Cylinders in the urine are very small casts of the renal tubule cavity. The presence of these indicates some health problems. Cylindruria occurs due to insufficient filtration of the kidneys. As a rule, this is due to any pathology.
They are detected during a general urinalysis (abbreviated as OAM). This analysis is recommended to be taken to absolutely all people who contacted a medical institution. OAM and a complete blood count (abbreviated as KLA) help identify many of the patient's health problems. Also, OAM and OAC is a standard procedure for a comprehensive examination.
Cylinders in the urine of a child
Urine normally has a slightly acid reaction. The pH should not exceed seven, the minimum value is five and a half. Cylinders form in the urine, which has an acid reaction. In addition, OAM may show an increased amount of protein.
The process of formation of these microscopic bodies indicates the presence of problems with the kidneys. Normally, the cylinders may be contained in the urine, but not more than two in the field of vision.
Types and causes
Cylinders in the urine can be formed in several ways:
- protein;
- epithelial cells;
- red blood cells.
It is also important to note that strong physical activity or a protein diet is the reason for the detection of single hyaline cylinders in the urine.
In total, three groups of cylinders stand out:
At the same time, granular are divided into several types:
- erythrocyte;
- leukocyte;
- epithelial.
Hyaline
Hyaline cylinders in the urine are the most common form. Outwardly they are transparent and homogeneous. The ends of the cylinders are rounded. It is very important to know that single (up to two) hyaline cylinders detected as a result of urine tests are normal for a healthy body. As mentioned earlier, the reason for this is physical activity and a protein diet. If there are more of them in the urine, then the reasons may be:
- jade;
- kidney tuberculosis;
- dehydration;
- pathology of CVS (cardiovascular system);
- liver disease and so on.
Granular
Granular cylinders in the urine can be of two types:
- coarse-grained;
- fine-grained.
They appear as a result of damage to the tubules of the kidneys. In this case, cellular elements disintegrate. If this type of cylinder is detected in the urine, then this indicates serious problems with the kidneys:
- glomerulonephritis;
- sclerotic changes;
- nephrolithiasis;
- the development of malignant neoplasms in the kidneys and so on.
Waxy
Waxy cylinders in the urine are completely different in appearance from other species, as they have a dense structure and look like wax. This is a very bad sign in studies, this type of cylinder indicates that some tubules are completely atrophied and there is no urine flow in them.
Waxy cylinders can be detected by examination of urine in the following cases:
- thermal (agonal) state ;
- chronic severe glomerulonephritis;
- renal amyloidosis;
- nephrotic syndrome ;
- toxic damage to the kidneys and so on.
Erythrocyte
Now briefly about the red blood cell in the urine. They are formed as follows: erythrocyte structures overlap or adhere to hyaline structures. The erythrocyte element can be distinguished from the structure of the cylinder itself. This helps to recognize hematuria (i.e. the presence of cylinders in the urine). There are cases when they are homogeneous. In this case, the cause may be:
- acute glomerulonephritis;
- kidney infarction ;
- vein thrombosis and so on.
The presence of red blood cells is always a pathology. Externally, this view has the following features:
- brownish color;
- the edges may be torn;
- cylinders are quite fragile.
To identify red blood cells, only fresh material needs to be examined. They talk about kidney and urinary tract diseases.
Leukocyte
Pathological cylinders in the urine can make it clear to the doctor what kind of pathological process is in the patient's urinary system. The laboratory technician who conducts the analysis is required to indicate what kind of cylinders are found in the urine. Now briefly about one more form - the leukocyte cylinder.
The detection of this form indicates serious diseases, among which pyelonephritis, sepsis, lupus nephritis can be distinguished and so on. They are formed as a result of adhesion of leukocytes to the hyaline matrix. Leukocyte cylinders are difficult to identify, and when examining the sediment of urine, they can be confused with the epithelial appearance, which we will talk about right now.
Epithelial
The epithelial cylinder is a protein structure that is formed by densification of epithelial cells. What do they result from? The reason for their formation lies in the decay and degenerative change of the tubules. The detection of this species indicates degenerative lesions of the kidneys.
They may appear in the urine of a kidney patient who has recently undergone a transplant operation. Their detection suggests that the graft is rejected by the body. However, this is not the only reason for their appearance in the urine. They appear when:
- acute tubular nephropathy;
- glomerulonephritis;
- terminal states and so on.
It is also important to note that the appearance of this type of cylinder for patients with glomerulonephritis is a very bad sign (damage to the tubular apparatus and the attachment of a secondary nephrotic syndrome).
Pigmented
This species consists of blood pigments that are brown in color. Pigment cylinders are formed in several cases:
- with transfusion of incompatible blood;
- when exposed to toxic substances and so on.
Once again, we remind you that all cylinders can be detected only in urine with an acid reaction, since alkaline affects them destructively. In urine with an alkaline reaction, they may not be detected at all or be present, but in small quantities.
When researching sediment, one should not forget that there may also be pseudocylinders formed by mucus or uric acid salt.