Urine analysis according to Nechyporenko
Urine analysis according to Nechiporenko is widely used in clinical laboratories, since it is a simple and informative study that allows to diagnose inflammatory processes of the urinary system, especially hidden ones. This technique was proposed by the Soviet oncologist A.Z. Nechiporenko.
The essence of the technique
- after detection in the general analysis of blood elevated levels of white blood cells or red blood cells,
- in the presence of cylinders in the general analysis of urine,
- in the pathology of the urinary system,
- to control the treatment.
In the study in 1 ml of urine shaped elements are determined, namely leukocytes, erythrocytes, cylinders.
- Leukocytes are the blood cells that are responsible for immune control. An increase in their normal amount always occurs with the development of inflammation.
- Red blood cells are blood cells that transport oxygen to organs and tissues. Normally, they are not in the urine, they appear with a serious pathology of the urinary organs.
- Cylinders are protein bodies that are formed during various pathologies in the tubules of the kidneys.
Cylinders are classified into:
- granular, formed as a result of lysis of the cells of the inner wall of the tubules,
- hyaline, which are formed from the protein of primary urine, which did not return to the blood,
- erythrocyte, which are erythrocytes that have blocked the renal tubules,
- waxy, which are formed from hyaline or granular as a result of their long stay in the renal tubule,
- epithelial - the detached epithelium of the renal tubule.
How to collect urine for Nechiporenko?
The correct collection of analysis is important because the reliability of the result depends on it.
- The day before the analysis, it is worth refraining from dyeing products (beetroot, carrot juice), refusing meat, alcohol, carbonated drinks, excessive sweets, confectionery, antibiotics, antimicrobial and diuretic drugs.
- If a woman has menstruation on the day of analysis, it is impossible to take the test, in order to avoid blood ingress into the urine.
- Night urine is collected for analysis, i.e. This is the first morning urination.
- The collection of urine is carried out in a special industrial container (plastic laboratory glass) or in a clean glass jar.
- Before urinating, the genitals should be thoroughly washed without hygiene products and soaps.
- Start and finish urination should be in the toilet, the average portion is collected in the container.
- Urine must be delivered to the study within 2 hours, because with longer storage it can multiply bacteria.
How to pass the analysis to the child?
- Undermine child without soap.
- Option 1 - fasten a urinal around the external genitalia and expect to urinate.
- Option 2 - put the child on the oilcloth and wait until he begins to write - substitute the prepared container under the stream of urine.
- It is possible to stimulate urination reflexively: by stroking the back along the spine (children under one year old) or by switching on the water in the tap (children over one year old).
- Warn the doctor that the entire portion of urine is tested.
Norms in children and adults are the same. Normal urinalysis suggests the following indicators:
- leukocytes: up to 2 thousand in 1 ml,
- red blood cells: up to 1 thousand in 1 ml,
- cylinders: up to 20 units of hyaline are allowed in 1 ml. Other cylinders in any quantity belong to the pathology.
Poor urinalysis is the excess of the indicated thresholds of the formed elements, as well as the detection of bacteria, protein or epithelium (the detection of the last three is noted in the direction of the study). This analysis indicates inflammation and other pathologies in the urinary system. However, do not rush to make a diagnosis - the results of the urine analysis according to Nechiporenko can only be interpreted by the attending physician!
Cylinders in the urine - the number of hyaline> 20, or other types of cylinders in any quantity
An increase in the number of hyaline cylinders (over 20 in 1 ml) and the detection of any other types of cylinders in any number is a sign of renal pathology.
Increasing the number of hyaline cylinders (over 20 in 1 ml).
These cylinders are formed from protein, which does not have time to be reabsorbed (returning from the primary urine to the blood) during the passage of the primary urine through the renal tubules.
- Chronic glomerulonephritis or acute glomerulonephritis
- Hypertonic disease
- Acceptance of diuretic drugs
Granular cylinders (detecting these cylinders in any quantity is pathological)
This type of cylinder is formed as a result of the destruction of the cells lining the inner surface of the renal tubule.
- Lead poisoning
- Viral infections
Waxy cylinders are formed as a result of a long stay in check the tubules of a hyaline or granular cylinder.
- Chronic renal failure
- Kidney amyloidosis
- Nephrotic syndrome
Normal red blood cells in the lumen of the renal tubule should not be. However, as a result of violations of the permeability of the vascular wall of the renal glomerulus, red blood cells can enter the lumen of the renal tubule. All red blood cells that have penetrated the renal tubule are excreted in the urine. However, in the case of massive penetration of erythrocytes into the renal tubule, its blockage occurs with the formation of erythrocyte cylinders.
- Acute glomerulonephritis
- Kidney infarction
- Renal vein thrombosis
- Malignant Hypertension
Formed as a result of rejection of the epithelium of the renal tubule. These cylinders are indicative of serious renal pathology.
- Acute tubular necrosis
- Acute viral infection
- Poisoning by salts of heavy metals and other nephrotoxic substances (ethylene glycol, phenols)
- Overdose of toxic to the kidney drugs (salicylates)
Indications for appointment
If a person has passed a general urine test and the results show abnormalities, the doctor may order clarifying examinations that will help determine the presence of the problem. One of these is urine analysis according to Nechyporenko.
It was developed by the Soviet urologist A.Z. Nechiporenko and specifies the amount of some bioelements in the sediment of 1 ml of urine. It is necessary for the determination of renal pathologies and accurate diagnosis.
Analz is appointed in in the following cases:
- If, after taking a general analysis, blood or protein is detected in the results, if the leukocytes or the level of urea and creatinine are too high,
- If there are already kidney pathologies in the body, or they were revealed during the diagnostic process (for example, during the ultrasound scan),
- He is appointed during treatment for kidney or urinary tract diseases,
- Sometimes he is appointed as a prophylactic analysis,
- Quite often, such an analysis is also assigned to women in the position. During pregnancy, it is important to identify any problems that may threaten this process.
What does the analysis by Nechyporenko
The analysis itself has a high accuracy and specifically determines the diseases of the kidneys and urinary tract. This is very different from the general analysis and other specific urine diagnostics. Among other things, it even makes it possible to assess the level of damage to the kidneys and, in general, the impact on them in systemic diseases. These are not only injuries, but also endocrinological diseases (diabetes, systemic lupus erythematosus, etc.).
In addition to the above, the doctor can determine using this analysis:
- Pyelonephritis. This inflammation of the renal pelvis, it can be both acute and chronic. This analysis allows to determine both the course of the disease.
- Glomerulonephritis. This is the inflammation of the kidney glomeruli. Serious disease, the detection of which in the early stages is extremely important for human health.
- Cystitis. Bladder inflammation is a very common disease that women often suffer from. The earlier it is possible to determine it, the greater the likelihood that the therapy will be successful and the cystitis will not go into the stage of chronic disease.
- Tumor kidney. Severe disease that is detected by this analysis and the sooner it is done, the better the treatment will be.
- Prostatitis. Since the prostate directly affects urinary function, the Nechiporenko analysis makes it possible to identify problems with prostatitis.
- The presence of toxins in the body. The liver and kidneys are the main filters of the body. If the body is seriously injured from intoxication, then the kidneys are one of the first to take the blow and filter toxins. As a result, these toxins can be detected in urine samples.
The analysis itself according to Nechiporenko is done fairly quickly, it is only important to take the collected material to the laboratory on time.
Preparation for the analysis is one of the most important processes, because the result that will be obtained at the output will depend on how the material is collected.
For a man, a woman (including a pregnant woman) and a child, the rules of preparation are generally the same. They are simple to implement and do not limit life very seriously:
- Since the analysis itself is carried out on renal pathology, it is necessary to exclude any effect on the kidneys before analysis. In particular, you should avoid any physical exertion the day before the collection and not to visit the bath or sauna at the same time.
- You need to slightly change the diet, eliminating spicy or overly sweet dishes. Juices (especially those capable of coloring urine in a different color) and alcohol are also excluded. Protein foods should also be reduced so that there is no disruption in the amount of protein in the urine and this does not contribute to the results.
- Diuretic drugs are contraindicated two days before sampling, as this affects the amount and composition of urine. If the intake of these drugs can not be canceled, the doctor must separately allow the patient to further use.
- Antibiotics or NSAIDs should also be completely eliminated a day or two before taking this analysis. They influence the results, as do diuretics, and can compromise their accuracy.
- It is impossible to disturb the water balance during the preparation for the test, as this affects the amount of urine. Contraindicated as drinking too much, and drink little liquid.
- It is necessary to collect the very first morning urine immediately after sleep. At this time, its composition is still as close as possible to the natural value for the body.
- It is necessary to carefully observe the hygiene of the urethra so that unnecessary components do not get into the urine samples. Therefore, before collecting samples, it is necessary to carefully carry out hygienic procedures of the genital organs.
- It is necessary to collect the urine, which is obtained in the middle of urination, skipping the first and last portions of urine. This is done to ensure that the sample was collected at the moment when any extraneous effects on the biomaterial are excluded.
- A portion of the collected material may be about 25 ml, this is enough for a full analysis.
- Urine collection tank must be sterile, such jars can be purchased at the pharmacy. If it is not possible to purchase a container, it is allowed to use a conventional glass container, treated with boiling water and dried.
- Make sure that the collected biomaterial is in the laboratory for 2 hours, as after the accuracy of the analysis may be impaired. Bacteria can multiply in the urine, some elements can disintegrate, which can make decoding the analysis difficult.
- For women, the peculiarity is the time of menstruation, which is necessary to skip and postpone the test for a period after it. During menstruation, blood may enter the fluid, which will disturb the purity of the samples and make it impossible to distinguish the blood from the urine due to pathology.
These rules are standard for almost any type of urine test (except for some special types for which additional rules are introduced).
It is impossible to take a sample from infants in the “usual way”; therefore, the collection of analysis is carried out with special devices - urine collectors for newborns and infants.
What is urine analysis for Nechyporenko?
Urine by Nechiporenko - quantitative laboratory analysis aimed at the study of urine sediment and the study of the concentration of biological bodies - leukocytes, cylinders, erythrocytes - in 1 ml of biological fluid. The purpose of this test is to identify pathological changes in the urinary system and determine the extent of kidney damage caused by injuries, diabetes, lupus erythematosus, amyloidosis.
The method helps:
- determine the level of inflammation
- identify the organ in which negative changes occur (kidneys, bladder, adrenal glands, urinary tract),
- identify the disease.
What does the analysis reveal?
The urine study according to Nechiporenko is carried out to determine the focus of inflammation and the nature of its occurrence. The analysis determines the deviations in the urinary, reproductive system:
- infections in the bladder, inflammation - cystitis,
- mineral seals in the kidney - kidney stone pathology,
- inflammation in the renal pelvis - pyelonephritis,
- violations of filtration and purification of blood in the glomeruli of the kidneys caused by their inflammation - glomerulonephritis,
- renal tissue necrosis - cell death due to renal vein thrombosis,
- inflammation or neoplasm in the prostate gland,
- poisoning the body with poisons, toxins, heavy metals.
Nechiporenko's urine test helps determine pyelonephritis
How to collect urine?
For analysis, the required amount of urine is 20-30 ml. The correctness of its collection - the key to the reliability of the results from the first time.
- The urine is collected on an empty stomach in the morning when urinating for the first time after a night's sleep.
- Before collecting the liquid, the external genitals should be well cleaned with soap and no aggressive ingredients and rinsed with water, dried with napkins and cotton pads.
- Urine for analysis is taken in the middle of the act of emitting urine - for 2-3 seconds, the patient urinates into the toilet, then the container is inserted and filled to 1/3 with fluid, then urination continues outside the container.
- Collect urine in a special container. Preference to give pharmacy containers, which are completely sterile. If they are not available, a pre-washed with detergent, thoroughly rinsed under running water and a dried jar will be suitable for collecting the biomaterial.
- Material must be handed over immediately after collection and no later than 2 hours. Later, bacteria will begin to multiply in the liquid, and some of the necessary elements will disappear, which greatly distorts the results of the analysis.
Stages of passing urine for analysis according to Nechiporenko
2-3 days before the study, do not take diuretic and antiviral drugs, antibiotics. Pay attention to the diet - to minimize fatty, spicy, sugary foods, protein foods, alcohol is prohibited. The day before the procedure, do not overwork, avoid stress. Women on the eve of the study do not douche, do not use vaginal suppositories.
What does the analysis show?
Urine method Nechiporenko pass for information about the content in 1 ml of biomaterial cylindrical structures, red blood cells and white blood cells.
This analysis is directed, if the patient has symptoms of a latent inflammatory process, with hematuria.
Repeated referral is prescribed both during treatment or after recovery to check for recurrences.
The analysis characterizes the condition of the kidneys and urinary tract. If the tubules or mucous membrane of the ureters, bladder or urethra is damaged, the examination results will change in a big way.
If the patient was prescribed an analysis, in no case should he be abandoned - he can really help in establishing the diagnosis.
Urine analysis according to Nechiporenko: normal
The body of each person is different, but many decades of laboratory practice allowed us to establish average values for such analyzes:
- the rate of red blood cells in the urine according to Nechiporenko is less than 1000 units in 1 ml of fluid,
- the number of leukocyte cells should not exceed 2000 units in 1 ml,
- cylinders in a healthy person are allocated in quantities of less than 20 pieces in 1 ml of urine and only a certain composition
The first two indicators are blood units that enter the urine in a small amount.
Leukocytes in urine perform protective functions and prevent the development of infections. If their content increases, it means that inflammation has developed in the urinary system, and the immune system forwards the greater number of such cells to enhance the protective barrier.
Red blood cells perform their functions only in the bloodstream, and may accidentally enter the urine. They penetrate the renal glomeruli with any sudden movements, or if the cell is smaller or damaged.
Повышение числа мэритроцитов — признак нарушения целостности клубочков, канальцев, слизистой оболочки мочевыводящих путей, это происходит при воспалительных процессах или вследствие травм. The intense penetration of red blood cells into an urine is called hematuria, which sometimes causes it to turn a dark reddish color.
Cylinders in the urine
The third indicator - cylinders - is a protein formation. They are formed from proteins, which in the process of filtration enter the primary urine, and in the process of reabsorption are not absorbed back into the blood.
Protein molecules can stick together with blood cells and inorganic salts, and such formations become congestion in the lumen of the renal tubules. As a result, typical cylinder structures are formed, which with a current of urine are eventually removed from the tubules and removed from the body.
The structure of the cylinders are:
- hyaline - only these cylinders are found in the urine of a healthy person.
When carrying a fetus, the woman's body is under a heavy load.
The urinary system works more intensively, since the amount of fluid in the body increases significantly.
For this reason, many women develop kidney problems or exacerbate previously acquired chronic diseases.
This examination may be assigned to the expectant mother, if abnormalities were shown by a general urinalysis. The purpose of the analysis according to Nechiporenko can confirm or refute the doctor's suspicions about any pathology, clarify the diagnosis, and also check whether the bad result of the tests was not the result of an incorrect biomaterial sampling. Before the examination, the doctor will once again remind you of all the rules for collecting urine.
If a urine test is prescribed for Nechiporenko during pregnancy, the rate of it should ideally also correspond to the usual indicators. But due to the peculiarities of the physiology of the woman, these parameters can approach the upper limits of the norm (that is, 1000 erythrocytes, or 2000 leukocyte cells, or 20 cylinders in 1 ml of urine). Results with higher rates indicate abnormalities in the body.
If the survey results are high enough, but fit into the normal range, do not worry - after birth, the load on the kidneys decreases and such physiological parameters stabilize.
How to take the urine right?
To get the correct test results you need to properly prepare for the delivery of the biomaterial.
A few days before the survey, it is necessary to eliminate the strong loads on the body, both physical and psychological.
You can not eat foods that significantly affect the chemical and physical properties of urine and its quantity, drinks and food with a diuretic effect, alcohol, soda, beets, blueberries, carrots are not recommended.
The water regime should be familiar - you should not deny yourself a liquid or use it too much, this directly affects the density of urine and can mislead the doctor when making a diagnosis.
Before passing the analysis, in the morning you need to thoroughly wash out. Women are advised to cover the genital opening with a clean cotton swab, because sometimes there are vaginal secretions that can affect the examination pattern.
The container needs a clean, dry, it is better to use special containers that are available in pharmacies for such purposes.
Any contamination can cause precipitation or clouding of the biomaterial, due to which the results of the survey will be unreliable.
The urine collected in the container is tightly closed and immediately delivered to the laboratory. Storage of biomaterial for more than 1-2 hours negatively affects the reliability of the analysis. The results of the survey, as a rule, give out the next day.
It is impossible to do an analysis according to Nechiporenko during menstruation or after cystoscopy, catheterization (within a week), since the discharge can get into the biomaterial and greatly distort the results of the analyzes.
If an analysis has been assigned, and the patient does not know the rules for taking it, you should immediately ask the attending physician in detail, so that later you do not have to repeat the examination because of errors.
About the norms and deviations in analyzes of urine according to Nechiporenko and Zimnitsky:
Urine analysis according to Nechiporenko is a very convenient study, which not only assesses the state of the urinary system as a whole, but can more or less accurately indicate the source of the pathological processes. If the diagnosis is confirmed, the patient will have to be re-examined. So the doctor will be able to assess the effectiveness of the prescribed treatment and control the healing process. The necessary conditions for obtaining reliable results are the strict observance of the rules for collecting urine and its careful study in the laboratory.
These substances are proteins that appear in the kidneys in the presence of an organ disease. The composition of the cylinders may differ, as well as their appearance. Hyaline type includes, in addition to protein, renal canals, granular cylinders composed of red blood cells. In the absence of pathological processes, the cylinders in the urine analysis according to Nechyporenko are absent. Even a minimal increase in their numbers indicates kidney disease.
The elements are called red blood cells, which are the most numerous in the human body. Erythrocytes transport oxygen cells to organs and tissues. These substances should not be present in the urine, but their presence is allowed in a minimum amount of not more than 1000 per 1 ml. The change in the red blood cell level in a big way indicates a serious deviation. Having discovered an excess of red blood cells, the specialist determines their structure, and on the basis of the data obtained, the doctor makes a diagnosis.
How many leukocytes should be
Substances have the appearance of living cells circulating through the body through the bloodstream. The main task of leukocytes is the continuous monitoring of the ability of a person to resist pathogenic bacteria. If the body is not able to cope with harmful substances, these particles themselves begin to fight with pathogens. The normal presence of leukocytes in the urine is not more than 2000. If it is detected during laboratory studies that this indicator is exceeded, it can be assumed that the inflammatory process has developed or that an infection has entered the urinary tract or the bladder.
How to collect urine for Nechiporenko
To obtain reliable results of urine analysis according to Nechiporenko, it is necessary to follow a number of simple rules:
- one day before the date when you intend to take the test, you can not drink alcohol, spicy seasonings and food that can change the color of urine,
- women should not be tested for Nechiporenko during menstruation,
- research should not be carried out within 7-8 days after retrograde urography or cystoscopy,
- 2-3 days before the urine test, physical activity should be abandoned,
- on the eve of a clinical study of urine according to Nechiporenko, diuretics, drinks and foods should not be taken,
- in the presence of inflammatory diseases of the genital organs should delay the study.
The collection of urine according to Nechiporenko is carried out in the morning when you first urinate, and you must start and finish emptying the bladder down the toilet, taking only the middle portion. For preparation of the fence, women need preliminary preparation: they should be thoroughly cleaned and the entrance to the vagina should be blocked off with a swab. While urinating with clean fingers, the labia should be parted. Men need to wash the head of the penis before collecting urine. Grudnichkov is also washed away, after making a fence either in a container, or on a clean oilcloth using a disposable urinal.
Adults should collect the liquid in a clean, dry container with a tight lid. The ideal option is a disposable sterile container, an alternative is sterilized glass jar. To collect the biomaterial for the sample Nechiporenko should not touching the container by the crotch. After collecting the fluid, it must be brought to the laboratory within two hours. Heat, leave in the sun or freeze urine is unacceptable.
The results of the analysis of Nechiporenko
The lab technician will tell you when to retrieve the biomaterial. The obtained conclusion, which indicates the number of leukocytes, erythrocytes and cylinders, should be attributed to the doctor for decryption. In a healthy person, all indicators should not exceed the norm. If bacteria or epithelial cells were detected, it is fixed in the direction and the doctor gives a conclusion based on the results obtained.
What it is?
The method was developed by the famous Soviet urologist A.Z. Nechiporenko. Its essence lies in the counting of certain biological elements per unit volume of urine, and not in the field of view of the microscope, as in the usual analysis. However, this analysis does not require complex equipment and does not take much time.
When is this type of analysis assigned?
The urine analysis according to Nechiporenko is prescribed if the general analysis of the patient’s urine or blood showed abnormalities and the nature of the pathology should be clarified by a physician. Or confirm its presence, as a general analysis can not always produce the correct result.
The Nechiporenko study in most cases is not a substitute for the standard urine test, but serves only as an adjunct to it. The most common study for Nechiporenko is prescribed by urologists, surgeons, general practitioners, and nephrologists.
Advantages of the Nechyporenko method:
- does not require expensive equipment
- easy to do for medical staff
- does not require complicated patient preparation,
- does not require a large amount of urine.
What deviations in the general analysis of urine can cause the appointment of the analysis for Nechyporenko:
- Traces of blood
- The presence of leukocytes,
- The presence of protein
- Increased urea and creatinine.
In addition, the analysis is prescribed for the detection of acute or chronic diseases of the kidneys and urinary system, for example, during ultrasound. Asymptomatic fever, systemic diseases with a high risk of kidney damage, and prophylactic examinations can also be grounds for prescribing a Nechiporenko analysis. Also, periodic analysis is carried out during the treatment of diseases of the urinary organs to monitor the effectiveness of treatment.
Often, analysis is also assigned to women who are carrying a child, as it helps to identify certain pathologies that may threaten the normal process of pregnancy and childbirth.
What is this type of analysis for?
The analysis has a greater diagnostic accuracy compared with the general analysis of urine. Its use can reveal a number of serious diseases of the urinary system and some other organs that are dangerous for the body, assess kidney damage in some systemic diseases (diabetes mellitus, systemic lupus erythematosus, injuries, amyloidosis).
What deviations can be detected by the doctor using the analysis:
- pyelonephritis - inflammation of the renal pelvis,
- glomerulonephritis - inflammation of the renal glomeruli, which are responsible for filtering and purifying the blood,
- cystitis - inflammation of the bladder caused by infectious causes
- kidney stone disease - a condition in which uroliths are found in the kidneys - dense mineral formations,
- kidney tumors
- kidney infarction,
- intoxication of the body,
What should the patient do to pass the analysis?
In order for the data obtained as a result of the analysis to be correct (and the analysis would not have to be retaken several times), the patient must observe a number of simple rules:
- Eliminate heavy exercise the day before the analysis, visiting the bath or sauna,
- The day before the analysis, spicy and very sweet dishes, alcohol, vegetable juices, especially beetroot and carrot, are excluded from the diet (as they can change the color of urine). It is recommended to reduce the amount of protein foods,
- Do not take diuretics for two days before the analysis. If necessary, taking this medication should be agreed with the doctor,
- It is not recommended to take antibacterial drugs, anti-inflammatory drugs (acetylsalicylic acid, ibuprofen, indomethacin) one day before the analysis,
- On the day preceding the analysis, it is not recommended to drink too much liquid or refrain from drinking,
- The first urine after morning awakening gathers,
- Before collecting urine it is recommended to wash the area surrounding the exit of the urethra with clean warm water
- When collecting urine, you should use only the liquid that was obtained in the middle of the process of urination,
- For analysis, it is enough to take 20-25 ml of urine,
- It is recommended to keep the urine in a clean, closed plastic or glass container. Containers designed for this purpose can be purchased at a pharmacy,
- Urine should be delivered to the laboratory no later than 2 hours after collection (during long-term storage, bacteria can appear in it, and some important elements will begin to disintegrate).
In principle, these recommendations are also suitable for the delivery of other types of urinalysis (with the exception of the Zimnitsky analysis and the daily collection of urine), and not just the Nechiporenko analysis.
When collecting urine in infants, you can use plastic bowls designed specifically for this purpose. There are garbage bags for both boys and girls. Stimulate urination in an infant can be by stroking the spine. When taking the test, the doctor should be warned that it contains all the urine in one act of urination.
Women should not be tested during menstruation, since it is likely that blood will enter the urine. When exacerbation of inflammatory diseases of the urinary organs, it is recommended to postpone the analysis. No analysis is also carried out for such female diseases as colpitis, since the probability of contamination of urine with white blood cells from the area of inflammation of the vagina is high. It is also impossible to carry out the analysis earlier than a week after retrograde urography, catheterization or cytoscopy.
Method of analysis
Urine is mixed, and part of it is poured into a separate tube. The tube is mounted on a centrifuge and spun for 3 minutes. Then in the test tube remains sediment. This sediment is subject to investigation. It is placed in a counting chamber, in which the number of necessary elements in the urine is calculated using a microscope. Then the number of biological elements is multiplied by a factor, so that you can determine their average number in one milliliter.
The following parameters are determined using urine analysis according to Nechiporenko:
- red blood cell count - red blood cells,
- white blood cell count - leukocyte,
- the number of protein hyaline cylinders,
- the presence of other cylindrical bodies (granular, waxy, epithelial, erythrocyte)
Exceeding the permissible norms for these parameters, as a rule, indicates various pathologies. The type of different blood cells also matters. For example, red blood cells in the urine can be both alive and dead (leached).
In a healthy person, the parameters should not exceed the following values:
- red blood cells - 1000 / ml
- leukocytes - 2000 / ml,
- hyaline cylinders - 20 / ml.
Also in the urine should not be other types of cylinders (granular, epithelial, erythrocyte, waxy), dead erythrocytes, bacteria. These norms are the same for people of all ages and genders.
If there is an excess of these parameters, it is necessary to consult a doctor for advice.
What are the parameters studied?
Red blood cells are blood cells that deliver oxygen to tissues. Theoretically, they should not be contained in the urine. But in practice, a small amount of red blood cells in the urine is still present. This is due to the fact that part of the red blood cells seeps through the renal barrier or the walls of the blood vessels of the tissues of the urinary organs. The abundance of red blood cells may indicate any inflammatory process in the urethra or kidneys, injuries, tumors, stones.
Leukocytes are blood cells that perform immune functions. They may be present in the urine in low concentrations. This suggests that the immune system is working normally. However, in the presence of infectious diseases, the number of leukocytes in the body increases. Consequently, an increased concentration of leukocytes in the urine may indicate any pathologies.
Hyaline cylinders are rents of the renal tubules, in which a number of substances are reabsorbed from the primary urine. They consist of a protein that did not have time to reabsorb into the blood. For some time the cylinders are in the tubules, and then washed out with urine. A small amount of hyaline cylinders can be contained in the urine of a healthy person. Their number often rises after intense physical exertion, emotional stress.
Granular and epithelial cylinders are remnants of cells surrounding the renal tubules. Эритроцитарные цилиндры образуются из эритроцитов, оказавшихся в канальцах. Восковидные цилиндры – это гиалиновые либо зернистые цилиндры, которые долго находились в просвете канальца.
How to interpret the results of the analysis?
Typically, a response to a urine test according to Nechiporenko, if it is performed at an ambulatory, can be expected during the day. If the Nechiporenko analysis showed normal, and the general urinalysis did not, then what does this mean? As a rule, this means errors in conducting a general urine analysis. Therefore, in such a case, a repeated general analysis is submitted, but after more thorough preparation.
What diseases may correspond to deviations from the norm in the analysis of Nechiporenko? Deviation from the norm of the same parameter may indicate different pathologies, and only a urinalysis will not be able to answer the question what kind of disease is present in a patient.
Possible pathologies with deviations from the norm:
- Leukocytes above 2000 / ml - pyelonephritis, glomerulonephritis, acute pancreatitis, systemic lupus erythematosus, fever, urolithiasis, bladder tumors, appendicitis, cystitis, prostatitis and vesicles (in men),
- Red blood cells above 1000 / ml - kidney stones and bladder, prostate, kidney and bladder tumors, polyps, injuries and damage to the urinary organs, purulent cystitis, heart failure, endocarditis, hemophilia, kidney tuberculosis, systemic lupus erythematosus, vitamin C deficiency
- The presence of dead red blood cells - nephrotic syndrome, hypertension, nephropathy, glomerulonephritis,
- Hyaline cylinders above 20 / ml - pyelonephritis, glomerulonephritis, hypertension, taking diuretics in large doses, emotional stress, dehydration and overheating of the body, signs of toxicosis (in pregnant women),
- The presence of granular cylinders - active glomerulonephritis, malignant pyelonephritis together with urolithiasis, intoxication, infections, autoimmune and systemic diseases of the connective tissue, hydronephrosis at the stage of structural changes in the kidneys, intense exercise,
- The presence of waxy cylinders - amyloidosis, nephrotic syndrome, chronic renal failure, rejection of the transplanted kidney,
- The presence of erythrocyte cylinders - hypertension, renal vein thrombosis, glomerulonephritis in the acute stage, kidney infarction,
- The presence of epithelial cylinders - acute tubular necrosis, viral infection, intoxication.
An accurate diagnosis can only be made by a urologist. At the same time, he will focus not only on the results of the analysis, but also on the patient's history, the results of other diagnostic procedures (blood test, X-ray, ultrasound, endoscopy, MRI, computed tomography, etc.).