Urine sediment microscopy is an integral and important part of an overall clinical study. Specialists distinguish between elements of disorganized and organized sediment. The main elements of an organized sediment are leukocytes, red blood cells, cylinders, epithelium; unorganized - amorphous or crystalline salts.
The sediment in the urine of healthy people may contain single cells of the squamous epithelium contained in the urethra and transitional epithelium, which is located in the renal pelvis, ureter and bladder. Renal epithelium in the urine of healthy people is completely absent.
With urethritis or prostatitis in men, a precipitate may form in the urine, consisting of squamous epithelium. In female urine, these cells are present in significant numbers. Often in urine, layers of such an epithelium and horny scales are found. This sediment is a confirmation of metaplasia of the mucous membranes of the urinary tract.
The presence of transitional epithelium is manifested during acute inflammatory processes in the renal pelvis, in the bladder, intoxication, neoplasms in the urinary tract, urolithiasis.
Epithelial cells of the urinary tubules appear during intoxication, nephritis, and insufficient blood circulation in the kidneys. Amyloidosis of the kidneys at the albuminuric stage is practically not accompanied by the appearance of renal epithelium, but in the azotemic stages and edematous-hypertensive, this happens quite often. An epithelium with signs of fatty degeneration that occurs with amyloidosis is an indicator of the attachment of the lipoid component. The same epithelium is often detected when lipoid nephrosis occurs. The appearance of renal epithelial cells in a significant amount is observed with necrotic nephrosis.
White sediment in urine may also be due to the presence of leukocytes in urine. Normally, they are absent in it, or single copies come across. Leukocyturia, characterized by the presence of more than 5 leukocytes in the sample, can be infectious and aseptic. The concept of pyuria means the detection of 10 leukocytes during microscopic analysis with a resolution of (x400) in the sediment obtained by centrifuging urine. Active white blood cells are absent. The detection of active leukocytes in urine is a confirmation of the presence of the inflammatory process, although it does not indicate the place of its localization.
Sediment in the urine, consisting of red blood cells, is a signal for further studies, since they are normally absent in urine. The most common causes of their appearance (hematuria) are chronic or acute glomerulonephritis, pyelocystitis, pyelitis, chronic renal failure, injuries of the kidneys or bladder, papilloma, urolithiasis, tuberculosis of the urinary tract and kidneys, overdose of drugs (anticoagulants, urotropin, sulfonamide, urotropin, tumors.
Precipitation in the urine from various types of cylinders indicates infections, intoxications, changes in the kidneys.
The precipitation of salts and various mineral elements depends on various properties of urine, especially pH. Hippuric and uric acid, uric acid salts, calcium phosphate, calcium sulfate precipitate in urine, which has an acid reaction. Tripelphosphates, magnesium phosphate, amorphous phosphates, calcium carbonate, sulfonamide crystals are found in urine with an alkaline reaction.
Uric acid is detected in renal failure, fever, leukemia, massive decaying tumors, resolving pneumonia, severe physical exertion, uric acid diathesis, and the consumption of a large number of meat products.
Amorphous urates give the urinary sediment a brick or pink color. In large quantities, they appear in urine in chronic and acute glomerulonephritis, congestion in the kidney, and febrile conditions.
Salts of oxalic acid (oxalates) are found in large quantities in urine with pyelonephritis, impaired calcium metabolism, diabetes mellitus, epilepsy, and excessive consumption of fruits and vegetables.
A precipitate in the urine formed by ammonium urate appears with cystitis, kidney infarction. Other elements that are not normal in urine also indicate the occurrence of various diseases. In case of any deviations from the norm of urine analysis, it is necessary to consult a specialist.