General urine analysis. Standards for general urine analysis. General urine analysis, interpretation. Urine norms in adults, women and men. Urine norm in children.

In the article you will read what indicators are included in a general urine analysis, what are the reference intervals for these indicators, what is the norm of leukocytes and red blood cells in the urine, how much protein and sugar can be in the urine, what epithelial cells are found in the analysis.

The information was prepared by doctors from CIR laboratories and clinics.

A general clinical examination of urine (general urinalysis, OAM) includes the determination of physical properties, chemical composition and microscopic examination of sediment.

Urine color

The color of urine normally ranges from light yellow to deep yellow and is due to the pigments it contains (urochrome A, urochrome B, uroethrin, uroresin, etc.).

Reference values:

Interpretation

The intensity of the color of urine depends on the amount of urine excreted and its specific gravity. Rich yellow urine is usually concentrated, excreted in small quantities and has a high specific gravity. Very light urine is slightly concentrated, has a low specific gravity and is excreted in large quantities.

Discoloration may be the result of a pathological process in the urinary system, the effects of dietary components, or medications taken.

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Transparency (turbidity)

Normal urine is clear. Cloudiness of urine can be the result of the presence of red blood cells, leukocytes, epithelium, bacteria, fat droplets, precipitation of salts, pH, mucus, urine storage temperature (low temperature promotes the precipitation of salts).

In cases where the urine is cloudy, you should find out whether it is immediately cloudy, or whether this cloudiness occurs some time after standing.

Specific gravity of urine (g/l)

In a healthy person, it can fluctuate over a fairly wide range throughout the day, which is associated with periodic food intake and loss of fluid through sweat and exhaled air.

Interpretation

The specific gravity of urine depends on the amount of substances dissolved in it: urea, uric acid, creatinine, salts.

• A decrease in the specific gravity of urine (hyposthenuria) to 1005-1010 g/l indicates a decrease in the concentrating ability of the kidneys, an increase in the amount of urine excreted, and drinking plenty of fluids.
• An increase in the specific gravity of urine (hypersthenuria) of more than 1030 g/l is observed with a decrease in the amount of urine excreted, in patients with acute glomerulonephritis, systemic diseases, and cardiovascular failure; it may be associated with the appearance or increase of edema, large loss of fluid (vomiting, diarrhea ), toxicosis of pregnant women.

OAM in pregnant women and children

Most often, pregnant women and children donate urine for analysis. This is explained by the fact that by deviations of parameter values ​​from normal values, it is easy to identify the disease at a very early stage. Decoding the results in pregnant women does not differ from a similar procedure for an ordinary adult. Early diagnosis of diseases allows you to deal with them faster and protect the health of the unborn baby. Most often, pregnant women are diagnosed with inflammatory diseases of the bladder, kidney pathologies, and asymptomatic bacteriuria using OAM.

In children, normal values ​​have a wider range of fluctuations. The results obtained after a general urine test may contain salts, glucose, bilirubin, protein, ketones, urobilinogen, which is not a sign of the disease, but is associated with the peculiarities of the children’s diet. But, in any case, it is necessary to show the results of OAM and consult with a pediatrician.

A general urine test is an important laboratory test. Doctors recommend taking urine to a laboratory for diagnosis at least once a year. At the same time, it is very difficult to judge the presence of any diseases in the body based on a single result. In order for the doctor to make a correct diagnosis, additional examination will be required. The doctor will tell you what procedures will be required.

Urine reaction (pH)

The pH of urine in a healthy person on a mixed diet is acidic or slightly acidic.

Interpretation

The urine reaction may vary depending on the nature of the food. The predominance of animal proteins in the diet leads to a sharply acidic reaction; with a vegetable diet, the urine reaction is alkaline.

• An acidic urine reaction is observed with fevers of various origins, diabetes mellitus in the stage of decompensation, fasting, and renal failure.
• An alkaline reaction of urine is characteristic of cystitis, pyelonephritis, significant hematuria, after vomiting, diarrhea, and drinking alkaline mineral water.

Chemical examination of urine

Currently, chemical testing of urine is carried out on automatic analyzers using the dry chemistry method.

Chemical testing includes determination in urine:

• squirrel
• glucose
• ketone bodies

Protein in urine, normal protein in urine

Normal urine contains a very small amount of protein (less than 0.002 g/l), which is not detected by qualitative samples, so it is considered that there is no protein in the urine. The appearance of protein in the urine is called proteinuria.

Interpretation

Physiological proteinuria includes cases of temporary appearance of protein in the urine that are not associated with diseases. Such proteinuria is possible in healthy people after eating a large amount of protein-rich food, after severe physical stress, emotional experiences, and epileptic seizures.

Functional proteinuria associated with hemodynamic stress can occur in children with fever, emotional stress, congestive heart failure or hypertension, or after cooling.

Pathological proteinuria is divided into renal (prerenal) and extrarenal (postrenal):

• Extrarenal proteinuria is caused by an admixture of protein secreted by the urinary tract and genitals; they are observed in cystitis, pyelitis, prostatitis, urethritis, vulvovaginitis. Such proteinuria rarely exceeds 1 g/l (except for cases of severe pyuria - detection of a large number of leukocytes in the urine).
• Renal proteinuria is most often associated with acute and chronic glomerulonephritis and pyelonephritis, nephropathy in pregnancy, febrile conditions, severe chronic heart failure, renal amyloidosis, lipoid nephrosis, renal tuberculosis, hemorrhagic fevers, hemorrhagic vasculitis, hypertension.

False-positive results when using test strips can be caused by severe hematuria, increased density (more than 1.025) and pH (above 8.0) of urine.

Determination of glucose (sugar). Normal level of glucose in urine.

Also, urine normally contains traces of glucose not exceeding 0.02%, which, like protein, is not detected by ordinary qualitative tests.

Interpretation

The appearance of glucose in the urine (glucosuria) can be physiological and pathological.

• Physiological glucosuria is observed when eating large amounts of carbohydrates (alimentary glucosuria), after emotional stress (emotional glucosuria), after taking certain medications (caffeine, glucocorticoids), and in case of poisoning with morphine, chloroform, phosphorus.
• Pathological glucosuria can be of pancreatic origin (diabetes mellitus), thyroid (hyperthyroidism), pituitary (Ishchenko-Cushing syndrome), hepatic (bronze diabetes). To correctly assess glucosuria, it is necessary to determine the amount of sugar in daily urine, which is especially important in patients with diabetes.

Ketone bodies in urine

Ketone bodies (acetone, acetoacetic acid, (B-hydroxybutyric acid)) can sometimes be detected in the urine of a healthy person with a very small intake of carbohydrates and a large amount of fats and proteins.

Interpretation

Ketone bodies appear in the urine during fasting, alcohol intoxication, diabetes mellitus, in children with vomiting and diarrhea, neuro-arthritic diathesis, as well as during severe infectious processes accompanied by a prolonged increase in temperature.

Preparation for the procedure

Preparation for a general urine test begins the day before the collection of biomaterial.
Certain foods, the amount of fluid you drink, taking medications and dietary supplements, and intense physical activity can distort the results of the study. The day before collecting urine, you should avoid foods that can affect the color of your urine: for example, beets and blueberries give your urine a reddish tint; consuming large amounts of carrots or carotene supplements may change the color of your urine to orange.

On the eve of urine collection, it is not recommended to drink alcohol, coffee, dietary supplements or strong tea. If possible, you should limit your intake of diuretics (diuretics). It is necessary to exclude serious physical activity, as well as visiting a bathhouse or sauna.

Women during menstruation are not recommended to donate urine for testing, since even a small amount of blood will significantly distort the test result.

You should warn your doctor about the medications you are taking, as well as about invasive examinations (for example, cystoscopy) on the eve of the test.

Method of collecting urine for general analysis

1. It is necessary to prepare in advance a disposable sterile container for collecting urine (can be purchased at a pharmacy or taken from the INVITRO medical office).
2. Before collecting urine, hygienic treatment of the external genitalia should be carried out, without using antibacterial and disinfectants.
   For children, you need to adhere to the following rules: girls are washed from front to back (from the pubis to the tailbone) so that bacteria that populate the intestines do not enter the urinary tract. Only wash the skin with soap, since contact with mucous membranes causes irritation, dryness and itching. In boys, the glans penis is fused with the foreskin (physiological phimosis), so it is not recommended to forcefully open the glans penis, as this leads to trauma to the delicate tissue. You just need to slightly pull the skin and rinse with water, but it is unacceptable to direct a stream of water into the opening of the urethra.
3. For general analysis, as a rule, the first morning urine sample is collected. First, release a small amount of urine into the toilet, then, without interrupting urination, place a container and collect approximately 50 ml of urine. In this case, it is necessary to ensure that the container does not touch the skin and mucous membranes.
4. After collecting urine, close the container tightly with a screw cap.
5. Special urinals have been developed for newborns and infants. You should not use urine squeezed out of a diaper or diaper - the results will be unreliable, since the diaper is a kind of filter for microscopic elements of urine, which are counted during the study.
6. When taking the test during the day, it is not recommended to drink large amounts of water, tea, coffee or diuretics to stimulate urination.

The turnaround time for a general urine test is usually 1 business day.