One of the most common types of tests at any age is a general urine test (OAM). The norm in children and adults indicates the satisfactory functioning of the urinary system and the absence of pathologies, disorders in the body. Depending on age, reference values may vary significantly. The norm of OAM in children is an indicator of the full development, formation of internal organs and systems.
Laboratory study of urine
In most cases, the doctor issues a direction for this analysis along with a general blood test. A study is conducted at different age periods. In practice, young children have to be tested more often than adults and adolescents.
Even the smallest changes in the body can be identified by decoding OAM in children. The norm of all indicators at the same time suggests that there is no cause for concern, while the violation of at least one of the criteria indicates the need for more detailed screening, diagnosis and, possibly, treatment. A general analysis of urine is an indispensable stage of the examination, which is often prescribed by pediatricians for preventive purposes. Knowing the norm of OAM in children, you can get a lot of information about the child’s health status, determine the future direction in diagnosis.
Unlike a blood test, urine testing is the simplest and most painless examination method that objectively demonstrates whether systems and vital internal organs function stably.
In carrying out laboratory diagnostics, a huge role is played by the quality collection of urine and its timely delivery for study. To a greater extent, the reliability of the results depends not only on the competence of health workers, but also on whether the elementary rules for collecting biomaterial by parents are observed. Upon completion of the study, it is necessary to decipher OAM in children. About the norm, excess or decrease of indicators, the conclusion is made by the attending physician.
In which cases you need to take a general urine test
An indication for the passage of this analysis can be an examination both with a preventive purpose and with suspicion of any diseases of the genitourinary system, stomach, pancreas, liver, cardiovascular system. In the absence of complaints and normal health, a urine test is recommended to be performed at least once a year.
The norm of OAM in children at 3 years old and, for example, 15 years old is significantly different. For babies, an analysis is usually prescribed to conduct a routine examination. In infants, it is necessarily carried out at the age of 1, 3 and 12 months. Urine analysis, carried out immediately after birth, helps to identify congenital abnormalities of the intrauterine development of the bladder, kidneys, to identify violations in the structure of the genitourinary system, which is especially important to find out in the first months of life. Since babies are not able to say what worries them, deciphering OAM in children can provide answers to a number of questions of interest.
In addition, the study of urine is the simplest way to detect inflammatory diseases of the kidneys, liver, ureters, and bile ducts. Urinalysis scores may be relevant when making diagnoses such as cholecystitis, cystitis, urolithiasis, and even oncology.
This type of laboratory test is often prescribed for respiratory diseases, during the treatment of viral or bacterial pathologies. The study is prescribed for a prolonged course of the disease, accompanied by characteristic symptoms, persistent fever. If a catarrhal disease does not recede for a month or more, the sick child must be sent for OAM. The norm in children will say that the therapy is selected correctly, but for the body to recover completely, it takes some time. Otherwise, you will urgently need to change the tactics of treatment or undergo a re-examination.
For bacterial diseases of the upper respiratory tract (tonsillitis or scarlet fever), it is advisable to pass a general urine test again a week after discharge. It will also make sure that the disease has receded.
Preventive examination
As already noted, the most common indication for a general urinalysis is a routine diagnosis. In infants, it is performed immediately after birth in order to identify congenital pathologies, at the age of one, three months and a year, and then annually. In children up to a year, the interpretation of OAM (urinalysis) is of particular importance, because during this period it is extremely important to monitor the health of the baby. This will help to prevent the development of serious diseases in a timely manner, the most common among which in babies are urinary tract infections, cystitis, urethritis.
In addition to a planned preventive examination, such a diagnosis will be advisable against the background of long-lasting infectious and inflammatory processes in the body. In addition, a general urinalysis is prescribed in order to identify the dynamics of recovery, the effectiveness of the therapy.
How to collect biomaterial?
To get the most correct and reliable data, you need to follow certain rules in the process of collecting urine for research:
- Before starting the procedure, you need to wash the child with warm water without soap.
- Urine must be collected on an empty stomach in the morning, as soon as the baby wakes up.
- Particular attention should be paid to dishes for collecting biomaterial - urine must be placed in sterilized glass or plastic dishes. The pharmacy sells special containers for this purpose.
- After collecting urine, you can store no more than three hours, preferably in a cool place.
Thus, having received the biomaterial, you need to transport it to the laboratory as soon as possible.
Difficulties in collecting urine in infants
This used to be a real problem, because babies have absolutely no control over their urination. To get biomaterial, parents had to “watch” the baby without a diaper with a sterile container. However, collecting urine is much easier today. In any pharmacy you can find a miniature disposable device - urinal. It is a small sterile package that is attached externally to the baby's genitals. The urinal is suitable for use by both girls and boys.
The bag is easily fixed on the skin with adhesive tape, which is located at the edges of the hole. There is no need to wait for the act of urination. Having fixed the urinal, the child can wear a diaper, and after a while, check whether the baby has urinated or not. Once the research material has been collected, it is poured into sterile dishes.
In older children, collecting urine is much easier. If the child already knows how to control the process of urination, care must be taken in advance to clean the pot. As soon as the baby urinates in it, you can pour urine into a special container.
The main indicators of the norm
The primary interpretation of the analysis in children (OAM) is in the laboratory. Specialists study the provided biomaterial according to various criteria. Each of the indicators has reference values. With a slight deviation from the norm of OAM in a child up to a year and older children, the doctor may prescribe an additional examination.
So, for example, to determine the quality of urine, its color is important. This criterion depends on the presence of coloring pigments. The color of urine may be more pronounced with excessive nutrition, taking medications. In a healthy child, straw yellow is considered a normal shade of urine, and in older children, amber yellow. Transparency matters too. This indicator indicates the presence of sediment in the urine. Normally, it should be transparent. Slight turbidity is allowed if the biomaterial was delivered to the laboratory 5 or more hours after collection.
The second fundamentally important indicator is the smell, despite the fact that information about it is not indicated in the OAM results. Normally, in children 3 years of age, the aroma of urine becomes the same as in an adult. Urine has an unusual aroma, slightly reminiscent of the smell of meat broth, while in a healthy person it should not be sharp.
The next criterion is density. It depends on the chemical composition of urine. To a greater extent, the specific gravity of urine indicates the filtering functions of the kidneys. With an increased density of urine, dehydration is suspected. This indicator of OAM in children should normally be within the following limits:
- in the first days after birth - 1008-1018 mg / l;
- up to six months of age - 1002-1003 mg / l;
- from six months to three years - 1006-1009 mg / l;
- from three to five years - 1010-1019 mg / l;
- at seven years old - 1008-1021 mg / l;
- after 10 years - 1011-1025 mg / l.
Interestingly, with excessive consumption of protein products, the density of urine increases, and with excessive consumption of fiber it decreases.
When studying the urine of an adult or a child, such a parameter as acidity is taken into account. It indicates the percentage of alkali and acid in urine. This criterion is not stable, because it is constantly changing depending on the diet. The norm is a pH level in the range of 5-7 units.
Chemical composition and other characteristics
Such a reference value of OAM as specific gravity makes it possible to assess the state of health of a child. However, this parameter is not constant and should change in children with age. Normally, OAM in both children and adults demonstrates the absence of a number of substances in the chemical composition of urine. So, for example, in a healthy child in the urine are not detected:
- Proteins are organic substances made up of amino acids. Their presence in the urine indicates an inflammatory process in the urinary system. An exception is the results of analysis of urine of newborns - in infants of the first days of life a slight presence of protein is allowed (up to 5 mg / l).
- Glucose is a simple carbohydrate. If it enters the urine, then its concentration in the blood is overestimated. In infants, glucose may appear in urine collected after feeding.
- Bilirubin is one of the elements in the composition of bile. In urine, it should not be, as well as urobilinogen, a component formed from bilirubin.
- Ketone bodies are toxic by-products of fat and carbohydrate metabolism. Ketone bodies can appear in the urine with a diet rich in proteins and fats, and a deficiency of carbohydrates. The presence of indican, a derivative of indoxyl, is not allowed in the urine.
In the urine of a healthy child, a small number of cells of the upper epithelial layer may occur. They enter the sample from the outer surface of the epidermis when collecting biomaterial. The presence of mucus and cylinders in the urine (these are microscopic particles of the cavity of the renal tubules) indicates poor functioning of the kidneys, which do not fully perform their filtration functions.
Urine in a healthy child is an absolutely sterile biological fluid. Pathogens may be present for diseases of the genitourinary system or poor hygiene when collecting urine. Most often in the tests, E. coli, Klebsiella, Proteus, Enterococcus and Lactobacillus are found.
Red and white blood cells, red blood cells and white blood cells, may indicate inflammatory and infectious processes in the kidneys, urinary bladder, and urinary tract. Normally, they should not be in the urine, but in children up to a year in OAM, there may be a small amount of them.
Oxalates, phosphates, urates are crystals of salts, the percentage of which directly depends on the diet of the child and the degree of his physical activity. When decoding OAM in children, the doctor must necessarily take this factor into account.
Deviation from the norm of organoleptic parameters
Not always excess or decrease in normal parameters indicates pathology. Urine is a biological fluid that contains various organic compounds. Urine is based on water, in which several hundred microcomponents are present, while the predominant part of them does not have specific characteristics.
For a day, 30-50 g of dry substances (salts and urea) are excreted through the urogenital system of the child, about 70-80 g of an adult are excreted. The urine excretion rate and the concentration of various components are determined by the full functioning of the kidneys, filtration and elimination of fluid from the body. Organoleptic parameters, including shade, smell, degree of transparency and quantitative indicator of urine, can indicate a number of disorders in the functioning of the urinary system.
As already noted, first of all, laboratory specialists pay attention to the color of urine. Normally, it should be light yellow or straw. If the urine has a dark yellow hue, dehydration or heart problems are suggested. An almost brown hue of urine may indicate a malfunction in the liver, structural disorders of the gallbladder. A reddish color resembling meat slop is usually observed with hematuria. This phenomenon occurs against the background of infectious and inflammatory diseases of the kidneys, trauma to the lumbar region, the presence of stones or sand in the urinary tract.
Turbid urine also suggests the course of the pathological process in the kidneys or bladder. Transparency decreases with an increase in the content of blood cells and urea, as well as when epithelial cells get into the collection of biomaterial.
If urine has a pronounced pungent odor, the baby’s body may be suffering from dehydration. The pungent aroma of urine can be a symptom of diabetes. If the liquid smells of acetone, inflammation in the bladder is diagnosed. The smell of rot indicates a bacterial infection of the urinary tract, to confirm which, in addition to OAM, children are prescribed bacterial urine.
Daily volume
A cause for concern may be an insufficient amount of fluid released during the day. The norm of urine volume depends on the age of the child and is calculated by the following formula: 100 x (L – 1) + 600, where L is the number of years.
An increase in the daily volume of urine excreted is not considered pathological if it is caused by the use of diuretic drinks, watermelon, etc. Restrictions in water consumption, increased sweating, vomiting, or diarrhea lead to a decrease in natural diuresis. In infants born prematurely, reduced diuresis is considered the norm, but if the baby does not urinate for 12-18 hours, anuria is diagnosed.
Kidney and urinary tract diseases in children
These pathologies are most often indicated by blood elements, cylinders and salts in urine. Biomaterial samples are examined under a microscope. If pathology is suspected, a general blood test (KLA) is simultaneously performed. The interpretation of OAM in children (the norm of various indicators may vary depending on the age and gender of the child) includes the definition of the basic elements:
- red blood cells;
- white blood cells;
- bacteria;
- salts.
When red blood cells appear in the urine, such kidney diseases in a child as pyelonephritis, glomerulonephritis, cystitis are suggested. The concentration of red blood cells sometimes increases with viral diseases and severe chemical intoxication of the body. A small number of red blood cells can be observed with physical stress.
Normally, white blood cells in OAM in children should not be. Their appearance also indicates renal dysfunction, an inflammatory or purulent process. If leukocytes are detected in the urine of girls, it is recommended to re-take the analysis, since white blood cells could accidentally enter the urine from the surface of the labia.
Bacteria, as already noted, appear in urine for one of two reasons: infection of the urinary tract or violation of the rules for collecting urine. The salt content increases with an unbalanced diet, consisting mainly of fatty and sweet foods. , , .
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Ketone bodies identified in the urine require special attention - these are the decay products of fats and carbohydrates. An increase in their concentration contributes to a deficiency of glucose in the body. Most often, ketonuria is diagnosed in children under the age of five and leads to the development of acetonemic syndrome. When decoding OAM in children under one year old, ketonuria is extremely rare.
What to do in case of deviations from the norm?
Do not panic and make hasty decisions. Having received the results of a general urine test, you must always consult a pediatrician. Not all deviations from normal indicators are cause for worry. First of all, it is impossible to 100% exclude the distortion of laboratory results. In addition, the cause of errors can be the intake of medicines or vitamins, a sharp change in the climate zone, severe overstrain and other circumstances.
For diagnosis and treatment, not only the results of the analysis are important, but also the clinical picture, patient complaints, atypical manifestations. If a specialist suspects a serious illness, then to confirm the diagnosis, he can prescribe a re-examination in order to exclude the possibility of errors in the laboratory report and confirm his assumptions.