Do you really understand urine routine?

 Urine protein

Physiological proteinuria

❖ Functional proteinuria: proteinuria caused by strenuous exercise, fever, cold, nervousness, etc. The protein is usually not more than one "+", and renal glomerular permeability is increased due to renal ischemia, renal vasospasm or congestion Due.

❖ Postive proteinuria: When the lordosis or standing for a long time, the renal vein pressure led to increased renal venous pressure, glomerular filtration of protein due to poor absorption. Qualitative proteinuria qualitative test sometimes up to "++", usually disappear after bed rest, more common with children and youth.

❖ Infectious proteinuria: such as injecting small amounts of protein or large amounts of protein at a time.

Pathological proteinuria

❖ Glomerular diseases: such as acute glomerulonephritis, lupus nephritis, allergic purpura nephritis, diabetic nephropathy and so on.

❖ Tubular disease: such as active pyelonephritis, interstitial nephritis, pregnancy-induced hypertension syndrome, heavy metal (mercury, cadmium, bismuth) poisoning and the application of certain drugs.

❖ Nephropathy involves both glomeruli and tubules. Both low molecular and high molecular proteins in the urine are significantly increased, and are indicators of renal insufficiency. They are found in chronic glomerulonephritis and chronic pyelonephritis.

❖ Serious urinary tract infection, acute hemolytic disease, multiple myeloma, macroglobulinemia and so on.

Urine specific gravity

Commonly used to measure the concentration and dilution function of the kidney, the normal value of 1.005-1.025.

Urine increased specific gravity: seen in dehydration, fever, proteinuria, acute glomerulonephritis, heart failure, peripheral circulation disorders and the use of contrast agents.

Decreased urinary weight: seen in a large number of drinking water, diabetes insipidus, chronic nephritis, uremia, acute nephritis polyuria, primary aldosteronism and so on.

Urine ketone body

Under normal conditions, there is no ketone body in the urine. However, the intake of carbohydrates is too small and body fat can release ketone body such as acetone, acetoacetate and B hydroxybutyrate when they consume energy, resulting in positive urine ketone body test.

Urine ketone body positive: found in diabetes, diabetic ketoacidosis, strenuous exercise, hunger, diarrhea, severe vomiting and pregnancy.

Urine glucose

Physiological diabetes

Physiological diabetes is due to an increase of glomerular filtration and a decrease of relative absorption of renal tubules. It is found in a large intake of glucose, intravenous glucose, mental stress, agitation and pregnancy.

Pathological diabetes

❖ Diabetes

❖ Renal Diabetes: Found in Familial Diabetes, Chronic Nephritis, Nephrotic Syndrome, Neonatal Diabetes, etc.

Other: hyperthyroidism, adrenal tumors, craniocerebral trauma, cerebrovascular accident, pituitary tumor, acute myocardial infarction may also appear positive urine sugar

False positive or false negative

Urine was a strong positive oxidant, hydrogen peroxide pollution can occur when the false positive. Large amounts of salicylate, high urinary, urinary ketone bodies> 400 mg / L or a long-lasting specimen can cause false-negatives. Special attention should be paid to the false negatives caused by high concentrations of vitamin C on glucose.

Red blood cells

Normal ≤ 2 / hpf,> 3 hpf is microscopic hematuria.

Erythrocytes: seen in urinary tract inflammation, cancer, stones and so on. If the abnormal morphology of red blood cells, suggesting that renal disease, but also found in systemic diseases such as idiopathic thrombocytopenic purpura, hemophilia, aplastic anemia, systemic lupus erythematosus, and urinary system adjacent organs Diseases such as prostatitis, pelvic inflammatory disease and so on. Women's menstrual period and menstrual period before and after a few days, red blood cells can also occur, physiological phenomena, should be excluded.

Epithelial cells and tube type

Renal parenchymal damage, such as glomerulonephritis, can be seen more tubular epithelial cells, renal tubular epithelial cells and tubular necrosis and renal allograft rejection and interstitial nephritis. Urinary tract inflammation, but also more squamous epithelial cells and transitional epithelial cells.

Appeared tubular parenchymal damage, found in acute or chronic glomerulonephritis, renal failure and so on.

Red blood cell tube: Tip of renal bleeding, can be seen in acute glomerulonephritis, renal hemorrhage, acute glomerular necrosis, renal infarction, malignant hypertension.

White blood cell tube: Tip renal parenchymal bacterial infection, such as acute pyelonephritis, renal abscess, contribute to the identification of pyelonephritis and cystitis, which is negative.

Particle tube type: normal urine without coarse particle tube type, particle tube type appear and increase, suggesting that the kidney has substantial lesions, indicating that the deterioration of renal disease or advanced into late.

Wax sample Tube: Tip tubular serious disease, poor prognosis, such as chronic glomerular, advanced nephritis, uremia, renal insufficiency.

Fat tube: Tip tubular damage, tubular epithelial cells steatosis, such as subacute glomerulonephritis, chronic glomerulonephritis, toxic nephropathy, etc., especially more common in nephrotic syndrome.

Urine crystallization

Serious gout, jaundice, oxalic acid stones can occur in patients with urinary crystallization.