Types of urine sediment
For a more complete use of these microscopic examination of urine sediment for diagnostic purposes it is advisable to allocate seven types of precipitation.
Saline type of precipitation It is characterized by a large number of and amorphous (or) crystalline salts of. The amorphous volume pinkish sediment yield urate, whitish phosphate, brick red crystal - uric acid crystals, Crystal whitish - crystals and so tripelfosfatov. d.
Oxalate crystals, ammonium acid urate and neutral phosphate may occur independently and in conjunction with other salts acidic or alkaline urine. Perhaps among the detection of crystalline salts and splices (phosphatic, oxalate, uric acid), indicating the presence of conditions for the formation of stones.
The content of cellular elements (leukocytes, erythrocyte, epithelial cells and others.) It depends on the type of salt (amorfnыe, Crystal). The number of leukocytes is most often in the normal range, red blood cells can be detected in the presence of salt crystals due to injury of the mucous membrane of the urinary tract. Where, when the crystalline precipitate, especially with concretions of salts, encountered epithelial cells from different areas of the urinary tract (renal pelvis, ureters, Bladder). The amorphous precipitate is found only a small number of epithelial cells of the bladder. In the urine of women, Besides, meets neorogovevayuschy and keratinizing stratified squamous epithelium of the external genitalia. Protein - traces or missing.
Desquamative type. The draft identifies cells stratified squamous epithelium of the external genitalia in women, or epithelial cells of the bladder at strengthening its desquamation without elements of inflammation (protein is absent, the number of leukocytes in the normal range). Severe desquamation of epithelial cells from different parts of the urinary tract occurs during the passage of crystalline salts. Many epithelial cells with signs of malignant transformation may occur in bladder cancer.
Catarrhal type of precipitation the most commonly observed. It is characterized by the presence of a small amount of protein and elements catarrh: mucus, leukocytes - separately, clusters and groups, often together with the cells of the vaginal epithelium, urethra, prostate, renal pelvis, etc.. There may be isolated and red cells. By the nature of the epithelium in the sediment can be seen on the localization of the pathological process (pyelitis, uretrit, prostatitis, cystitis, and others.).
Festering type. The precipitate volume, on microscopic examination revealed neutrophilic granulocytes, densely covering the entire field of view of the microscope. Protein content - up 1 g / l. It occurs in acute exacerbation of purulent cystitis and chronic cystitis, acute purulent pyelonephritis and exacerbation of chronic, purulent pielotsistite, acute renal failure. In all these diseases (except UNP) require staining Ziehl - Nelsenu.
Hemorrhagic type. Brown precipitate, red, loose. When microscopic examination marked by red blood cells, completely covering all fields of view. Observed in acute and sub-acute glomerulonefrite, gematuricheskoj form of chronic Glomerulonephritis, Tuberculosis and tumors of the kidney and bladder, nephrolithiasis, acute renal failure.
Kidney type. When sediment microscopic examination of this type is detected jepiteliocity kidneys and cylinders. They can occur in different quantities, from single product to several instances in each field of view. Depending on the severity of the pathological process of renal epithelial cells may be unchanged or be in a State of protein, grained, adipose, gialinovo-drip and vakuol'noj dystrophy. There are various types of cylinders, It is possible to have all 10 of their varieties. In the sludge, usually, red blood cells are. Renal pathology, with microhematuria, except nefroticescoy and often mixed form of chronic Glomerulonephritis, nefroticski syndrome and chronic renal insufficiency, erythrocytes leached and fragmented.
At makrogematurii, caused acute kidney failure, erythrocytes unchanged, in all other cases, the pathology of the kidneys-unmodified leached. Protein — from traces of up to several grams per 1 l.
Necrotizing type. In the sludge detected necrotic patches, which may contain:
- elastic fibers (tuberculosis, abscess, tumor);
- tvorozhistyj necrosis, sometimes with jepitelioidnymi giant cells or multi-core cells Pirogov-Langhansa (the disintegration of tuberculosis granulomas);
- fibrous framework and accumulation of bacteria, gematoidina crystals and hemosiderin, tumor cells (not always).
In practice, most often a combination of different types of urine sediment, but the present classification allows not only to navigate the features of sludge, but to some extent determine the localization and the nature of the pathological process.
