Microscopy of urine sediment is an integral andan important part of the overall clinical study. Specialists distinguish elements of unorganized and organized sediment. The main elements of the organized sediment are leukocytes, erythrocytes, cylinders, epithelium; unorganized - amorphous or crystalline salts.
Sediment in urine in healthy people can containsingle cells of flat epithelium contained in the urethra and transitional epithelium, which is located in the renal pelvis, ureter and bladder. The kidney epithelium in the urine of healthy people is completely absent.
With urethritis or prostatitis in men cana precipitate is formed in the urine, consisting of a flat epithelium. In the female urine, these cells are present in a significant amount. Often in urine, there are layers of such epithelium and horny scales. This sediment is a confirmation of metaplasia of the mucous membranes of the urinary tract.
The presence of the transitional epithelium is manifested during acute inflammatory processes in the renal pelvis, in the bladder, intoxications, neoplasms in the urinary tract, urolithiasis.
Cells of the epithelium of the urinary tubules appear atintoxications, nephritis, insufficient blood circulation in the kidneys. Amyloidosis of the kidneys at the albuminuric stage is almost not accompanied by the appearance of the renal epithelium, but in the azotemic stages and the edema-hypertensive it happens quite often. Epithelium, which has signs of fatty degeneration, which occurs when amyloidosis is an indicator of the attachment of the lipoid component. The same epithelium is often detected in the appearance of lipid nephrosis. The appearance of renal epithelial cells in a significant amount is observed with necrotic nephroses.
A white precipitate in urine can be caused andthe presence of leukocytes in urine. Normally, they are absent, or single specimens are found. Leukocyturia, characterized by the presence of more than 5 leukocytes in the sample of analysis, can be infectious and aseptic. The concept of pyuria means the detection of 10 leukocytes in microscopic analysis with a resolution (x 400) in the sediment obtained by centrifuging urine. Active leukocytes are absent in the norm. Detection of active leukocytes in urine is a confirmation of the presence of an inflammatory process, although it does not indicate the place of its localization.
The sediment in the urine, consisting of erythrocytes, isa signal for further research, as they are normally absent in urine. The most common causes of hematuria are chronic or acute glomerulonephritis, pyelocystitis, pyelitis, chronic renal failure, kidney or bladder injury, papilloma, urolithiasis, tuberculosis of the urinary tract and kidneys, overdose of drugs (anticoagulants, urotropine, sulfonamides), tumor.
Sediment in the urine from various types of cylinders indicates infections, intoxications, changes in the kidneys.
The precipitation of salts and various mineralelements depends on various properties of urine, especially on pH. Hippuric and uric acid, urate salts, calcium phosphate, calcium sulphate precipitate in urine, which has an acid reaction. Triphyl phosphates, magnesium phosphate, amorphous phosphates, calcium carbonate, sulfanilamide crystals are found in urine, which has an alkaline reaction.
Uric acid is detected in the kidneyinsufficiency, fever, leukemia, massive decaying tumors, resolving pneumonia, heavy physical exertion, urate acid diathesis, consumption of a large number of meat products.
Аморфные ураты придают мочевому осадку кирпичный or pink color. In large quantities, they appear in urine with chronic and acute glomerulonephritis, stagnant phenomena in the kidney, fever states.
Salts of oxalic acid (oxalates) are found in large quantities in urine with pyelonephritis, calcium metabolism disorders, diabetes mellitus, epilepsy, with excessive consumption of vegetables and fruits.
Urinary sediment, formed by uric acid ammoniumappears with cystitis, renal infarction. Other elements that are not normal in urine also indicate the occurrence of various diseases. At any deviations from the norm of urine analysis it is necessary to get advice from a specialist.
