In the article, we consider a general analysis of urine in a child.
Any disease diagnosed at an early stage is much easier to treat than its neglected form. This rule is especially true for the child's body, because its pathology often develops faster than in adults. You can detect the disease at the initial stage thanks to clinical tests, including a general urine test in a child. It is necessary to carefully monitor the occurrence of the first alarming signs, which can indicate the onset of serious health disorders of a small patient.
Urine collection in children
For a general analysis, a portion of urine is taken in the morning, immediately after waking up (on an empty stomach), before this, thorough hygiene procedures are carried out.
Dishes for collecting biomaterial for analysis should be dry and clean. Urine should be stored for no more than an hour and a half until the study. When taking any medications, you need to warn the doctor about this, since some drugs affect the results of the analysis.
You can not drink too much mineral water, since the reaction of urine changes because of this. It is necessary that previous urination occur no later than 5-6 hours before receiving morning urine.
How to pass a general urine test to a child, every parent should know.
Capacity preparation
From evening, you need to choose dishes made of transparent white glass, about 100 milliliters in volume, with a sealed lid. You can purchase a container at the pharmacy.
A container with a lid is washed thoroughly in soapy water and poured with boiling water. Put, without wiping, dry down with the neck.
Patient preparation and analysis collection
How to prepare for a general urine test in a child?
Need to wash your hands with soap. The child should be washed immediately after waking up.
For girls: wash the external genital area with movements from front to back. First, the area between the labia is thoroughly washed (using a cotton swab moistened with a pale solution of potassium permanganate, chamomile or plain water).
Boys: when washing, they need to slightly move the skin from the head of the penis (naturally, without causing a pain reaction in the child). Up to the age of three, boys may have physiological phimosis (a condition in which the head is not completely excreted), but the skin should still be slightly moved to wash the area under it under water. It is forbidden to open the head by force; this can cause injury.
The most convenient procedure for collecting material for a general analysis of the urine of a child at 3 years old is to carry out in the bathroom. Different urine collection tactics are used depending on age.
For girls: keeping the labia in a diluted position, let out a little urine (one to two seconds) past the container.
For boys: keeping the foreskin in the retracted position, let out some urine also past the jar. After this, urination does not stop, the container is substituted under the stream and is half full.
Dishes must be carefully closed with a lid.
How much urine is needed for a general analysis of the child? The minimum amount that is sufficient for at least partial testing is 10 ml. If the mother managed to collect it, the laboratory assistants will take a sample. It is desirable that the level of urine in the container is at least 1 cm from the bottom of the container. It is recommended to take the average portion.
After a year, up to 100 milliliters of urine can be excreted in children. The child slowly wears off diapers, switching to using the potty. For research, 50-70 ml is enough.
Urine collection in young children
The first way. To collect material for a general analysis of urine in a child of 2 years, you can use a special disposable children's urine collector. It is a small elongated transparent bag with a sticky edging and a hole. It is sold in a pharmacy and can be used for both boys and girls. It is advisable to buy several pieces at once - in case one is spoiled.
How to collect a general urine test in children is interesting to many.
To collect urine, the urinal is attached in accordance with its instructions. After filling, the adhesive base of the device is carefully folded, the hole closes. They are attached to children's skin, preferably in the morning, so that urination occurs during morning feeding when waking up.
There is one more way. The capacity is taken in the hand (it is advisable not to touch its neck). The boy’s urine can be collected directly into the dishes or into a condom. To collect biomaterial from a girl, you need to sterilize a saucer, heat it under warm water. Then put a girl on it, then after urination, pour the urine into a prepared dish.
Indicators: norm and possible deviations
First of all, you need to determine what indicators are analyzed in the process of a general urine test in a child. Let's consider each of them in more detail.
Organoleptic indicators in the study of the urine of a child
How is the decoding of the general analysis of urine in children? The first stage is a study of organoleptic indicators - the smell and appearance of urine and some other properties.
Volume. So, what does a general urinalysis in children reveal ? The rate according to which a certain amount of urine is to be produced per day is known. Naturally, this indicator is determined not only by the patient’s health status and age, but also by external factors - the amount of food eaten and the fluid drunk, air temperature and physical activity. The approximate normal level of urine volume during the day can be calculated as follows: 600 + 100 × (N - 1) = volume in milliliters, where N is the age of the child. Using this formula, you can get a normal value with an error of 200 to 300 milliliters. With a daily amount exceeding the obtained result more than twice, the cause may be cystitis, hypothermia, inflammation or neurosis. With a volume of less than a third of the norm, there may be kidney disease.
Color. In children's urine, the normal shade is amber, light yellow. Shades of urine, which differ from normal ones, can be caused by foods (for example, beets) and drugs. If these factors are not taken into account, then pale or colorless urine may indicate diabetes mellitus, a saturated red color indicates injuries to the kidneys.
It should be noted that the urine of a newborn baby during the first ten days after birth can vary from transparent to orange-brick. This is quite normal and is due to the formation of the children's genitourinary system.
Smell. This also reveals a general urine test in children. Normally, the newborn’s urine almost does not smell, with time, a specific characteristic smell appears in the discharge, but most often it is not expressed very much. A pungent smell signals acetonemia, a urinary tract infection, or diabetes.
What other indicators of urinalysis in children are?
Foaminess. When the bubble with biomaterial is shaken, an unstable white foam will appear on its surface, disappearing quite quickly. This result is normal. With a long subsidence of the foam, we can talk about a large amount of protein. This is the norm for babies. However, when the baby leaves infancy, excessive foaming can indicate allergies, stress, dehydration, hypothermia or the recovery period after an infectious pathology.
Transparency. In children, fresh urine is predominantly clear. But after standing for a while, it can become muddy. Such a reaction is due to the influence of external factors or the nutritional characteristics of the child and is normal if it is not constant. Otherwise, with a change in transparency, we can talk about calcium oxalate or uric acid diathesis.
Analysis of children's urine: physico-chemical parameters
Density, which is also called specific gravity, can change, which depends on various external factors and age. The normal value is from 1.003 to 1.035 grams per liter, and in newborns it most often approaches the lower limit and increases with age. An increased density of urine appears with excessive fluid intake, diabetes mellitus, oliguria or dehydration. A low value may also indicate diabetes insipidus, polyuria, or kidney failure.
Acidity (pH). Its normal indicator is from five to seven on a pH scale. When collecting an analysis after a meal, a slight excess of this level can be recorded. In other cases, a high degree of pH can indicate chronic kidney failure or a tumor of the genitourinary organs, low - tuberculosis, diarrhea, dehydration, diabetes.
A general urine and blood test is prescribed to a child very often.
Biochemical parameters in the study of children's urine
Thanks to the biochemical composition of children's urine, you can understand how well the genitourinary organs and kidneys function.
Protein. Protein content is one of the most important characteristics in the general analysis of children's urine. If pathology is absent, then the protein is contained in an amount as close to zero as possible per day, not more than 0.08 grams (if there is physical activity, then not more than 0.25 grams). With an overestimated indicator, we can talk about the presence of inflammatory pathologies of the urinary tract in a child (for example, urethritis or cystitis), renal tuberculosis, tumors, and some other specific diseases.
Glucose (sugar). This indicator, like the previous ones, should be close to zero. It may be slightly higher if the child eats too many sugary foods, as well as after severe stress, but such changes are short-lived. With a consistently high glucose level for no apparent reason, it is necessary in the near future to additionally pass an analysis for this indicator. The only exception is newborn babies, for them the content in the urine of a certain concentration of sugar is considered within the normal range.
It is important to know that breastfeeding reduces the concentration of baby urine. Almost all substances received by a baby with breast milk are processed by the body without waste. Artificial feeding increases the load on the kidneys of the child.
Bilirubin. The content of this substance in the urine may indicate abnormal liver activity or the presence of stones in the urinary tract or kidneys. It is also possible that a high degree of bilirubin is caused by an unbalanced diet, for example, an excess of carbohydrates in the daily diet.
Ketone bodies. This term refers to the content in children urine of substances such as beta-hydroxybutyric and acetoacetic acid, acetone. With a severe lack of glucose in the child's body, fats begin to decay actively, resulting in the release of ketone bodies with urine and respiration.
The sugar content in children's liver is lower than in adults, and therefore a high concentration of ketone bodies in urine can be triggered by a deficiency of carbohydrates, starvation and severe stress. However, there are pathological factors - various infectious diseases or diabetes in a child.
Urobilinogen. This substance may be present in a healthy child in the urine, but only in small quantities. If the degree of urobilinogen is above ten μmol, then the presence of a disease is suspected - intestinal inflammation or liver failure.
Decryption of the general analysis of urine in children should be carried out by a qualified specialist.
Microscopic properties of children's urine
Not everyone knows what this indicator is talking about.
The study of such properties is carried out after a special procedure required to obtain a precipitate. Using a centrifuge, the contents of the tube are shaken for several minutes until the necessary dense suspension is obtained at the bottom of the vessel. It is such a precipitate that is examined under a microscope. The set of indicators of microscopic analysis of children's urine is divided into two types - inorganic and organic.
It is important to comply with hygiene requirements before taking biomaterial. With insufficiently washed external genital organs of the child, there may be distortions in the result of the analysis. For example, when studying the sediment, an increased degree of leukocytes will be determined. There is no reason to worry if the content of white blood cells in the field of vision is not more than five, sometimes one of the kidney diseases is suspected. The content of red blood cells (red blood cells) in a healthy child in the urine should not be higher than two pieces also in the field of view. A high concentration indicates a particular viral infection, which is associated with fever, poisoning with toxins or urolithiasis.
The microscopic properties of the general analysis of children's urine also include the content of different types of cylindrical particles - wax, granular and hyaline. For each species, a complete indicator is a complete absence. If hyaline cylinders are found in the child's urine, one must be wary of infectious diseases (rubella, measles, chickenpox, flu) Granular cylinders often accompany renal tubular lesions and fever. Wax cylindrical particles indicate chronic renal pathologies.
Bacteria that are found in children's urine are a rather dangerous sign, which is most often accompanied by other symptoms - burning in the lower abdomen and pain when urinating. Their presence indicates pathologies of the urinary system of the child.
Amylase is an enzyme formed in the pancreas. Substances with violations of the activity of this body penetrate the bloodstream and then into the urine. In children's urine, the normal concentration of amylase is up to 460 units per liter.
The next indicator is yeast. Their presence speaks of candidiasis, which, in turn, is the cause of incorrect antibiotic therapy. Inorganic substances that can be found in children's urine are different types of salts. Their presence in the sediment most often does not indicate any disease, but is only a symptom of the child’s improper diet. For the listed analysis parameters to be reliable, you need to know what factors could affect the accuracy.
How to pass a general urine test to a child, it is important to find out in advance.
Factors affecting the accuracy of the results for this type of study
First of all, before taking biomaterial, all hygiene recommendations must be observed. Otherwise, the finished result will be distorted by certain impurities. Before this, the child should be limited in the use of a number of products that can affect the color of secretions - rhubarb, carrots, beets, etc. Drugs can also have the same effect - for example, aspirin can stain urine in a pinkish color. That is why, when interruption of the treatment course is undesirable, it is recommended to consult a specialist before analysis.
The ability to decipher the results of a study of children's urine is a useful skill, it will come in handy if there is a suspicion of a disease. However, in no case should you independently make a diagnosis. Only a professional doctor can assess a situation based on a combination of all factors.
Where can I pass baby urine?
If the child is one year old, a general urine test can also be prescribed. Where to take it?
The choice of medical institutions that examine the urine of a child according to the indicators listed above is extremely wide: from state clinics to private institutions. In Moscow, this can be done in the laboratories "MobilMed", "Biotest", "MedOk".
How to determine the quality of the future result of a general urine test? In children, they can also be erroneous. In this case, the analysis is best repeated.