Even in ancient times, the Aesculapius could determine the condition of an individual by the appearance of urine. In the modern world, urine analysis is considered mandatory for various examinations and examinations. Urine is a product of the body's vital activity, which contains about 95 percent of water. In addition, it contains slags, toxic substances and decomposition products. The study of these components gives the doctor the opportunity to timely identify the pathology and choose the right treatment tactics.
Indications for urine tests
This analysis is carried out in the following cases:
- Routine preventive examination. A urine test is carried out three times in crumbs up to 1 year, and two times after a year for a child. Before each vaccination and in the presence of pathologies of a chronic nature. Before entering a preschool and school educational institution. During the medical examination.
- Monitoring the effectiveness of treatment. After a course of pharmacotherapy. With frequent or prolonged colds.
- For diagnostic purposes. If you suspect problems with the bladder or kidneys, as well as when the baby complains of pain in the kidneys or painful urination. When identifying signs of the disease, such as pain in the back, the presence of blood impurities in urine and more.
- With a bacterial infection. After a disease caused by pathogens, for example, after scarlet fever. The analysis is handed over after recovery, since there is a high risk of developing complications in which the urinary system suffers.
Types of urine tests
The interpretation of the urine analysis in the child, the norm and deviation from it are of important diagnostic value. There are several types of urine analysis: Reberg test; on hormones; sowing for sensitivity to antibiotics; by Nechiporenko; Sulkovich test; Zimnitsky test; general and others. In a laboratory study, biomaterial is studied in the following areas:
- biochemical;
- organoleptic;
- physicochemical;
- microscopic
- organoleptic;
- microbiological (bacteriological).
Let's consider some of them in more detail.
Types of urine tests that are prescribed for diagnostic purposes
For diagnostic purposes, the following urine tests are recommended:
- According to Nechiporenko - indicated for suspected diseases such as pyelonephritis, cystitis, glomerulonephritis. For research, you need an average portion of morning urine. After collection, it can be stored for no more than one and a half hours.
- According to Zimnitsky - assess the condition of the kidneys. How much urine does a child need to pass to a laboratory for analysis by this method? For analysis, urine is collected during the day, every three hours in eight containers, including at night. Each container is pre-signed. If the child did not defecate at night, then the container is left empty. Start collecting at nine in the morning and finish at the same time the next day. Store containers with biomaterial in the refrigerator.
- Sulkovich test - screening test. The amount of calcium in the body is determined. Collect urine in the morning on an empty stomach. The first small portion is passed, and then the remaining portion is collected in a prepared sterile container. After a maximum of two hours, the biomaterial is taken to the laboratory.
- Reberg test - evaluate the effectiveness of the kidneys. The first emptying after sleep is carried out in a pot or toilet. Next, all the urine that will be released during the day is collected in a special large container. Store it in the refrigerator. Of the total volume of urine collected, how much will a child need to analyze? Before taking the sample to the laboratory, the urine is mixed and at least 50 ml is poured into a container to collect urine. It is this biomaterial that is subject to research.
- According to Amburge - it is used for the differential diagnosis of pathology of the kidneys of an inflammatory nature. The advantage of the method is its great information content. Before collecting biomaterial, the bladder is emptied. And then they stand for three hours and collect the biomaterial that has accumulated over this period. In this case, take the average portion. For three hours you can eat and drink without restrictions. Thanks to the test, a quantitative count is made of red and white blood cell cells, i.e., red blood cells and white blood cells.
- For hormones - in the laboratory of the institution where the study will be carried out, the legal representatives of the child need to get a dry preservative. Urine will be collected at home for 24, 12 and 6 hours in containers with this preservative. The first morning urine is not suitable for analysis, and the rest is collected. Then it is mixed, the required volume is poured into the container and taken to the laboratory.
- Determination of sensitivity to antibiotics - collect the average portion of morning urine in a sterile container.
Urinalysis or OAM for short
A general urine test in children is one of the most affordable and inexpensive types of research that allows you to find out the state of work of organs and systems of a small patient. The decryption of the general analysis is informative. Only a doctor can interpret it correctly. In a general analysis, or it is also called clinical, the following parameters are evaluated:
- specific gravity;
- acidity;
- color;
- smell;
- transparency;
- cellular elements;
- glucose
- proteins;
- bacteria
- and other.
Preparatory activities before passing the analysis
How to pass a urine test to a child? In order for the results of the study to reflect the true picture of the state of health, the preparation of the biomaterial should be properly prepared. To do this, you must perform the following simple steps:
- On the eve of the test, do not give the baby vegetables and fruits that can affect the color change of urine.
- If the child takes any drugs, then they should be canceled in agreement with the treating doctor.
- Collect biomaterial in a special sterile plastic container. Quite often, parents ask the doctor about how much urine a child needs to analyze? For example, for a general analysis in an infant, it will take about ten, and after a year - fifty milliliters. Volume is especially important when performing other research methods. To collect urine from infants, it is best to use urinals that are universal or designed only for boys or girls. You can purchase these medical products at any pharmacy institution.
- The child's genitals toilet is required before collecting urine. Girls are washed with a cotton swab dipped in water from front to back, and they also treat the area between the labia. In boys, during this manipulation, the glans penis is exposed, moving the foreskin.
- For analysis, the middle part of the morning portion of urine is suitable. The whole portion is taken from infants, since it is quite problematic to get the average.
- The collected biomaterial is stored in the refrigerator for no more than two hours. It is important to remember that it should be taken to the laboratory as quickly as possible so that the main indicators do not change.
Norms of urine tests in children
Allowable indicators are directly dependent on the age of the crumbs and the type of analysis.
In the general analysis of urine in children, normal indicators are as follows:
- Density (specific gravity) - it is influenced by the amount of substances dissolved in the urine - salts, uric acid, creatinine, urea. A low specific gravity indicates a malfunction of the kidneys, the release of a large volume of urine, and that the child is drinking a lot of fluids. An increase in this indicator is observed with large losses of fluid (diarrhea, vomiting), systemic diseases, toxicosis, and heart failure. During the day, this indicator changes.
- Acidity - normally the environment is acidic or slightly acidic. For example, up to a month it is in the range of 5.4โ5.9; and from fifteen to eighteen, from 4.7 to 7.5. Thus, depending on age, a different norm. On the results of urinalysis in children by this indicator, in addition to age, the diet also affects. The intake of a large amount of protein food of animal origin contributes to the formation of a carcass environment. In addition, the acidic environment is detected during fasting, renal failure, diabetes mellitus, fever. Alkaline - typical for children on a vegetable diet, as well as for conditions such as hematuria, pyelonephritis, cystitis, the condition after vomiting or diarrhea.
- Color - from saturated straw to amber yellow.
- Transparency. Urine should be completely transparent - this is the norm. Deciphering the urine analysis in the child showed turbidity - this may indicate the precipitation of salts, the presence of mucus, epithelial cells, fat droplets, white blood cells, red blood cells, as well as improper storage of biomaterial.
If urine is cloudy, then find out when the turbidity has come, since this indicator is affected by food intake, loss of fluid with exhaled air or sweat.
- The smell is specific, but not sharp.
- Glucose - it should not be.
- Squirrels. For all age categories of children only minor traces are permissible.
- White blood cells - the results of a general urine test in children in a single portion of urine should normally correspond to the following parameters: for girls, within 8โ10, for the opposite sex, up to 5.
- Red blood cells - should not be.
- Bile pigments - these include urobilinogen, bilirubin. The latter is excreted through the intestines. Detection of even a small amount requires further investigation. Failure to eliminate and its penetration into the kidneys indicates a disease of the gallbladder and liver. Urobilinogen is a substance obtained by processing bilirubin in the intestine. It penetrates the liver and bloodstream. Most of it binds to the liver and a small amount gets into the kidneys and then excreted with urine. If it is detected in excess of the norm, a pathology of the intestines and liver is suspected in the child. Normally, there should be no bilirubin, and the level of urobilinogen is insignificant.
- Indikan - normally it is absent. Its presence in the urine is associated with a malfunction of the digestive system.
Proteinuria
If, when deciphering the results of a urine test, a child has identified protein, then this indicates the development of serious disorders. In these cases, consultation with a pediatric nephrologist is required. There are several types of proteinuria: pathological, functional, physiological. The latter includes cases in which the protein appears in urine temporarily. This type is not considered abnormal and occurs in healthy individuals after strong emotional experiences or physical exertion, eating foods containing a large amount of protein. Functional - occurs in children against congestive heart failure, fever, emotional stress, or hypothermia. Pathological proteinuria is divided into:
- Renal - often it is associated with fever, glomerulonephritis or pyelonephritis in the acute and chronic stages, hypertension and other abnormalities.
- Extrarenal - in this case, the protein appears in the urine as a result of its excretion by the genitals and urinary tract. Protein is found in pyelitis, vulvovaginitis, urethritis, cystitis.
When conducting an analysis using test strips, false-positive results are possible. The reason is pronounced hematuria, urine acidity is higher than eight, high density, i.e. more than 1,025.
Glucosuria
The appearance of glucose in the urine of the baby is also considered an alarm and a deviation from the norm. Deciphering the urine analysis in the child showed glucosuria. This indicates a malfunction in the endocrine system. Sugar in the urine of children of all ages should not be. Its detection is both pathological and physiological. In the first case, glucosuria can be of the following origin:
- hepatic;
- pancreatic;
- thyrogenic.
Physiological observed:
- When poisoning with phosphorus, chloroform or morphine;
- When taking a large amount of carbohydrates.
- After intense emotional stress.
- After taking caffeine and glucocorticoids.
To obtain a reliable result, glucose is determined in daily urine.
Ketone bodies
These include acetone, B-hydroxybutyric and acetoacetic acid. Children of all age groups of ketone bodies should not be - this is the norm. Deciphering the urine analysis in the child showed a small amount of ketone bodies. This phenomenon is associated with insufficient intake of carbohydrates and a large amount of protein, fat. If the child is on a low-carb diet, then the identification of ketone bodies is considered the norm. Starvation, diarrhea, vomiting, diabetes mellitus, severe infections are provocateurs of the appearance of ketone bodies in the urine.
Features of bacteriological analysis
In a conventional urine analysis, bacteria can be detected by evaluating sediment microscopy. Laboratory assistants are interested in such indicators as:
- red blood cells;
- white blood cells;
- protein.
With an increase in the concentration of white blood cells, as well as with the appearance of mucus, bacteriosis is recommended. Sometimes an express test is performed to detect nitrites in the urine. If they are found, it means that there are bacteria. It is important to remember that the information content of this method is 50 percent. Thus, if there are white blood cells in the urine, then bacteria are best looked for by bacterial culture. The results of which will be ready in five to seven days.
Bacteriuria
If a childโs urinalysis is poor, what does it mean? Most likely, bacteria were found in urine, which should not be, that is, it should be absolutely sterile. If the microorganism content exceeds 105 g / ml, bacteriuria is suspected. In addition, the detection of salts, blood, sediment, pus and mucus indicates inflammatory processes.
In a healthy baby, they should not be contained in urine. If a large number of epithelial cells are detected, the analysis is repeated, since the reason often lies in the poorly performed toilet of the baby's genitals before collecting the biomaterial. If bacteria and mucus are detected in urine, then laboratory tests are repeated at least three times. This is necessary to be sure that there is no error or error. The factors provoking the appearance of microorganisms in urine in crumbs are as follows:
- hypothermia;
- infectious and inflammatory processes;
- kidney disease
- angina;
- furunculosis;
- other.
Microscopic examination
This is a study of the precipitate, which is obtained by centrifugation; spend it after they determined the chemical and physical properties of urine. Distinguish sediment unorganized - mucus, salts, and organized - cylinders, leukocytes, epithelial cells, red blood cells, bacteria, fungi - these indicators are revealed by decoding the analysis of urine in children. The norm of the epithelium is a small amount, from 1 to 3. Poor genital hygiene contributes to its appearance before collecting material. These are mainly urinary tract cells, the upper layer of the bladder or urinary tubules. There are flat epithelium, transitional, renal. If a large number of it is detected, then this indicates an infection and inflammation of the organs of the urinary system.
Cylinders - they should not be. The appearance of these protein substances signals problems from the kidneys. In addition, their appearance in urine indicates intoxication, general infection, malnutrition, dehydration, and more. In newborns, the presence of hyaline cylinders is the norm.
White blood cells and red blood cells in urine
An overestimated amount of white blood cells in the urine of infants is observed with infection of the body. This is mainly due to:
- diseases of the genitourinary system and excretory tracts;
- genetic abnormalities.
However, not in all cases, the high content of leukocytes indicates a serious pathology. This may be due to teething, and with a slight malaise after a disease. If the parents noticed the following signs in the crumbs, then you should consult a doctor.
- Crying before emptying.
- Difficult or frequent urination.
- Temperature rise.
- The urine is cloudy and dark in color, in addition, it contains flakes.
Before taking any measures, the doctor will prescribe a urine test for the child. White blood cells in the biomaterial are examined in several ways using the following devices:
- Analyzer - highly accurate. The number of white bodies in 1 ฮผl is detected. Norm no more than 10.
- Microscope - count cells in sight. In this case, the norm is from 1 to 6.
If leukocytes in an amount exceeding the allowable standards were found in the baby in the urine, then the pediatric doctor must recommend a second test, the need for which is explained by the following:
- Errors occur when collecting biomaterial in babies.
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If, according to the results of urine analysis in children, significant deviations from acceptable indicators were revealed, then a study is conducted on Nechiporenko. In this case, the number of white blood cells in one milliliter is calculated. It is used to confirm the presence of infection. Next, sowing is carried out in order to identify the pathogen.
Detection of red blood cells requires an additional examination of the baby. They appear in the urine with pathologies such as cystitis, kidney injury, pyelonephritis, urolithiasis, glomerulonephritis and some others.
Fugitive sediment
Slime - a small amount is allowed. If, when deciphering the analysis of urine in children, the norm is too high, then the reason lies in the inflammatory process that occurs in the genitourinary system, or in poor preparation for the analysis.
Salts - acidity and properties of urine influence their precipitation. This parameter has important diagnostic value. The cause of their loss can be both pathological and physiological. In the first case, it signals serious diseases (anemia, diabetes mellitus, leukemia, pyelonephritis, cirrhosis and others). Secondly, excessive consumption of apples, lingonberries, spinach, cabbage, blueberries or heavy physical exertion. Indirectly, an increase in urine inorganic acids indicates urolithiasis. Salt crystals are found in infants by natural feeding and with the introduction of complementary foods. However, this is not considered a deviation from the norm.
Conclusion
If you find deviations from acceptable values โโin the analysis of urine in children, you should not panic, since a single intake of biomaterial is not a basis for making a diagnosis. Often in children, a second study gives the opposite result. Thus, if leukocytes, glucose, protein, red blood cells, bilirubin and acetone are detected in the babyโs urine, you should consult your pediatrician. He will direct for re-examination. In addition, if necessary, the doctor will recommend consulting a narrow specialist and undergo an additional examination. If the urine test in the child is correct, then this means that all indicators are within normal limits.