A general urine test or OAM for short is a laboratory test that is carried out in any medical institution. In the process of its study, the physical and chemical characteristics of urine are studied, and a microscopic examination of the sediment is also carried out. Some standards for urine analysis in adults and children are different.
general information
Urine or urine is a liquid of biological nature, which is the end product of the life process of an individual. Her education is carried out in the kidneys in several stages. Together with it, the product of protein metabolism comes out of the body - urea, uric acid, electrolytes, hormones and vitamins. Studying this biomaterial, assess the condition and work of the kidneys, digestive and cardiovascular organs. The laboratory conducts physical, chemical and microscopic studies of the general analysis of urine. The norms and reasons for deviating from it are discussed below.
Indications for the appointment of a general urine test
This type of study is indicated in the following cases:
- to monitor ongoing therapy;
- after suffering scarlet fever, sore throat and some other diseases;
- prostate diagnosis;
- patients with chronic diseases and undergoing medical observation in the clinic;
- to identify pathologies of the urinary system and kidneys;
- with suspected endocrine pathology (diabetes mellitus, pancreatitis) and neoplasms;
- passing periodic medical preventive examinations;
- medical examination.
Biological fluid is examined in several ways. Below, pathology and norm will be considered. The decoding of the general analysis of urine is best entrusted to doctors to conduct a comprehensive assessment of all the parameters obtained and decide on further treatment tactics.
How to collect urine?
There are several easy-to-follow rules, compliance with which will help to obtain reliable results:
- on the eve to exclude products containing coloring matter, chocolate and alcohol-containing drinks;
- collecting biomaterial in the morning on an empty stomach;
- best if the last urination was at least six hours before the morning harvest;
- Before collecting urine, both men and women need to perform genital hygiene using ordinary soap;
- an intermediate portion of urine from 50 to 100 ml is collected, since the first contains epithelial cells of the urethral mucosa, and this will distort the results of the analysis;
- the container for collecting biomaterial should be washed or sterilized, the lid should fit snugly;
- a portion of urine is collected immediately in a prepared jar;
- until the biomaterial is delivered to the laboratory, it is stored in a cool place, but not more than one and a half hours.
The norm and decoding of the general analysis of urine in adults is presented below.
PH medium
Normally, the reaction of urine is weakly acidic or acidic. Its changes depend on the diet and on the presence of pathological processes in the body. With diabetes in the stage of decompensation, renal failure, starvation - acidic environment. After drinking mineral alkaline water, vomiting, diarrhea, hematuria, as well as with cystitis, pyelonephritis, the reaction of urine is alkaline.
Color
Depends on the pigments contained in urine. The color range from light yellow to deep yellow is considered to be the norm. The result of a general urinalysis may be different. This indicator is influenced by the specific gravity and the allocated volume of urine. If the emitted biological fluid is bright yellow in color, then it has, as a rule, a high specific gravity and leaves in a small amount. Conversely, light-colored urine is excreted in a large volume and has a low specific gravity. Change in staining of urine is possible with pathology, taking certain medications or food products. Consider in more detail the possible color of urine and what it is associated with:
- Red. It can be of various shades. Such staining indicates the presence of red blood cells in it, the appearance of which is due to inflammation of the bladder, nephropathy, lead poisoning and other pathologies. In addition, this color may appear when taking certain medications.
- Tawny or taupe. This staining results from the presence of bilirubin and bile pigments in the urine.
- Dark yellow. It means that the individual has excessive sweating or he drinks little fluid. The reason may be dehydration, due to high temperature, vomiting or diarrhea, as well as the consumption of a fairly large amount of carrots, starvation and lack of milk for the baby who is breast-fed. The appearance of this color signals a pathology of the liver and heart muscle.
- The green color of urine in the analysis (the norm is given above) means the presence of pus in the biomaterial.
- White. This shade is formed when urine contains fats, lymph or phosphates, which appear due to oncology of the urinary system, kidney damage with tubercle bacillus.
- Urine acquires a dark or black-brown color due to the presence of the following pathologies in the individual: melanosarcoma, nocturnal paroxysmal hemoglobinuria, melanoma, hematoglobinuria.
- Pink. Such an unusual shade is acquired by the biological fluid when phenolphthalein is excreted by the kidneys.
- Transparent. Pale urine signals a violation of the kidneys, the presence of diabetes insipidus. In addition, this color appears when taking a large amount of liquid or taking diuretic drugs.
- A greenish brown hue is detected in patients receiving treatment with certain drugs, for example, indomethacin or amitriptyline.
- Yellowish orange. This color is different from the norm. In the general analysis of urine, it appears as a result of taking multivitamin complexes or products with a high content of beta-carotene, as well as vitamins of groups C and B.
Odor, specific gravity
Urine has its own special smell, but in the presence of some pathologies it changes. For example, with inflammation in the genital or urinary system, ammonia appears, and a smell resembling soaked apples or acetone indicates diabetes mellitus.
In a healthy individual, the specific gravity during the day can vary, but at the same time fit into the norm. Deciphering the results of the analysis of urine showed hypostenuria, i.e., a decrease in the specific gravity below the permissible minimum boundary. The reason is an increased withdrawal of biological fluid, a decrease in the concentration ability of the kidneys, as well as heavy drinking. Hyperstenuria or an increase in the specific gravity above the maximum permissible values indicates a large loss of fluid due to vomiting, diarrhea, toxicosis in pregnant women; diseases of the heart and blood vessels, the presence of acute glomerulonephritis. In all these cases, a small amount of urine is released. The reason for the specific gravity fluctuations is associated with fluid loss, food intake and expired air. Substances dissolved in urine, such as salts, creatinine, uric acid, urea, also have an effect on this indicator.
Transparency
Urine should be clear in normal. The results of urine analysis showed turbidity - this means it contains microorganisms, red blood cells, epithelial cells, white blood cells, mucus, salts precipitated, fat droplets. In addition, improper storage temperature of urine also affects this indicator. When turbidity is detected, they find out when it acquired such a consistency: immediately after isolation from the body or as a result of storage.
Protein
In the analysis of urine (norm 0) it should not be. The appearance of it in urine is caused by the following reasons.
Physiological:
- against the background of the use of a large volume of products enriched with protein substances;
- as a result of stress;
- epilepsy attacks;
- emotional overload;
- great physical activity.
Functional. They are associated with acute violation of regional and systemic hemodynamics in the background:
- elevated temperature;
- emotional stress;
- arterial hypertension;
- heart failure;
- hypothermia
Pathological, which are divided into:
- Extrarenal. An admixture of protein substances in urine appears due to prostatitis, pyelitis, cystitis, vulvovaginitis and urethritis.
- Kidney. The reason is glomerulonephritis, chronic or acute pyelonephritis, nephropathy of pregnant women, severe heart failure, hemorrhagic fever or vasculitis, renal amyloidosis, hypertension, lipoid nephrosis, kidney tuberculosis.
When using medical devices (test strips), there can be a false positive result, the cause of which is pronounced hematuria, increased density and alkaline environment of urine.
Glucose
This parameter should not be present in the norm. Deciphering urine analysis in adults showed the presence of glucose, what is the reason? Its appearance can be caused by various factors. Distinguish glucosuria:
- Pathological. It has a different occurrence: Ishchenko-Cushing's syndrome is pituitary, diabetes is pancreatic, and hemochromatosis is hepatic. For a reliable assessment, the concentration of glucose is determined in daily urine.
- Physiological. Appears after emotional stress, consuming a fairly large number of carbohydrates or after taking certain hormonal drugs, with poisoning with chloroform, phosphorus and narcotic morphine-like analgesics.
Bilirubin and hemoglobin
Bilirubin should not be normal in adults. Deciphering the analysis of urine revealed it in urine - this indicates a violation of the liver, outflow of bile, hemolytic anemia, alcohol poisoning.
The appearance of hemoglobin in the urine is an alarming sign, it signals such serious pathologies as sepsis, burns, intoxication with chemicals, hemolytic anemia. In addition, myoglobin is detected in the analysis with high physical exertion, damage to muscle tissue, myocardial infarction, myopathy.
Ketone bodies
These include acetoacetate, acetone and 3-hydroxybutyrate. In a practically healthy individual, urine analysis (norm 0) does not reveal them. Their appearance is provoked by alcohol poisoning, starvation, diabetes mellitus, and in children with diarrhea, vomiting, diathesis, neuro-arthritic, severe infectious process.
Nitrite
Normally, they are absent. When urine is in the bladder for more than four hours, bacteria that it contains are exposed to it. This situation is observed with the progression of infections of the genitourinary system. Detection of nitrites indicates bacteriuria.
Microscopic examination
It is carried out after the chemical and physical properties of urine have been determined. The precipitate obtained by centrifugation is divided into:
- Organized, in which white and red blood cells, epithelium, cylinders are detected.
- Unorganized - mucus, crystals of salts, tyrosine, cystine, lecithin. Deposition of salts in the sediment depends on the acidity, as well as on the properties of urine. This indicator is important for diagnosis.
In addition, the residue may contain fungi of various species, microorganisms, spermatozoa.
White blood cells in the analysis of urine: norm and decoding
Normally, they should not be detected, however, one-time values are permissible. If more than five white blood cells are detected in the field of view, infectious processes in the urinary system are suspected, as well as amyloidosis, glomerulonephritis, renal transplant rejection, interstitial nephritis in the chronic stage. The presence of ten or more bodies in the sediment is a sign of a severe inflammatory process in the urinary system. Detection of active white blood cells, which are normally absent, signals an inflammation of the urinary system.
Epithelium in the analysis of urine: norm and decoding
It is divided into:
- Flat. In women, they are found in huge numbers. In men, with prostatitis and urethritis, it increases.
- Transition. An increase in the quantitative composition of these cells is associated with acute inflammatory processes in the renal pelvis, bladder, urolithiasis, intoxication, and tumors of the urinary tract.
- Renal. Appears with poisoning, jade, circulatory failure. The reasons for the presence of a large number of such cells are necrotic nephrosis, which is caused by intoxication with antifreeze, mercury and other substances.
In the field of view, single fragments of the first two types are allowed, the latter should not be.
Red blood cells
According to the results of studies of a general analysis of urine in an adult, they should normally not be present. Detection of red blood cells is associated with pathologies of organic, autoimmune, infectious genesis. When detecting red blood cells in any even the smallest values, additional types of examinations, medical supervision and repeated delivery of the analysis are required.
Cylinders, bacteria
There are cylinders:
- hyaline;
- cylindroids;
- granular
- leukocyte;
- waxy;
- epithelial;
- erythrocyte;
Normally, the first species may occur singly. All others should be absent. A comparison of the decoding of the general analysis of urine and the norm of this indicator revealed that cylinders are present in the biomaterial - this indicates intoxication, infection or impaired renal function.
Normally, bacteria are absent or their number is minimal and not higher than two thousand cells in one milliliter. The results of the general analysis indicate only the fact of the presence of microbes in the urine.
In an alkaline environment, the following are detected: phosphates, ammonium uric acid, tripelfosphates. In acidic - oxalates (calcium carbonate and oxalate), uric acid salts of calcium, sodium, magnesium, potassium and uric acid.
Urinalysis in children
In urine, the same indicators are determined as in adults.
Consider in more detail the norms of urine analysis in children:
- The color should be yellow straw. However, in the first months in children, it may be colorless. A change in urine staining occurs when taking certain foods, as well as medications. A dark shade of urine indicates damage to the kidneys.
- Acidity. The permissible norm is from slightly acidic to slightly alkaline. Deviations are observed if the child has vomiting, intestinal infection, inflammation of the urinary tract and some other pathologies. For example, in diabetes, the environment is acidic.
- Transparency. If there is an infection in the body, metabolic disorders, the urine becomes cloudy. Normally, urine is transparent.
- Specific gravity. The norm depends on the age of the child. A decrease in this indicator occurs in kidney diseases. Increase - with dehydration or the presence of glucose or protein in a biological fluid.
- White blood cells. An increase in excess of permissible values (more than 2) indicates pyelonephritis, cystitis and problems with the genitals.
- Red blood cells in a urinalysis. Normally, from 0 to 1 in the field of view.
- Epithelium. An increase in the number of these cells occurs in inflammatory processes in the urinary tract.
- Protein. It should not be.
- Ketone or acetone bodies. Normally absent. Their presence occurs with severe dehydration, starvation and diabetes.
- Glucose. The presence of this indicator indicates diabetes mellitus.
- And also according to the results of urine analysis in children, bacteria, fungi and salts should not normally be present.
Conclusion
Using such a simple analysis, various diseases of the kidneys, prostate gland, bladder, pyelonephritis, neoplasms and other pathological conditions are diagnosed at the very early stages, i.e. when the clinic is still absent. Despite the fact that urine is produced by the kidneys and is the final product, it serves as an indicator of all diseases.
With it, the doctor receives the necessary information about the state of the organs and systems of the individual's body. Correct decoding of the results of a general analysis of urine and norm makes it possible to detect even the smallest malfunctions in the body. And only a doctor can competently compare all the parameters. Therefore, for any deviations from the norm, you should consult a doctor.