Urine analysis according to Nechyporenko (how to collect, which shows decoding)
In order for the patient to make the correct diagnosis, the doctor prescribes a number of diagnostic procedures. The collection of urinalysis according to Nechiporenko belongs to the group of basic medical examinations. We will talk about this method of diagnosing diseases in this article.
Why take it?
To pass a urine test for Nechiporenko to the patient is recommended when the results of the general analysis show a deviation from the norm. This type of examination allows you to more accurately determine the causes of the disease and assign the correct treatment to the patient. Urine "from the middle of the jet" - so you can call the urine analysis according to Nechiporenko. How to collect? We are talking about this further.
Preparing from the evening
This type of examination involves the study of the composition of the middle portion of morning urine. But for the surrender, you need to start preparing the day before. What should be done?
- Pay attention to the food you are going to have dinner with. You can not eat foods that may affect the color change of the urine. These are vegetables and fruits of bright colors: beetroot grape vinaigrette, carrots, pomegranate, plums.
- Before the examination should limit yourself to physical exertion.
- Do not take diuretics in the evening before passing urine. They may affect the chemical composition of the urine.
- Prepare the dishes in which you are going to collect the urine. Ideal for this - special sterile containers sold in a pharmacy. They are made of transparent plastic and can be different in size and configuration. Examples of such containers you can see in the photo. But it is possible to pass urine and use ordinary glass jars of small size. They need to be thoroughly washed and boiled in clean water for a few minutes.
What to do in the morning?
You need to pass a urine test according to Nechiporenko. How to collect it according to the rules? Immediately after waking up go to the shower. There conduct a thorough toilet of the external genitals. If you need to collect the urine in the conditions of the clinic, and there is no possibility to wash out, use a damp cloth. Wipe labia and outer opening of the urethra.
Women need to know this
It is not recommended to take this type of analysis to women during critical days. Menstrual blood, falling into the urine, changes its composition and color. This means that the diagnostic results will not be absolutely correct. If it is very necessary to conduct an examination during the period of menstruation, then the material can be taken using a urethral catheter. But you will not be able to carry out this procedure yourself. Contact a medical institution for assistance.
Do not worry if the doctor has ordered you to pass a urine test according to Nechyporenko. How to assemble it, you already know. Follow the recommendations provided in this article, and then the diagnostic results will be accurate. And this is a guarantee that you will be given the correct diagnosis and will be prescribed an effective treatment.
The essence and benefits of analysis
This analysis is named after the Soviet scientist who created it - the doctor Alexander Ivanovich Nechiporenko. Typically, this examination is prescribed to determine the urinary system diseases. The advantage of urine analysis according to Nechyporenko is that such an analysis more reliably determines the number of leukocytes, erythrocytes and protein elements in urine.
Indications for appointment and which doctors may prescribe
The indications for this examination are as follows:
- pain when urinating,
- noticeable change in daily urine volume,
- frequent urination,
- low frequency of urination,
- pathologies that lead to kidney disease,
- control in the treatment of renal ailments and diseases of the urinary tract,
- poor overall urinalysis.
How to pass
Before collecting urine analysis according to Nechiporenko, one should adhere to a certain regimen:
- two days before collecting urine do not eat a lot of meat, mushrooms. Do not eat spicy, smoked, fried. Limit the consumption of sweets, soda, strong tea and coffee,
- one day before the urine test, do not consume products that can stain urine (beets, carrots, blueberries),
- eliminate alcohol,
- Do not use any drugs, herbal. Check with your doctor about drug withdrawal,
- avoid physical overload, avoid nervous stress, do not overheat.
How to collect
First you need to prepare a container for collecting urine: buy a special jar from a pharmacy or use another previously sterilized dry container. Collect the first morning urine, be sure to wash well beforehand.
During urination, the middle part of the urine is taken, that is, the initial part of the jet is ignored, then the prepared container is substituted and a sufficient amount is collected, and the end of the jet is also missed.
Before collecting the urine for Nechiporenko in adult men, they are advised to wash the penis and genitals thoroughly with soap, to pay particular attention to washing the folds of the foreskin, because if there is a genital infection, it can get into the urine and affect the results.
Young children are also well washed, give a drink of clean water and planted on the pot (after sterilizing it with boiling water), but it is better to hold the child over the sterile bag. For very young children, it will be good to use a special pediatric collection bag.
Women do not want to collect urine for monthly bleeding. But after childbirth or for some disorders, bleeding can be long. If adult women have any bleeding, then before collecting urine for Nechiporenko analysis, a tampon must be inserted into the vagina after hygiene procedures.
The delivery of urine for Nechiporenko during pregnancy - how and why?
Women who are expecting a child, pass a urine analysis according to Nechyporenko by the same rules as ordinary adult women.
This condition can appear during pregnancy in both healthy women and women with already diseased kidneys. If this disease is not treated, it can lead to eclampsia, which can result in a coma.
Category of patients who need research
This study is written out to identify the following diseases:
- urolithiasis disease,
- tumors of the urinary system,
- kidney infarction.
The analysis rate according to Nechiporenko and the possible consequences of deviations
In a healthy patient, a urine analysis according to Nechiporenko shows that all the tested particles are within the normal range:
- the number of red blood cells is not more than 1000 in 1 ml,
- the number of leukocytes is not more than 2000 in 1 ml,
- the number of cylinders in 1 mm does not exceed 20 units.
Norm and abnormalities in pregnant women
In the analysis of urine by Nechiporenko in pregnant women consider two indicators - white blood cells and red blood cells. When deciphering such an analysis for women who are expecting a child, they are often close to the maximum permissible and may be slightly higher than the norms in the table for ordinary women and men.
If the number of leukocytes is in the range of 2000-4000, then this is considered normal in a pregnant woman, but the doctor should monitor this indicator and prescribe repeated tests.
If a urine analysis according to Nechiporenko in women who are expecting a child shows that there is protein and leukocytes are elevated, then this indicates an inflammatory process in the kidneys.
Detection of protein (more than 10 cylinders) in the urine at a late period of pregnancy warns of the possibility of late toxicosis.
How much is done urine analysis according to Nechyporenko
Labarotnye studies are done within two hours. The main thing is to pass the biomaterial correctly and, as usual, the results of the tests according to Nechiporenko can be collected the next day.
Unfortunately, phenomena such as drafts, infections, viruses, reduced immunity, have a negative effect on the human urogenital system. In such cases, the appointment of a urine analysis according to Nechiporenko in combination with other studies is an effective way to make an accurate diagnosis and select the appropriate treatment.
Preparation and rules for collecting urine for analysis
In order for the results of the analysis to be reliable, you must follow all the rules of preparation and correctly collect urine
The patient collects material for the study independently at home. The accuracy of the analysis results depends on how well it prepares and collects urine.
Most often, errors as a result arise not through the fault of laboratory technicians, but because of non-compliance with the rules of urine collection according to Nechiporenko and ingress of foreign particles into the material.
- 2 days before the analysis, it is recommended to refrain from spicy, smoked, fried foods, fast food, large amounts of sweet, carbonated drinks, strong coffee and tea. These products violate the composition of urine and can shift its performance. For example, the use of fungi on the eve of the analysis can lead to the appearance of protein in the urine.
- It is necessary to exclude from the diet products that stain urine (beets, carrots, blueberries), 12 hours before the test.
- It is not recommended to drink alcohol one day before urine collection, and also not to take any drugs. Regarding the admission and cancellation of the drug is necessary to consult a doctor.
- The day before the delivery of urine it is necessary to avoid heavy physical exertion and nervous overstrain. It is also undesirable to overheat.
Women are not recommended to pass urine during menstruation. Blood may enter the urine, leading to erroneous results. If the bleeding is prolonged or postpartum, and you need to pass the urine before you begin to urinate, you need to insert a tampon into the vagina.
For urine analysis according to Nechyporenko, you need to collect a medium morning portion of urine.
Before the urine collection procedure you need to prepare the container. It is advisable to purchase a sterile container in a pharmacy. If not, urine is collected in any clean and dry container. Before this, the container should be washed, sterilized and dried thoroughly.
In the morning before collecting urine it is necessary to wash out. The first portion of urine goes down the toilet, then into the container and you need to finish it again into the toilet. After the urine collection procedure, you need to close the lid tightly and deliver to the laboratory for analysis within an hour. Urine should not be stored for more than 2 hours and be in a warm place. She begins to wander and becomes unsuitable for research.
Deciphering urinalysis according to Nechiporenko: indicators and norm
The analysis of Nechiporenko includes several indicators. Normally, neither leukocytes, nor erythrocytes, nor cylinders (protein elements) should not be present in the urine. Healthy kidneys do not pass blood cells and proteins.
The presence of these elements indicates that the kidney tissue is damaged. Deciphering urinalysis:
- Leukocytes. These are the cells responsible for the body’s immune response. They actively stand out when pathogens enter the body. They are able to penetrate to the hearth of inflammation and eliminate the causative agent of the disease. Leukocytes should be present in the blood, but should not be present in the urine, they indicate the presence of an inflammatory process. Normally, they are either absent or present in a small amount (up to 2000 per 1 ml of urine). The presence of leukocytes in the urine is called leukocyturia. In this case, further examination is prescribed: ultrasound examination of the kidneys and bladder, urinalysis for bacposa.
- Erythrocytes. The presence of red blood cells in the urine is called hematuria. They may be present in the urine in amounts of up to 1 000 per 1 ml of material. The presence of red blood cells in the urine indicates the presence of bleeding, damage to the tissues of the kidneys, bladder, ureters or urethra, inflammation, tumor processes. Often, inflammation and bleeding are present simultaneously. Red blood cells in the urine can be modified (without hemoglobin) and unchanged (with hemoglobin).
- Hyaline Cylinders. May be present in the urine in an amount of up to 20 units per 1 ml of material. Cylinders appear in the urine due to the presence of protein in it, which is in itself a sign of pathology. Hyaline cylinders are composed exclusively of protein. The presence of these cylinders indicates damage to the kidney tissue and often occurs with nephritis, glomerulonephritis, pyelonephritis.
- Granular cylinders. Granular cylinders are protein particles from the renal tubules. The epithelial cells adhering to their surface give them a grainy appearance. The presence of these particles indicates a disease of the renal tubules (glomerulonephritis, nephropathy, amyloidosis). They may also be present in the urine in amounts of up to 20 units per 1 ml.
Possible reasons for the increase in performance
A high level of urine analysis may indicate kidney disease.
To make an accurate diagnosis, you may need additional examination (ultrasound, MRI). The diagnosis can be assumed on the basis of exactly which indicators have increased.
The causes of deviation may be physiological. For example, if a patient gave urine during a viral disease, at an elevated temperature, neglected the rules of preparation. In women, the cause of poor performance may be monthly. If vaginal discharge comes into contact with urine analysis, hematuria and leukocyturia can be detected.
The reasons for the increase in the level of indicators can serve as various diseases of the urinary system:
- Glomerulonephritis. In this disease, the glomeruli are inflamed. In the urine analysis according to Nechyporenko, absolutely all indicators can be increased, since the glomerulonephritis disrupts the filtering ability of the kidneys. Among the symptoms can be identified dark bloody urine, the presence of edema, high blood pressure, reducing the amount of urine.
- Heart attack kidney. This is a fairly rare disease in which kidney tissue dies due to lack of blood flow. With a kidney infarction, the red blood cells will be increased in the analysis. The disease begins with renal failure, then blood appears in the urine, and urination stops completely. If the blood supply stops for both kidneys, the disease can be fatal.
- Bladder tumor. This cancer is more common in the elderly. In the urine, this increases the number of leukocytes. Detect a tumor can be during an ultrasound or MRI. Symptoms include impaired urination, blood in the urine.
- Eclampsia. This is a severe form of preeclampsia, which can lead to coma. This condition occurs in pregnant women. It is dangerous for both mother and child. With eclampsia, there is a detachment of the placenta, high blood pressure, renal failure.
More information about the urine analysis by Nechyporenko can be found in the video:
In what cases is assigned
Donating a urine analysis according to Nechiporenko is necessary in the direction of the therapist, family doctor, specialists from the urological or nephrology department. This study is required when detecting abnormalities in the general analysis of urine, if there are discrepancies between the patient's complaints and general test data, to determine the effectiveness of treatment and monitor the course of the disease over time.
The main reasons for the appointment of the analysis for Nechiporenko:
- Detection of damage to the kidney and ureter in urolithiasis.
- Control of antibiotics in the treatment of bacterial infections.
- Determining the presence of infections in the urogenital organs, including chronic and sluggish.
- Diagnosis of kidney dysfunction due to injuries and diseases - vasculitis, diabetes mellitus, glomerulonephritis.
- Identification of the causes of painful urination, excessively large or insufficient excretion of urine during the day, frequent or too rare urges.
What is different from other urine tests?
Urinalysis refers to screening methods, it can be used to identify various pathologies. First, the entire collected portion of urine is examined to identify its physico-chemical characteristics. Secondly, a microscopic examination of the urine sediment is carried out, it counts the presence of bacteria, salts, blood elements and cylinders - peculiar casts of protein and cells that are formed in the kidney tubules. As a result of the analysis, it will be indicated how many leukocytes and erythrocytes are detected in the field of view, i.e. within sight of the microscope. Cylinders in quantitative terms are indicated less frequently. The most frequent result is “no cylinders detected” or “single cylinders”, sometimes with an indication of their appearance.
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Urine analysis according to Nechiporenko is considered a clarifying study. With it, calculate how many red blood cells, white blood cells and cylinders is in 1 ml of urine. Cylinders are sorted by composition, and the number of each type is indicated, which allows to make the diagnosis more accurate. This analysis is able to identify violations at the initial stage, which is especially important for pregnant women and young children. Therefore, they analyze the collected urine according to the method of Nechyporenko prescribed with the slightest doubt.
If kidney disease is also prescribed analysis of Zimnitsky. Это исследование всего объема мочи за 24 часа без выделения ее отдельных элементов.According to changes in the density and volume of urine after sleep and during wakefulness, a renal failure is judged.
How to collect urine for analysis by Nechiporenko
For analysis, you need special containers on which there must be a mention of their sterility. They can be inexpensively purchased at the pharmacy. Glass and plastic jars from the products are not recommended, as dirt or traces of detergents on their walls can distort the results. Some laboratories allow collecting urine only in their own containers, which are issued on the eve of the analysis on a small margin.
Properly deliver urine directly into the container, and not pour it from other containers. The exception is small children and bed patients. For them, you can use urinals, which are also purchased at the pharmacy.
The basic rule for collecting urine is that only the middle portion of the urine should fall into the jar. This means that the first 2 seconds of the stream is directed into the toilet, and only then fill the container. The first drops of urine flush away dirt and epithelium from the perineum and urethra.
No matter how perfect the hygiene is, it is impossible to avoid contamination of urine, so the Nechiporenko analysis may be unreliable. Should not be in a jar and the last portion of urine, because it contains sediment from the bladder.
How much urine is needed for analysis depends on the condition of the patient. With normal well-being, you will need 100 ml. If this amount cannot be collected (for example, if urination is increased during cystitis), it is enough to pass 20 g of urine for analysis. The analysis can be performed even in the most difficult cases. If urine is not excreted, it can be taken in a medical facility with a catheter, even if only a few milliliters have accumulated in the bladder.
How to take a urine test - algorithm:
- Discuss with your doctor which of the medications taken may distort the result. 2 days before delivery, cancel these drugs.
- On the day before the analysis, exclude carbonated and alcoholic beverages, as well as food, the dyes of which can pass into the urine - beets, blueberries, carrots. The rest of the diet should be normal, without abrupt changes.
- On the eve of the collection of urine to avoid strong physical exertion.
- At night, before analyzing, abstain from sex.
- In the evening, wash well with detergent, in the morning - repeat the toilet with clean water without soap. Women during menstruation need to use tampons and hold the toilet even more carefully.
- Collect urine during the first urination after a night of sleep.
- Immediately deliver the container to the laboratory. The maximum storage time of the test liquid is no more than 1.5 hours. On delivery avoid overcooling urine.
If you accurately perform all the points of this algorithm, the result of the analysis will be as reliable as possible.
Additionally: The occurrence of acetone in urine and its consequences - http://diabetiya.ru/analizy/aceton-v-moche-pri-saharnom-diabete.html
Urine analysis according to Nechyporenko - a common study, which is carried out only if there are certain indications. Send to him can nephrologist, urologist and therapist.
The main indications for this survey are:
- Increased creatinine and urea levels.
- Prolonged increase in body temperature, which does not get off medications.
- The appearance of the cylinder in the urine.
- Regular examination of patients with nephrological and urological pathologies.
- No change in the result of the general urine analysis during treatment.
- Examination before pregnancy.
- Improper development or structure of the organs of the genitourinary system.
- The need to determine the dynamics during treatment.
- Pathological changes of internal organs diagnosed by ultrasound.
If the urine test according to Nechiporenko showed that the tests were normal, then during the OAM serious mistakes were probably made or you simply didn’t collect the material correctly.
In this case, you will have to retake the complete urinalysis once again, and you will need to be more thoroughly prepared for it. If the urine analysis according to Nechiporenko still shows a deviation from the norm, then the specialist makes a conclusion about the presence of pathologies in the work of the kidneys or the ureter.
If the results show that the body is in order, then all pathologies of the kidneys and urinary system are completely excluded.
Diagnosis of any deviation from the norm requires the appointment of a further extended survey. Rely solely on the results of urine analysis according to Nechiporenko is not worth it, because there is still a certain error. In general, you can follow the following algorithm:
When leukocyturia exceeding 2000 / ml, there is a suspicion about:
If the level of hematuria exceeds 1000 / ml, then this may indicate:
- Acute or chronic glomerulonephritis.
- Prostate cancer (check for cancer).
- Infarction of the kidneys.
- Stones or crystals in the kidneys or bladder.
- Malignant neoplasms in the kidneys.
- Polyps in the bladder.
- Urinary tract and kidney injuries.
With an increase in hyaline cylindruria above 20 / ml, the following diseases may occur:
- Kidney damage caused by hypertension.
- Acute or chronic pyelonephritis.
- Glomerulonephritis in the acute stage.
- Long and regular intake of diuretic drugs.
When granular cylinders appear in the urine, a specialist concludes that the following diseases are present:
- General intoxication of the body.
- The active stage of glomerulonephritis.
- Viral and bacterial infections.
- Malignant neoplasms.
- Hydronephrosis due to structural changes in renal tissue.
- Heavy metal poisoning.
- Immune and autoimmune diseases.
The appearance of waxy cylinders in the urine usually indicates chronic kidney failure, nephrotic syndrome, organic changes in the kidneys, or amyloidosis.
If epithelial cylinders are in the urine, it is advisable to talk about the presence of a viral infection, an overdose of nephrotic drugs, poisoning or the acute necrotic syndrome.
When erythrocyte cylinders appear in the urine, the doctor concludes that there are injuries to the kidneys, renal infarction, acute glomerulonephritis, a crisis course of arterial hypertension, renal artery thrombosis.
How to collect urine for analysis on Nechiporenko?
Urine analysis according to Nechyporenko is a specific study that can reveal serious diseases of the kidneys and the urinary system. To get the most accurate results, you must carefully prepare for delivery.
To this end, it is recommended to adhere to the following recommendations:
- The day before the analysis is strictly prohibited to play sports. It is also worth minimizing stress and emotional turmoil.
- A few days before the study, begin to follow a healthy diet: stop eating fatty, fried, coloring foods.
- Limit drug use several days before the test.
- It is strictly forbidden to pass a urinalysis during menstruation, immediately after sexual intercourse or during a viral infection - so you are guaranteed to get a false result.
- Before you take the urine, you must thoroughly wash out. You do not need to use any hygiene products.
- Prepare the container in advance: to do this, purchase a plastic container or sterilize a glass jar with a lid.
- It is necessary to take urine only during urination. You should not take the first urine for analysis, as there will be bacteria and fractions accumulated during the night that can distort the results.
- In order to conduct a urine analysis according to Nechyporenko, it is enough to get 20-25 milliliters of this biological fluid.
How long can urine be stored?
Urine for analysis by Nechiporenko is not subject to storage. It must be sent to the laboratory as soon as possible. In the urine, bacteria begin to multiply rapidly at room temperature.
Because of this, the result may show increased bacteriuria. Store urine for analysis on Nechiporenko can be no more than 1-1.5 hours, while the temperature should not exceed 4 degrees. For this, it is best to use a refrigerator.
Keep in mind that it is also impossible to put urine in the frost — structural changes occur when the urine freezes, and the results will be distorted. Try to transfer urine to the laboratory as soon as possible.
How to prepare urine in a child?
Urine analysis according to Nechiporenko is often prescribed to children. It is rather difficult to collect biological material from them. In this case, be sure to wash the child before collecting urine so that bacteria and viruses from the outside world or the intestines do not get into it.
In total there are 2 ways to collect urine from a child for analysis according to Nechyporenko:
- Buy a special children's urinal at the pharmacy. It must be fixed on the genitals of the child, and then wait for the natural urination. If you collect urine in this way, be sure to report it in the laboratory - some impurities may be present in the urine.
- Put the baby on a prepared diaper. After that, stimulate the child to urinate: stroke his spine, turn on the sound of pouring water. Prepare a container for collecting urine in advance. In this case, the biological fluid will be cleaner, therefore, the result will be more accurate.
Urine analysis according to Nechiporenko is a fairly informative diagnostic study that helps to determine many pathologies in a short time.
It should be borne in mind that, despite the high accuracy, there is still an error in conducting this study. If you get bad results, the specialist still sends the patient to re-study.