalein in an alkaline reaction;
- dark brown – use of sulfonamides (biseptol), metronidazole, bearberry-based drugs;
- greenish-brown– taking indomethacin, amitriptyline;
- orange-yellow - after the introduction of vitamins B, C, multivitamin complexes, as well as eating food with beta-caratine - persimmons, apricots, carrots, bright orange fruits and vegetables.
Smell
Usually the material has a special specific smell. A change in it indicates certain diseases. For example, an ammonia smell means an inflammatory process of the genitourinary system (urethritis, pyelonephritis) or a decaying tumor. And with diabetes mellitus, the smell of “soaked apples” or acetone occurs.
Urine specific gravity (sg)
The determination of relative density is of great clinical importance, since this value reflects the ability of the human kidney to concentrate and dilute. The specific gravity of urine is measured by the substances found in it (various salts, sugar,).
| Norm indicator for different ages | Increase in relative density | Specific gravity reduction |
|
An EF of more than 1026 is called hypersthenuria. This condition is observed when:
|
A decrease in EF or hyposthenuria (less than 1018) is detected when:
|
Urine pH reaction
The urine of a healthy person has a neutral or slightly acidic reaction. Its change is associated, first of all, with the nature of the diet (meat or vegetables), as well as with a number of diseases. It should be remembered that if urine stands at room temperature for a long time, this leads to its alkalization and destruction of formed elements, thereby changing the results of the analysis.
What diseases can change the pH of the material?
| Acid reaction (pH< 5,0) | Alkaline reaction (pH ≥ 7.0) |
|
|
Total protein
The presence of a small amount of protein in the material is possible during psycho-emotional stress, physical overexertion, sports competitions, taking a cold shower or bath (orthostatic proteinuria). An increase in total protein in the urine over 0.14 g/day (proteinuria) is a serious sign of the presence of certain diseases (see).
Special types of proteins can be determined in the test liquid:
- Bence-Jones protein – for myeloma, Waldenström microglobulinemia;
- β2-microglobulin – in case of damage to the renal tubules.
Degrees of increase in total protein in urine:
Glucose
The presence of glucose in the urine (glucosuria) is directly related to blood sugar levels: the more glucose in the blood, the more of it will be excreted from the body. Glucosuria is the first sign of DIABETES MELLITUS! Also, sugar in the urine may increase if:
- acute pancreatitis;
- thyrotoxicosis;
- renal diabetes;
- steroid diabetes, Itsenko-Cushing's disease;
- sepsis;
- brain tumors;
- pheochromacytoma;
- the action of toxic substances (morphine, strychnine, phosphorus, chloroform).
But not in all cases glucosuria indicates a disease. Normally, this condition occurs when overeating sweets, under constant stress, and in pregnant women.
Ketone bodies
Ketone bodies are products of fat metabolism. Normally, a very small amount of them is formed in the body. Ketones include: acetone, β-hydroxybutyric acid and acetoacetic acid.
The detection of ketones in the urine (ketonuria or) indicates the following:
- uncompensated diabetes mellitus;
- low-carbohydrate diet, fasting, cachexia;
- excessive production of steroid hormones in tumors of the brain and adrenal cortex;
- acetonemic vomiting in children;
- dysentery;
- thyrotoxicosis;
- acromegaly;
- eclampsia in pregnant women;
- intoxication.
Leukocytes in urine
The detection of a large number of these cells in the urine always indicates an inflammatory process in the urinary system, be it cystitis or pyelonephritis. If the number of white blood cells is more than 60 per field of view, it is called pyuria (pus in the urine). The analysis may include both neutrophils and lymphocytes. In chronic inflammation, leukocytes are a more reliable indicator than bacteria, which are not always detected.
Red blood cells in urine
In the urine of a healthy person, red blood cells are absent or are detected in the form of single cells (0-1-2-3 in the field of view). Normally, their appearance is associated with heavy physical labor and sports. In women, red blood cells may be included in the analysis during menstruation or pregnancy.
Depending on the number of red blood cells in the urine, the following are distinguished:
- mild erythrocyturia - up to 20 cells in a microscope;
- moderate severity – from 20 to 200 cells;
- pronounced erythrocyturia (hematuria) - more than 200 cells in the field of view.
Depending on which part of the urinary system the red blood cells enter the urine, they are found leached or unchanged. Reasons for the presence of red blood cells in urine:
- kidney injuries - tear, bruise, rupture
- urolithiasis disease
- kidney infarction
- urethritis, cystitis, acute glomerulonephritis
- bladder cancer, kidney cancer, prostate cancer
Why does blood appear in urine?
- glomerulo- and pyelonephritis (acute and chronic);
- urolithiasis disease;
- acute cystitis;
- kidney infarction;
- kidney and bladder cancer;
- prostate adenoma;
- trauma to the genitourinary system;
- hemorrhagic diathesis;
- systemic lupus erythematosus;
- hemorrhagic fever (Ebola, Crimean, Congo);
- kidney amyloidosis;
- poisoning with benzene, aniline, snake venom;
- kidney tuberculosis;
- lipoid nephrosis.
Epithelium
Epithelial cells are always found in the analysis. They get there by sloughing off the mucous membrane of the urinary tract. Depending on the origin, transitional vtc (bladder), squamous (lower urinary tract) and renal (kidney) epithelium are distinguished. An increase in epithelial cells in the urinary sediment indicates inflammatory diseases and poisoning with heavy metal salts.
Cylinders
The casts are so-called “protein casts” of the urinary tract. Depending on the appearance and origin, they are distinguished:
| Name | Where does it come from? | What diseases does it occur in? |
| Hyaline | Kidney tubules |
|
| Grainy | Kidney tubules |
|
| Waxy | Formed from compacted hyaline and granular cylinders when they are retained in the tubules |
|
| Epithelial | Renal tubular epithelium |
|
| Erythrocyte | Red blood cells |
|
| Pigment | Hemoglobin, bilirubin, myoglobin |
|
| Leukocyte | Leukocytes |
|
Bilirubin in urine
Bilirubin cannot normally be found in the urine, since it is excreted into the intestinal lumen as part of bile. When the level of bilirubin in the blood is elevated, the kidneys take over the function of removing it. Causes of bilirubin in urine:
- hepatitis
- destruction of red blood cells in malaria, hemolytic disease, toxic hemolysis, sickle cell anemia
- cholelithiasis
Urobilinogen in urine
Urobilinogen is a substance formed from bilirubin released with bile in the intestinal lumen. From the intestine, it partially returns to the blood and enters the liver through the bloodstream, where it is excreted again with bile. If the liver is not able to bind all the incoming urobilinogen, part of it enters the general bloodstream, then this urobilinogen is excreted from the body by the kidneys. Reasons for the release of urobilinogen in the urine:
- liver failure
- inflammation of the intestines - colitis, enterocolitis
- massive destruction of red blood cells
Hemoglobin in urine
Hemoglobin is a protein involved in the transfer of oxygen to cells; it is found inside the red blood cell. When severe destruction of red blood cells occurs, a large amount of hemoglobin is released into the blood, and the spleen and liver do not have time to break it down. In this case, free hemoglobin is excreted in the urine. Also, during myocardial infarction, when muscle tissue is compressed, myoglobin (similar in structure to hemoglobin) can be released into the blood, which is also partially excreted by the kidneys. The causes of hemoglobin in urine are:
- malaria
- burns
- blood transfusion
- hemolytic disease
- damage to muscle tissue - contusion with hematoma, crash syndrome
- poisoning with sulfa drugs, phenol, mushrooms
Salt crystals
There are many ions and salts dissolved in urine. Excess of them leads to the formation of sediment and stones, which cause urolithiasis. The following are most often found in material sediment:
Bacteria and fungi
The detection of over 50,000 bacteria in 1 ml of material indicates inflammation of the urinary tract. Then the patient is recommended to undergo a urine culture to determine the specific type of microorganisms and their sensitivity to antibiotics. The presence of fungal mycelium in the analysis indicates candidiasis or a decrease in local immunity after taking antibiotics.
Slime
Normally there should be no mucus in the urine. Its presence indicates an acute or chronic inflammatory process of the genitourinary system.
In conclusion, I would like to add that a general urine test is an important diagnostic indicator. A person can independently pay attention to changes in urine and consult a doctor. Even healthy people are recommended to take this test at least once a year. It should also be remembered that a single result is not an indicator of pathology. It is very important to take tests over time in order to make a final conclusion about the presence of the disease.
In the article we will consider the norms of general urine analysis in women.
This is a comprehensive study of material in laboratory conditions, which can determine the chemical and physical properties of urine. Based on the indicators obtained as a result of the study, the doctor is able to confirm a number of diseases.
General women's health is part of any diagnostic measures, as it is quite easy to perform and provides comprehensive information about the state of health. Upon receiving the results of the study, the specialist makes a diagnosis and, if necessary, prescribes additional examination, including visits to highly qualified specialists.
What is the norm for a general urine test in women is interesting to many.
Collection and delivery of urine analysis
Most often indicated for women during gestation. It is during pregnancy that urine can show the presence of pathological processes in the body, which will allow the problem to be diagnosed in a timely manner and appropriate measures taken.
It is important to know how to collect urine for a general analysis for women.
Such a study is prescribed in the following cases:
- Study and evaluation of the urinary system. The analysis is also prescribed if pathologies in other systems and internal organs are suspected.
- Monitoring the development of the disease and assessing the quality and effectiveness of therapy.
- Preventive examination.
The study of urine helps to diagnose various pathologies of the kidneys, prostate gland, bladder, neoplasms, pyelonephritis and other diseases in the early stages of development, even in the absence of clinical manifestations.
How to take a general urine test for women?
Before collecting urine, it is necessary to carefully observe the rules of intimate hygiene of the genitourinary system. This will prevent contaminants from entering the collected fluid, which can spoil the results of a general urine test in women.
Urine is collected in a sterile container, preferably in a special urine collection container purchased at a pharmacy.
How to properly take a general urine test for a woman?
12 hours before the intended collection of biomaterial, it is recommended to stop taking medications that may affect the analysis parameters. The study should be carried out no later than two hours after urine collection.
To conduct a general urine test, you need to collect a morning portion of the fluid that accumulates in the bladder during sleep. This material is considered the most revealing and reliable regarding the required research.
General urine test: normal in women
A general urine test involves an assessment of a number of indicators, the norm of which is the following results:
- The color of the liquid should be any shade of yellow.
- Transparency. Urine should be clear without turbidity.
- The smell in the normal state is non-specific and mild.
- Reaction or alkaline balance. Urine is acidic with a pH less than 7.
What other normal indicators are found in a general urine test in women?
The normal indicators for general urine analysis in pregnant women are presented in the table.
General urine testing is carried out quite quickly, even despite the extensive number of indicators being tested. The composition and properties of urine can change dramatically depending on the health of the body in general and the kidneys in particular. That is why this analysis is very valuable for the doctor.
Let's look at the decoding of a general urine test in women. The norm is described above.
Urine shade
The color of urine directly depends on the amount of fluid a person drinks per day, as well as the ability of the kidneys to concentrate urine. If the urine is watery, pale and colorless for a long time, this may indicate diabetes mellitus and insulin-dependent diabetes, as well as chronic kidney failure.
If the urine is intensely colored, it can be assumed that there is fluid loss outside the kidneys, which is typical for diarrhea and fever. Shades from pink to red-brown indicate blood in the urine, which indicates the following diseases:
- Urolithiasis disease.
- The presence of a neoplasm in the organs of the genitourinary system.
- Tuberculosis.
If clots are found in the urine, we can talk about glomerulonephritis, which occurs in an acute form. A dark red tint to urine appears with massive hemolysis of blood cells, namely red blood cells. Against the background of icteric syndrome, urine may become brown or greenish. Black color is found in melanosarcoma, alkaptonuria and melanoma. The color of milk is characteristic of a disease such as lipiduria.
Transparency
This indicator is also important when analyzing general urine samples. Normally, urine is clear during the first hours after collecting the fluid.
Doctors name the following pathological conditions as the causes of cloudy urine:
- Cystitis, glomerulonephritis and other diseases of the urolithiasis, which involve the inclusion of red blood cells.
- The presence of a large number of leukocytes against the background of inflammatory pathologies.
- Identification of pathogenic microflora.
- Increased protein content in urine.
- Increased level of epithelial cells.
- There is a large amount of salt in the urine.
Slight turbidity is acceptable if we are talking about a small amount of mucus or epithelial cells. The smell of urine in a normal state should be, as already mentioned, mild and non-specific. Most people are familiar with it, however, it can change against the background of pathologies. An ammonia or putrid odor is characteristic of infectious diseases. Diabetic urine smells like rotten apples.
Specific gravity, acidity and pH level of urine
In a normal state, the urine reaction is described as slightly acidic, and fluctuations in pH levels should be in the range of 4.8-7.5.
An increase in urine pH may indicate certain infectious diseases of the urinary system, as well as chronic kidney failure, increased function of the parathyroid glands, prolonged vomiting and hyperkalemia.
A decrease in pH level indicates pathologies such as diabetes, tuberculosis, hypokalemia, dehydration, fever, etc.
The specific gravity of urine normally has a wide range - 1.012-1.025. Specific gravity is determined based on substances dissolved in the urine, including uric acid, salts, creatinine and urea.
Hypersthenuria is diagnosed when the relative density of urine exceeds 1.026. This pathological condition is typical for the following diseases:
- Increasing swelling.
- Nephrotic diseases.
- Diabetes.
- Toxicosis during gestation.
- Injection of contrast for X-ray examination.
Hyposthenuria involves a decrease in the specific gravity of urine to below 1.018 and manifests itself in the following pathologies:
- Acute damage to the kidney tubules.
- Diabetes insipidus.
- Chronic kidney failure.
- Increased pressure in arteries of a malignant nature.
- Taking certain types of diuretics.
- Drinking plenty of fluids.
The relative density of urine shows the ability of the kidneys to concentrate and dilute this substance.
Protein and glucose
Normally, the protein content in urine should not be more than 0.033 g/l. An increase in this indicator may indicate nephrotic disease, as well as an inflammatory process and other pathological conditions. This condition is dangerous for a woman carrying a child, as her kidneys may fail, which will jeopardize the life and health of both mother and child. For this reason, doctors pay special attention to protein in the urine of a pregnant woman.
Pathologies that can lead to an increase in protein content in urine are:
- Colds.
- Pathologies of the urinary system.
- Kidney diseases.
- Inflammatory diseases of the urinary system, including cystitis and vulvovaginitis.
All of these ailments are accompanied by a significant increase in protein content in the urine, which can reach 1 g/l or more.
In addition, protein in the urine can be increased as the body's response to hypothermia, as well as high-intensity physical activity.
Glucose in urine is also an important diagnostic indicator. In a healthy body, there should be no glucose in urine. However, an increase in glucose to 0.8 mmol per liter is acceptable. Such a slight deviation does not indicate the presence of pathology.
If the concentration of sugar in urine exceeds the specified norm, the specialist concludes that the following diseases and conditions are present:
- Pancreatitis.
- Pregnancy.
- Cushing's syndrome.
- Eating a lot of sugary foods.
The most common cause of increased glucose levels in the urine is diabetes. This diagnosis can be confirmed by the results of a blood sugar test.
Ketone bodies and epithelium
Ketone bodies are known to everyone as acetone or hydroxybutyric and acetoacetic acid. The reason why ketone bodies may appear in urine is due to disturbances occurring in the metabolic system. There are also other medical conditions that can lead to the appearance of ketone bodies, including:
- Diabetes.
- Alcohol intoxication.
- Pancreatitis in acute form.
- Injuries that damage the central nervous system.
- Acetemic type vomiting in a child.
- Long-term refusal to eat.
- The predominance of fatty and protein foods in the diet.
- Thyrotoxicosis, characterized by increased levels of thyroid hormones.
- Cushing's disease.
Epithelial cells and casts
Such indicators of general urine analysis in women as epithelial cells are almost always found in urine during examination. They enter the urine during the act of urination, being removed from the mucous membrane of the urinary tract. The epithelium can be divided into transitional, squamous and renal, depending on the origin of the cells. A significant increase in epithelial cells in urine sediment indicates inflammatory diseases, as well as intoxication with heavy metal salts.
The cylinder is a protein that has coagulated in the lumen of the kidney tubules. In human daily urine, single cylinders can be detected in the field of view. In the normal state, they are absent and their appearance indicates cylindruria and is a sign of kidney damage. The casts can be granular, hyaline, pigmented, epithelial, etc.
Cylindruria may indicate the following pathological conditions:
- Kidney diseases.
- Hepatitis of infectious origin.
- Scarlet fever.
- Systemic lupus erythematosus.
- Osteomyelitis.
Hemoglobin and bilirubin
A positive urine test for the presence of free hemoglobin or myoglobin indicates muscle necrosis, as well as hemolysis of red blood cells of the intrarenal, intravascular or urinary type. In addition, the detection of myoglobin in urine indicates the following disorders:
- High intensity physical activity, including sports.
- Myocardial infarction.
- Progressive myopathy.
- Rhabdomyolysis.
Hemoglobin in urine indicates the presence of hemolytic anemia, sepsis, burns and severe intoxication.
The reasons for the presence of bilirubin in urine may be the following pathologies:
- Hepatitis.
- Cirrhosis.
- Kidney failure.
- Willenbrand's disease.
- Cholelithiasis.
In addition, extensive destruction of red blood cells can lead to the appearance of bilirubin.
In a normal general urine test, women should not have red blood cells and a large number of white blood cells.
Red blood cells and white blood cells
Physiological reasons for the appearance of red blood cells in the urine can be the use of certain medications, as well as prolonged stay in an upright position, walking and increased physical activity. If physiological factors are excluded, the specialist draws a conclusion about the pathological causes of the appearance of red blood cells in urine.
An increase in the number of leukocytes in the field of view during analysis indicates inflammatory diseases in the kidneys and urinary tract. In addition, sometimes we are talking about sterile leukocyturia, when there is no dysuria and bacteriuria in the urine.
The causes of leukocyturia can be pathological conditions such as pyelonephritis, chronic glomerulonephritis, urethritis, cystitis, the presence of stones in the ureter, systemic lupus erythematosus and tubulointerstitial nephritis.
What does a general urine test show in women, in addition to the indicated points?
Other impurities
Normally, urine in the bladder and kidneys is sterile. When urinating, various microbes penetrate into the liquid. The norm is 10,000 units per ml. Exceeding this indicator indicates an infectious disease of the genitourinary tract.
Candida fungus, which causes thrush, can also penetrate from a woman’s vagina into her urine. In this case, antifungal treatment is indicated.
The presence of mucus in urine may indicate an inflammatory process occurring in the genitourinary system in a chronic or acute form.
Salt in urine indicates metabolic disorders, vitamin deficiency, anemia, etc.
In order for all the indicators to be correct, you should know how to correctly take a general urine test for a woman.
Conclusion
Thus, this study is a reliable and effective way to test almost all systems and organs of the human body. The analysis is especially relevant for women during gestation, as it is an indicator of the normal functioning of the pregnant woman’s body. It is recommended to submit urine for general examination regularly even in the absence of signs of pathology.
We found out what the norms are for a general urine test in women.
Interpretation of general urine analysis indicators
General urine analysis refers to mandatory diagnostic procedures that are prescribed to all patients who apply to a health care facility.
Here we will tell you what urine indicators are measured during a general urinalysis, and what diseases are indicated by certain deviations of these indicators from the norm. And also about how to correctly collect urine for general analysis, 24-hour urine analysis and for urine analysis according to Nechiporenko.
In a general urine analysis, parameters such as specific gravity (relative density), color, transparency, odor, pH (acidity), protein content, glucose content, content of ketone bodies and bile pigments and some other indicators are examined.
The results of a urine test are given to the patient in the form of a table with incomprehensible letters that only a specialist can read. Below is a breakdown of those very “incomprehensible letters”, as well as norms and possible deviations for individual indicators.
Interpretation of general urine analysis indicators
BLd - red blood cells,
Bil - bilirubin,
Uro - urea,
KET ketones,
PRO protein,
NIT - nitrites (in the usual meaning - bacteriuria),
GLU - glucose,
pH - acidity,
S.G - density,
LEU - leukocytes,
UBG - urobilinogen.
The table shows the main indicators of a general urine test that is normal. We will discuss some of them in more detail below:
Norm of general urine analysis (table)
| General urine analysis(norm) |
|
| Urine color | various shades of yellow |
| Urine clarity | transparent |
| Urine smell | unsharp, non-specific |
| Urine reaction or pH | acidic, pH less than 7 |
| Specific gravity (relative density) of urine | 1.018 or more in the morning portion |
| Protein in urine | absent |
| Glucose in urine | absent |
| Ketone bodies in urine | none |
| Bilirubin in urine | absent |
| Urobilinogen in urine | |
| Hemoglobin in urine | absent |
| Red blood cells in urine (microscopy) | 0-3 in the field of view for women; 0-1 in sight for men |
| Leukocytes in urine (microscopy) | 0–6 in field of view for women; 0–3 in view for men |
| Epithelial cells in urine (microscopy) | 0-10 in field of view |
| Casts in urine (microscopy) | none |
| Salts in urine (microscopy) | none |
| Bacteria in urine | none |
| Mushrooms in urine | none |
| none |
|
Interpretation of urine test results
Urine test norms for adults and children (table)
Normal values (in field of view)
| Sediment element | from 0 to 18 years | over 18 years old | |||
|---|---|---|---|---|---|
| boys | girls | men | women | ||
| red blood cells | single in the preparation | 0 - 2 | |||
| leukocytes | 0 - 5 | 0 - 7 | 0 - 3 | 0 - 5 | |
| altered leukocytes | none | ||||
| epithelial cells | flat | single in the preparation | 0 - 3 | 0 - 5 | |
| transitional | 0 - 1 | ||||
| renal | none | ||||
| cylinders | hyaline | none | |||
| grainy | |||||
| waxy | |||||
| epithelial | |||||
| erythrocyte | |||||
The acid-base reaction of urine is normal
The urine reaction (pH) of urine in a healthy person on a mixed diet is acidic or slightly acidic.
Table: Urine acidity in children and adults is normal
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Specific gravity of urine (g/l) is normal
The specific gravity of a healthy person’s urine can fluctuate over a fairly wide range throughout the day, which is associated with periodic food intake and fluid loss through sweat and exhaled air.
Table: Specific gravity of urine in adults and children is normal
The specific gravity of urine depends on the amount of substances dissolved in it: urea, uric acid, creatinine, salts.
- A decrease in the specific gravity of urine (hyposthenuria) to 1005-1010 g/l indicates a decrease in the concentrating ability of the kidneys, an increase in the amount of urine excreted, and drinking plenty of fluids.
- An increase in the specific gravity of urine (hypersthenuria) of more than 1030 g/l is observed with a decrease in the amount of urine excreted, in patients with acute glomerulonephritis, systemic diseases, with cardiovascular failure, may be associated with the appearance or increase swelling, large loss of fluid (vomiting, diarrhea), toxicosis of pregnant women.
Protein in urine, normal protein in urine
Fine protein in urine absent. Appearance protein in urine- one of the most important symptoms of kidney and urinary tract disease. The appearance of protein in the urine is called proteinuria. Proteinuria is possible in healthy people after eating a large amount of protein-rich food, after severe physical stress, and after emotional experiences.
Pathological proteinuria divided into renal (prerenal) and extrarenal (postrenal):
- Extrarenal proteinuriacaused by an admixture of protein secreted by the urinary tract and genitals; they are observed at cystitis, pyelitis, prostatitis, urethritis, vulvovaginitis. Such proteinuria rarely exceeds 1 g/l (except for cases of severe pyuria - detection of a large number of leukocytes in the urine).
- Renal proteinuriamost often associated with acute and chronic glomerulonephritis and pyelonephritis, nephropathy of pregnant women, febrile conditions, severe chronic heart failure, renal amyloidosis, lipoid nephrosis, kidney tuberculosis, hemorrhagic fevers, hemorrhagic vasculitis, hypertension.
Glucose (sugar) in urine (normal)
Carbohydrates (glucose) in urine healthy person are contained in insignificant concentrations, their presence almost always serves as a sign diabetes mellitus. Thus, urine normally contains traces of glucose not exceeding 0.02%, which, like protein, is not detected by ordinary qualitative tests.
Urine test for red blood cells (normal)Source: http://med..php/%D0%B0%D0%BD%D0%B0%D0%BB%D0%B8%D0%B7%D1%8B/193-%D0%B0%D0%BD %D0%B0%D0%BB%D0%B8%D0%B7-%D0%BC%D0%BE%D1%87%D0%B8.html
Erythrocytes (red blood cells)Normally, there are no urine sediments or only single ones are found in the preparation. A general urine test in a healthy person should show no more than 2 red blood cells in the field of view of the microscope, and no more than 3 leukocytes in men and 5 in women.
An increased number of red blood cells is characteristic of many diseases: pyelonephritis, urolithiasis, glomerulonephritis, urinary tract infections, systemic lupus erythematosus or poisoning(especially poisonous mushrooms, snake venom, benzene and aniline derivatives).
Urine analysis for leukocytes (normal)
Fine leukocytes are absent in the urine, or single ones are detected in the preparation and in the field of view. An increased level of leukocytes indicates possible pathologies of the kidneys or urinary tract: glomerulonephritis, pyelonephritis, urethritis, cystitis, prostatitis.
Leukocyturia (more than 5 leukocytes in the field of view) can be infectious (bacterial inflammatory processes of the urinary tract) and aseptic (for glomerulonephritis, amyloidosis, chronic kidney transplant rejection, chronic interstitial nephritis). Pyuria The detection of 10 or more leukocytes in the field of view in the sediment during microscopy is considered.
Urine analysis for epithelium (normal)
Flat epithelium: In men, only single cells are normally detected, their number increases with urethritis and prostatitis. In the urine of women, squamous epithelial cells are present in greater numbers.
Transitional epithelial cells may be present in significant quantities when acute inflammatory processes in the bladder and renal pelvis, intoxication, urolithiasis and neoplasms of the urinary tract.
Almost everyone in their life has taken a general urine test (UU) at least several times. This study is one of the most popular in modern diagnostics, as it allows one to determine many indicators of the vital systems of the human body and record a number of developing pathologies.
At its core, urine is a biological fluid, thanks to which the process of removing metabolic products from the body occurs. Among other things, toxins, excess vitamins and hormones, ions, excess water and many other components are excreted with urine. Normally, this elimination process balances the levels of many components of the human body, collecting excess and waste products.
From a diagnostic point of view, urinalysis is highly valued due to a number of factors:
- It allows you to collect data on the functioning of many body systems.
- The urine test correlates with the blood test.
- The collection and procedure for donating urine is quite simple and does not require any special measures.
- The results of a urine test quite often make it possible to determine the presence of specific pathologies without additional research.
Many people know that urine analysis is included in the list of general diagnostic tests. For example, they donate urine during any medical examination. At the same time, there is a fairly clear list of diseases for which urine testing is suspected to be one of the main diagnostic methods. These include all types of diabetes, jaundice, cholangitis and cholelithiasis, pancreatitis, renal failure of all forms, almost all types of neoplasms, as well as inflammation of the genitourinary system.
In addition to specific diagnostics, a general urine test allows you to evaluate the functioning of the gastrointestinal tract, kidneys, cardiovascular system and other groups of organs. And this, along with blood tests, makes OAM one of the most popular types of diagnostics.
Rules for taking a urine test
The seemingly simple procedure for donating urine actually requires compliance with a number of simple rules. They allow you to avoid errors in the analysis and eliminate the manifestations of false indicators that can lead the doctor down the wrong path in terms of therapeutic treatment. The rules for collecting urine look like this:
- material for analysis is taken on an empty stomach in the morning. At the same time, it is best if the person does not visit the toilet during the night;
- Before collecting urine, you must wash your genitals to avoid foreign substances getting into the analysis;
- The “middle” urine is taken for analysis. That is, the first and last third of the urination process is carried out into the toilet;
- the urine collection container must be clean and dry;
- before taking the OAM, you do not need to eat foods that can color urine: beets, carrots and others;
- Urine must be delivered to the laboratory for analysis no later than an hour and a half after collection.
Indicators in urine analysis
Now, in more detail about the analysis itself. Urine in the laboratory is studied in five areas:
- organoleptic,
- physico-chemical,
- biochemical,
- microscopic,
- microbiological
Let's look at each of these groups of indicators in more detail.
Photo: Jarun Ontakrai/Shutterstock.com
Organoleptic examination of urine
This group includes those indicators that can be analyzed using the senses. In relation to urine, organoleptic indicators include:
- diuresis,
- smell,
- color,
- degree of transparency,
- foaminess.
Study of diuresis
Diuresis is the volume of urine that is released by the body over a certain period of time. This figure in normal condition should be equal to three quarters of the volume of liquid consumed by a person. In absolute terms, daily diuresis should be about two liters.
Diuresis is assessed not by the fluid taken for analysis, but by studying the patient’s medical history. In fact, in his words. Based on the information collected, the following are distinguished:
- polyuria – exceeding the normal daily urination volume. This condition is typical for diabetics, people in post-fever states and during the resorption of edema, as well as nervous overexcitation;
- oliguria – insufficient volume of urine excreted from the body, up to 500 milliliters per day. Oliguria is typical for kidney problems, fevers, and heart diseases;
- Anuria is a condition in which the volume of daily diuresis does not exceed 200 milliliters. A similar thing happens with blockage of the urinary tract, tumors, nephritis, meningitis, acute renal failure;
- pollakiuria - a sharp increase in the number of visits to the toilet. Indicates inflammatory processes in the urinary tract;
- olakisuria is the antipodean condition to pollakiuria - a rare urge to urinate. Neuro-reflex disorders;
- dysuria – painful sensations during urination, indicating an inflammatory process in the urinary system;
- enuresis – uncontrolled urination. Characteristic of pathologies of the central nervous system, fevers, acute inflammatory processes.
Studying the smell of urine
One of the most subjective indicators of analysis. There are about a dozen specific urine odors, which are designated by certain terms and indicate certain problems. In particular, fecal odor of urine indicates a vesico-rectal fistula, putrefactive odor indicates gangrenous inflammation of the bladder, ammonia odor indicates fermentation processes in the urinary tract, etc. Many laboratories do not use this indicator due to its subjectivity.
A non-pungent specific odor without foreign impurities is considered normal.
Urine color
This parameter on OAM forms is designated by the Latin word “Color”. The normal color of urine is yellow in any variation. This color is determined by urochromes, products of bilirubin metabolism. There are about a dozen urine color deviations. Let's look at them in table form:
| Urine color | Possible reasons |
| Dark yellow | Almost a harmless situation. The reason is the high concentration of urine caused by a lack of fluid in the body. In addition, this color can provoke carrots in the diet. It is also believed that dark yellow urine may be a manifestation of heart and liver disease, as well as malnutrition. |
| Brownish or greenish | Indicates a large amount of bilirubin, which is a manifestation of obstructive jaundice. In addition, urine of such shades can be a marker of hemolytic anemia and liver problems. |
| dirty red | A clear sign of blood in the urine. This can be caused by a hemolytic crisis, the use of the wrong blood type for transfusion, or porphyria. |
| Bluish | An indicator of increased decay processes in the intestines. This shade appears due to indoxyl sulfuric acid entering the urine in large quantities. |
| Black | Hemolytic anemia, melanoma, melanosarcoma. The manifestation occurs due to the ingress of certain substances into the urine - hemoglobin, melanin and others. |
| Pink | Indicates that an alkaline reaction in a certain place in the body has led to phenolphthalein entering the body. |
| Greenish yellow | Purulent inclusions in the urine. |
In addition, the color of urine is affected by certain foods with coloring pigments, so morning urine is taken for analysis to minimize their influence on this indicator.
Urine clarity
In a normal state, urine is transparent without visual foreign impurities. If there is turbidity in the liquid for analysis, the substance that caused it is determined in the laboratory. This is done using certain procedures:
- heating and adding an alkaline component, leading to the disappearance of turbidity, indicates the presence of uric acid salts in the urine - urates;
- if turbidity is removed by hydrochloric acid, then this is an indicator of the presence of oxalates;
- acetic acid reduces turbidity in the presence of phosphates;
- alcohol – there is fat in the urine;
- if there is pus in the urine, then when an alkaline component is added, a thick glassy mass is formed in the analyzed material.
Urine foaming
The foaminess of urine is analyzed by shaking. The normal level of urine is unstable, highly transparent foam in a small amount. The most obvious deviations are thick, persistent foam - a marker of the presence of protein in urine, as well as yellow foam, which provokes jaundice.
Physicochemical examination of urine
In the physicochemical part of the OAM, two indicators are determined: the density and acidity of urine. In the analysis form they are designated by the symbols “SG” and “pH”, respectively.
Urine density
The normal density of urine is 1010-1022 grams per liter of liquid. In a number of laboratories for morning urine these figures are pushed back to 1018-1026 g/l, but this is not significant. The density of urine depends on the presence of certain microcomponents in it: protein, sugar, salts, bacteria.
The condition of insufficient urine density is called hyposthenuria. It can be caused by diuretic medications, diabetes insipidus, renal failure, and hypertension.
When urine density increases above 1026 g/l, hypersthenuria develops. It is generally accepted that it is caused by toxicosis, diabetes mellitus, and swelling of various types.
Interestingly, in children under ten years of age, the SG indicator in a general urine test is slightly lower than in adults. And the range of 1007-1021 g/l is considered normal here.
Acidity of urine
The pH value in OAM is normally 5.0-7.0. That is, urine is a slightly acidic or neutral liquid. A change in the indicator towards an acidic reaction, that is, a pH less than five, is a likely consequence of the following pathologies:
- jade,
- acidosis.
In addition, an excessively meat-based diet and a number of medications, including banal ascorbic acid, can lead to an acidic urine reaction.
A pH above 7.0 is alkaline. The reasons for this may lie in the predominance of vegetables in food, the use of alkaline mineral water, renal failure, hyperkalemia, alkalosis, and inflammatory processes of the genitourinary system.
Biochemical examination of urine
The biochemical part of the general urine test is aimed at determining protein in urine. This indicator is designated “PRO”. The norm is considered to be a protein concentration not exceeding 0.033 grams per liter. However, this figure is not a completely correct designation. The fact is that normally there should be no protein in the urine, but the laboratory methods used can only determine this concentration, so it is from this that it is customary to diagnose deviations. Excess protein concentration is called proteinuria. It can be mild (protein up to 0.5 g/l), moderate (up to 2 g/l) and severe (more than 2 g/l). The main reason for the increase in the volume of protein in urine is nephritis. In addition, physical activity, protein foods, and exposure to high or low temperatures can lead to mild proteinuria.
Microscopic examination of urine
At this stage of general urine analysis, organized and unorganized sediment, as well as cylindruria, are examined. In total, urine microscopy allows you to determine about a dozen components of the analyzed liquid.
Organized sediment research
This point gives an idea of the presence of four components in urine. Let's look at them in table form:
| Component (designation in the analysis form) | The indicator is normal | Reasons for rejection |
| Squamous epithelium (SEP) | Units are present in the field of view under study. | An increase in squamous epithelium, which are the cells that form the upper layer of the bladder, is evidence of the possible development of cystitis, as well as various forms of nephropathy. |
| Columnar epithelium (Cil) | Absent | Inflammatory pathologies of the urinary system. |
| Red blood cells (BLD) | Up to three in sight | Infections or inflammations of the kidneys, traumatic lesions of the kidneys, prostate, malignant tumors. |
| Leukocytes (LEU) | Three to five units in view | Excess indicates inflammatory processes. |
Study of disorganized sediment
This study focuses on the ions and salts in urine. In total, there can be up to ten of them. But most often urates are found in the urine (can be a manifestation of gout, leukemia, diathesis, hepatitis), phosphates (cystitis) and oxalates (diabetes, pyelonephritis). In addition to them, ammonium uric acid, uric acid, and tripel phosphates can be released in the unorganized sediment, but they do not have a clear specification.
Cylindruria
This term refers to the study of protein casts that form in the urinary tract. Cylinders are classified according to place of origin and appearance:
- hyaline casts that form in the renal tubules indicate increased urine acidity, nephropathy, proteinuria, intoxication or poisoning with heavy metal salts;
- granular cylinders are formed in the same place as hyaline ones. May be a manifestation of renal tubular problems, nephrotic syndrome;
- erythrocyte casts are found in urine during renal infarction, renal vein thrombosis, glomerulonephritis.
Casts of the epithelial, waxy, pigment and leukocyte types are also found, but they appear much less frequently.
Microbiological examination of urine
The final stage of urine testing includes determining the presence of bilirubin, hemoglobin, glucose and urobilinogen in the urine.
Bilirubin (BIL - designation in the analysis form) is absent in the urine with normal levels. In this case, in the analysis form you can see the entry “neg” or “negative.” The appearance of this bile pigment indicates an excess of its concentration in the blood, which is why the function of removing bilirubin from the body is transferred to the kidneys. This may be a manifestation of cirrhosis, hepatitis, liver failure, etc.
There is also no hemoglobin in urine normally. Its appearance is evidence of severe destruction of red blood cells, which causes the volume of hemoglobin in the blood to increase. The spleen and liver, which break down hemoglobin, cannot cope with high concentrations, and it is excreted from the body in the urine. Fixation of hemoglobin in the TAM can be a manifestation of hemolytic disease and malaria, a consequence of contusions, burns and traumatic injuries, or poisoning with a number of substances.
Glucose (GLU) is normally present in urine in concentrations up to 0.15 g/l. Exceeding this figure is one of the first signs of diabetes. In addition, an increase in blood glucose can cause pancreatitis, renal diabetes, sepsis, and brain tumors. In addition, an increase in glucose concentration in urine may be due to excessive sugar consumption, as well as stress, especially in women during pregnancy.
Urobilinogen (UBG), which is a breakdown product of bilirubin, can be present in urine at concentrations of up to 17 micromoles per liter. Exceeding this figure is a consequence of the inability of the liver to bind incoming urobilinogen and its removal from the body through the kidneys. Inflammatory processes in the intestines, significant destruction of red blood cells, and kidney failure can lead to exceeding the standard urobilinogen level.
