Changes in the urine are deviations from the norm of laboratory parameters of urine. They include a change in the amount of urine excreted (oliguria, polyuria), physicochemical properties (hypo- and hyperstenuria), the presence of impurities (bacteriuria, hematuria, pyuria, etc.). May indicate infectious inflammation, endocrine disorders, damage to the kidneys, liver, the presence of stones. Changes in the urine are diagnosed using laboratory tests: general and biochemical analysis, bakposev, functional tests. Treatment depends on the cause of the identified disorders.
Classification
Changes in the appearance of urine may indicate certain pathological processes in the body: its color, transparency, smell. However, laboratory analysis of urine provides more accurate diagnostic information. Depending on the nature of the deviations and the method of their detection, there are:
- Change in the amount of urine. It is determined by assessing the daily diuresis. Normally, the amount of urine excreted per day is from 80 to 200 ml. With a decrease in urine volume below 50 ml, they speak of oliguria, with an increase of more than 2 liters, polyuria.
- Changes in the cellular composition of urine. Diagnosed in the study of a general analysis of urine, samples according to Nechiporenko. Normally, there are single leukocytes, erythrocytes, epithelial cells, cylinders in the urine. An increase in leukocytes may indicate an inflammatory process (pyelonephritis, cystitis), erythrocytes - glomerulonephritis, ICD, oncological diseases of the urinary organs.
- Change in physical properties. It is determined as part of a general analysis, the Zimnitsky test. The main properties of urine are density and pH. Isostenuria (unchanging urine density) is a sign of renal failure, hypostenuria (reduced density) occurs with diabetes insipidus, the use of large amounts of fluid, hyperstenuria is characteristic of diabetes mellitus, dehydration, nephrotic syndrome.
- Changes in the biochemical composition of urine. With various pathologies, substances such as glucose, protein, bilirubin, myoglobin, ketone bodies, etc. appear in the urine. Proteinuria is typical for glomerulonephritis, nephropathy, glucosuria - for diabetes mellitus, acute pancreatitis, Cushing's syndrome. The causes of bilirubinuria can be hepatitis, cirrhosis of the liver, cholelithiasis; urobilinogenuria - hemolytic anemia, liver failure. Myoglobinuria is found in rhabdomyolysis, acute renal failure.
- Identification of foreign impurities. In a healthy person, there are no bacteria, fungi, parasites in the urine. With the appearance of bacteriuria and pyuria, one should think about urethritis, cystitis, vulvovaginitis. Hematuria is characteristic of glomerulonephritis, kidney injury, urolithiasis, tumors.