Nechiporenko's urine analysis is correct. How to correctly collect a urine test according to Nechiporenko. What is the difference between a general urine test and Nechiporenko?

During a medical examination, the doctor prescribes a set of tests to the patient, the results of which indicate the nature and severity of the disease. Urine according to Nechiporenko is not included in the list of priority tests, but if the analysis is recommended, you should approach it responsibly. Incorrectly collected urine guarantees distortion of the indicators, so the specialist has to re-order the test.

Characteristics of analysis according to Nechiporenko

Urinalysis according to Nechiporenko is a laboratory research method that determines the microscopic content of formed and inorganic elements in one milliliter of biological fluid.

The study is carried out:

if the patient has a history of kidney and urinary tract diseases;
when the patient’s complaints directly indicate illnesses of the urinary system;
with unsatisfactory performance of a general (clinical) urine test;
during pregnancy.

People suffering from chronic urological and nephrological diseases often donate urine according to Nechiporenko. Based on this analysis, the doctor draws conclusions about the stage of the pathology (exacerbation, complete or partial remission).

If the patient’s complaints directly indicate kidney or bladder disease, the doctor may not wait for the results of a general urine test, but immediately prescribe a Nechiporenko test

A clinical urine test is prescribed to everyone who has an appointment with a therapist or is admitted to a hospital. The Nechiporenko test is advisable when a general analysis shows the presence in the urine of:

a significant number of leukocytes, erythrocytes;
cylinders;
inorganic salts (urates, phosphates, oxalates);
bacteria.

In many cases it is impossible to limit oneself to only a general urine test, since it focuses on research physical and chemical properties urine (acidity, specific gravity, color, transparency). Using a microscope, a laboratory technician examines the general sediment for the presence of microorganisms, blood cells, protein, and salts. The Nechiporenko study specifically shows the quantitative content of erythrocytes, leukocytes and hyaline casts. The laboratory assistant’s task is to accurately count them in the sediment, which is obtained from one milliliter of urine taken for examination.

During the Nechiporenko test, the laboratory assistant studies not the physical and chemical parameters of urine, but the quantitative content of various elements in it

During pregnancy, a woman’s urinary system becomes vulnerable for many reasons:

The kidneys are forced to pass more fluid through themselves, since the fetal circulatory system is part of the maternal one. This leads to functional changes - the renal pelvis expands, the ureters lengthen.
As the fetus enlarges, the bladder is pushed upward and compressed. Urination becomes more frequent. In rare cases, urine backflows from the bladder into the kidneys, which leads to inflammation.
In the first trimester of pregnancy, immunity decreases, which is necessary for the successful development of the embryo. early. Along with this, the risk of developing inflammatory diseases of the urinary organs is growing.
Bakvaginosis (bacterial infection) of the vagina during pregnancy often leads to an ascending infection of the bladder. The infection enters the female urethra, through which it rises higher. Subsequently, infection of the ureters and kidneys is possible.

Once every two weeks, a pregnant woman undergoes a clinical urine test. If there are deviations in it, the doctor prescribes a Nechiporenko test.

At any stage of pregnancy, urine tests are taken in order to promptly recognize pathologies that threaten the health of the woman and the unborn child.

The analysis time is two hours. You can get the result in your hands the next day.

There are no contraindications to the Nechiporenko test. However, it is not advisable for women to donate urine during menstruation. If necessary, you should use a tampon to menstrual blood did not get into the urine.

How to properly collect urine

Prepare in advance for a urine test according to Nechiporenko:

For 2-3 days, give up excess protein foods, especially coarse-fiber meat. Do not consume smoked meats, pickles, carbonated and alcoholic drinks, coffee, strong tea, semi-finished products, fast food.
The day before the test, exclude foods that color the urine (carrots, beets, berries and brightly colored fruits).
If you take any medications, herbs, or vitamins, consult your doctor in advance about whether you need to stop using them before taking the test.
On the day before the test, avoid physical activity, stress, overheating, and hypothermia.
In the evening, wash your genitals thoroughly with soap.
The night before the test, refrain from intimacy.

Collect urine in the morning, immediately after waking up. Follow these rules:

Wash your hands, wash yourself with warm water without additional hygiene products. If you decide to use soap, you need to rinse it off thoroughly.
Prepare a sterile disposable container.
Start urinating into the toilet (first 2-3 seconds). The first urine is not suitable for research, since it washes the urethra and urethra, in which a certain amount of bacteria accumulates overnight, even in a healthy person.
Fill the container with a medium portion of urine (the required volume is from 20 to 100 ml).
Finish peeing in the toilet too. Sediment from the bladder - primary suspension - may enter the final urine. It forms directly in the bladder and is not a consequence of inflammation. If such a sediment gets into the urine for analysis, the Nechiporenko result will be biased.
Close the container tightly with the lid.
Try to deliver the material for research to the laboratory as quickly as possible, but no later than 1.5–2 hours after delivery. If it is winter outside, pack the test jar so that it is not exposed to cold temperatures during transportation.

Urinalysis according to Nechiporenko is effective only if the biomaterial is collected correctly

For urine analysis according to Nechiporenko, use only a sterile container - a special container that is sold in any pharmacy. It is not recommended today to donate urine in a regular jar, since it is difficult to disinfect properly.

Sterile disposable containers for urine collection are inexpensive and practical, they are convenient for transporting collected liquid to the laboratory

Interpretation of results: norms and deviations

The standards of analysis according to Nechiporenko for children and adults do not differ. During pregnancy, indicators that are at the highest limit of normal are considered acceptable.

Table: normal indicators of urine analysis according to Nechiporenko and pathology indicated by deviations

Index	The norm is 1 ml	What do deviations indicate?	What diseases can be indicated by exceeded values?
Red blood cells	Up to 1000 units	The appearance of erythrocyte blood cells in the urine indicates that in one of the parts of the urinary system there is a traumatic factor of a mechanical nature. For example, salt, sand or stones passing through the urinary tract damage their internal linings	Urolithiasis disease
		During inflammation of the bladder, its mucous membrane is damaged by bacteria. From the resulting microtraumas, a few red blood cells enter the urine.	Cystitis (inflammation of the bladder) or cystopyelitis (purulent inflammation of the inner bladder membrane)
		If there are significantly more red blood cells than normal, this indicates that the filtration system of nephrons (the cells that make up the kidney tissue) is globally unable to cope with its function. Blood regularly enters the urine, which indicates kidney disease that is dangerous to human life.	Glomerulonephritis (inflammation of the kidney glomeruli with their damage), acute or chronic renal failure
Leukocytes	Up to 2000 units	Exceeding the norm always indicates an acute inflammatory process of the urinary system	Cystitis, pyelonephritis (inflammation of the kidneys with damage to the parenchyma and pyelocaliceal structures), urolithiasis, urethritis (inflammation urethra)
Hyaline cylinders	Up to 20 units	They are simple protein compounds that appear in small quantities even in healthy people due to excessive physical activity or stress. Exceeding the norm speaks not only about diseases of the urinary system, but also about pathologies outside its limits	Glomerulonephritis, pyelonephritis, kidney tumors, urolithiasis, diabetic nephropathy (kidney damage due to diabetes), kidney damage from poisons. Extrarenal diseases leading to cylindruria include congestive heart failure, malignant hypertension (persistent increase in blood pressure), fever with dehydration, and heat stroke. In pregnant women, casts in the urine indicate toxicosis.
Other types of cylinders	None	Complex formations, which in addition to protein include renal epithelium, red blood cells or cells of destroyed kidney tubules
Bacteria	None	Appears in urine during inflammatory processes of a bacterial nature	Cystitis, pyelonephritis, urethritis
Epithelium	No or only occasionally	An excessive amount of squamous epithelium indicates inflammation in the lower parts of the urinary system	Urethritis
		Transitional epithelium appears in the analysis due to inflammation in the bladder, ureters or renal pelvis	Cystitis, pyelonephritis
		The renal epithelium lines the tubules of the same name, so its appearance in the urine indicates damage to the nephrons. Normally, such epithelial cells do not appear in urine	Glomerulonephritis, chronic pyelonephritis, renal failure, multiple cysts and malignant kidney tumors

Typically, a laboratory technician who performs a urine test according to Nechiporenko counts only red blood cells, leukocytes and casts. If he discovers other pathological inclusions, he must indicate them even if there is no special column on the form.

In the standard form for recording urine results according to Nechiporenko, only the most important indicators, therefore, the laboratory technician does not always consider it necessary to indicate the presence of other pathological inclusions

Features of urine collection in infants

Collecting urine for a child under one year old according to Nechiporenko is not easy. The effectiveness of the analysis depends on the actions of the adults who are nearby. Their task is to collect at least ten milliliters of the child’s urine correctly.

Collecting urine from a baby according to Nechiporenko is a difficult but feasible task

Many parents prefer the use of children's urine bags. But in this way it will not be possible to collect an average portion of urine. The result will be unreliable. The method is more suitable for clinical analysis urine. You also cannot collect urine in a condom or bag, squeeze it out of a diaper, cotton wool or napkin, or drain it from the pot. In pediatric practice, such parental ingenuity is common and always leads to distorted results and re-prescription of the Nechiporenko test.

The best way to collect urine infant in this manner:

As soon as your baby wakes up, wash him thoroughly.
Place the child on a moisture-absorbent bedding, do not cover the genitals.
Put on sterile gloves yourself and prepare a disposable jar.
If the child is restless and wants to eat, give him clean water, but do not feed him.
When the baby starts to urinate, replace the container after 1-2 seconds.
As soon as the stream begins to dry up, remove the container so that the last drops remain on the litter.
Close the container and deliver the urine to the laboratory as quickly as possible.

This method requires observation and patience from an adult, but it is most suitable for collecting urine according to Nechiporenko. The main thing is that the room is warm and the baby does not catch a cold.

A simple way to speed up urination in a child is to create a realistic sound of water running using an audio or video gadget or by pouring liquid from one container to another.

The sound of flowing water reflexively stimulates urination in a person of any age

In a specialized urological hospital, urine collection for small patients according to Nechiporenko can be performed using a urological catheter. Parents should not worry, since a modern pediatric urinary catheter is a thin and flexible tube that does not cause pain to the baby during insertion. In addition, only disposable catheters are now used, which eliminates the possibility of infection. A qualified healthcare worker inserts a catheter through the urethra into the bladder and independently takes the required portion of urine for analysis, pouring it into a sterile container. If a doctor recommends taking a Nechiporenko test for a child in this way, this indicates that a reliable result is needed.

Urological catheters come in different thicknesses, but the thinnest ones are used for children

If a urine test according to Nechiporenko is prescribed, this indicates that the doctor suspects the patient has serious diseases of the urinary system or wants to make sure that they are absent. The test results will tell the specialist what additional examinations to prescribe to confirm the suspected diagnosis and what therapy is appropriate. Urine donation according to Nechiporenko after a course of treatment will allow you to assess the patient’s condition over time.

Quite often, after obtaining general results, the doctor prescribes additional tests, in particular a urine sample using the Nechiporenko method. It is important for making a correct diagnosis. What does a urine test according to Nechiporenko show? This is what we will talk about today.

When is it appointed?

This study will be required if the clinical (general) analysis shows any deviations from existing standards.

In order to conduct and then decipher a urine test according to Nechiporenko, a laboratory doctor needs 1 ml of liquid, in which the number of its constituent elements is calculated. The entire counting process is carried out using a special laboratory device.

The following indicators are considered the norm:

leukocytes - no more than 2000 units;
red blood cells - no more than 1000 units;
cylinders - no more than 20 units.

Any deviations from the given indicators indicate pathological processes affecting the human genitourinary system.

So, answering the question: “What does a urine test according to Nechiporenko show?” - we can say that this study helps to identify deviations in its composition, and therefore help in diagnosing the corresponding disease.

according to Nechiporenko: leukocytes

An increased number of leukocytes confirms the presence of infection and inflammatory process in the genitourinary system. The most common cause of an increase in this number is cystitis. This is called inflammation of the bladder. Due to the increased number of leukocytes, urine loses its natural transparency and becomes more turbid, and a thick sediment appears with a loose or mucous consistency.

Red blood cells

With an increased rate of red blood cells, first of all, their structure is determined. These particles can be modified or unmodified. If there is a sufficiently large number of red blood cells with an altered structure, then this indicates kidney disease.

Cylinders

Even a slight increase in this indicator is a sign of an abnormal process affecting the kidney tissue. There are different types of cylinders, so depending on the type identified, the final diagnosis is made.

Since the topic of our conversation is the question of what a urine test according to Nechiporenko shows, therefore below are the main diseases in which the change occurs. It is for diagnosing these very complex diseases that this study is intended.

Urine according to Nechiporenko: what the analysis shows

As mentioned earlier, this study contributes to a more accurate diagnosis by indicating certain abnormalities.

Most often, urine according to Nechiporenko helps diagnose the following diseases.

Preparing for the test

On the eve of submitting urine for laboratory testing, you should avoid vegetables and fruits that can change its color. You should also not take diuretics.

The material collected for the study should be delivered to the clinic laboratory on the same day. Storing liquid for a long time may affect its physical properties, promote the growth of bacteria or the destruction of elements present in the sediment. Such inaccurate data can prevent a correct diagnosis and lead to unpleasant consequences.

We donate urine according to Nechiporenko

Let's figure out how to donate urine according to Nechiporenko. For this analysis, you will need morning urine, since it accumulates during the night and is therefore not subject to daily fluctuations. The volume of liquid required for the study must be at least 70 ml.

Also important point is the air temperature during delivery of the analysis to the laboratory. Cooled material too much also gives an incorrect result: a precipitate appears in the form of salts. It can be interpreted as the presence of kidney disease.

Before donating urine according to Nechiporenko, it is advisable not to take any medicines. This can quite distort the research results.

Collection

Analysis according to Nechiporenko: how to collect? First of all, you should definitely toilet the external genitalia. Soap and boiled water are perfect for this. If it is not possible to go to the bathroom, then you can use a solution of furatsilin or a solution of potassium permanganate. If this important rule is not followed, the material collected for analysis may give incorrect results. “Extra” red and white blood cells appear in it, making it difficult to diagnose the disease.

The sample should be collected in a clean, dry container (glass jar), washed most thoroughly. The basic rule when collecting urine using the Nechiporenko method is to collect its average portion. To do this, you should first urinate a little in the toilet, then collect.

During collection, try not to touch the body with the bottle so that unnecessary elements do not get there. Then close the container and take it to the laboratory.

Now you know why this test is prescribed, as well as what the Nechiporenko urine test shows. As a rule, the attending physician refers for this study not only when clarification of the diagnosis is required, but also to monitor the treatment process as a whole. Sometimes it is necessary to take this sample more than once, since the results turn out to be “blurred” for various reasons.

If it is necessary to obtain a more accurate clinical picture of the disease, additional diagnostic methods may be prescribed to make a diagnosis. These types of additional research include the Nechiporenko method of urine analysis.

What is Nechiporenko analysis?

Nechiporenko's research is considered one of the most informative laboratory research methods. The method was developed by a Soviet urologist, after whom it received its name. The advantage of this diagnostic method is its low cost and short diagnostic time. The method belongs to the category of microscopic examination and its implementation does not require high-tech equipment or specially trained specialists with a unique profile. Such a study today can be carried out in any laboratory of a medical institution.

Not all patients are prescribed a referral; even at their individual request, the doctor assesses the need for such a diagnosis. The study is carried out when blood and urine values differ during a general analysis. The method is used to clarify the overall picture in cases of suspected urological diseases of an infectious and inflammatory nature.

The study is prescribed when a general urine test reveals an increased level of red blood cells and white blood cells, detection of casts, and pathological changes in the genitourinary system. The analysis is based on the study of such pathological indicators as leukocytes, erythrocytes, and casts. Such an analysis may be prescribed by the attending physician to monitor the effectiveness of the course of treatment. Urinalysis according to Nechiporenko is prescribed by the following doctors:

therapist;
urologist;
nephrologist;
surgeon

Unlike a general urine test, a study using the Nechiporenko method always requires preliminary preparation from the patient, changes in diet and hygiene requirements when collecting fluid for analysis. The main difference between the Nechiporenko research method and a general urine analysis is that the average portion of urine is taken as the material . It does not contain:

flushing from the urethra;
sediment from the bladder.

In this analysis, the elements contained in urine are counted in a special way. The timing of the analysis may vary slightly depending on the number of patients and the urgency of the study. On average, a laboratory test is prepared within 7 hours. The patient can usually pick up the finished result the next day after it is submitted.

Urinalysis according to Nechiporenko: how to prepare

The reliability of a future diagnosis largely depends on how correctly the urine test was collected. It is required not only to take the correct portion, but also fulfill a number of essential requirements, preceding the actual collection. Non-compliance the most important rules is fraught with obtaining unreliable analysis results, which can lead to an incorrect interpretation of the clinical picture by the doctor.

A week before the test, you cannot carry out special diagnostic procedures that could cause damage to the urethra. Such procedures include:

cystoscopy;
urography;
urethroscopy;
taking a smear from the urinary canal.

3 days before the Nechiporenko analysis, it is worth excluding large physical exercise and avoid hypothermia or overheating of the body. Must be avoided stressful situations and conflicts. It is recommended to prepare a sterile container for collecting the analysis in advance.

It is worth making a number of adjustments to your diet:

In women, the material cannot be taken on the day of menstruation, as on such days it is possible that blood fluid may enter the portion.

How to properly collect urine for analysis

Urine collection should be done in a special sterilized container. Today, you can purchase special plastic containers at the pharmacy for a small amount. Any glass container of small volume, previously washed and sterilized, can be suitable for this.

The first morning urine is collected. The first portion should be released, only the average urination is taken. Before taking, be sure to thoroughly wash your genitals without using soap. Antibacterial agents should not be used for washing. Getting even a small amount of an antibacterial agent into a liquid is detrimental to bacteria and microorganisms, which will lead to unreliable laboratory tests.

In two hours urine must be submitted for laboratory testing. After this time, bacteria will begin to develop in the urine and the results may be skewed. At room temperature, intensive growth of bacteria begins in the urine, so initial storage of the material in the refrigerator at a temperature of +4 C 0 is permissible, but not more than 1.5 hours. When delivering urine during a cold period, the sample must not be allowed to freeze, as this will cause cell destruction and may distort the clinical picture.

How to collect urine from a child

For young parents, the need to collect urine often causes panic, since collecting material for research from a child can be quite difficult.

On the eve of the test, the child must be given a sufficient amount of fluid to drink, which will guarantee that he will urinate in the morning. The baby's genitals are washed thoroughly under running warm water. There are several options for collecting analysis:

To conduct research, it is enough to take 20-35 ml of urine. The following can lead to unreliability of the resulting analysis:

non-compliance with the rules for taking fluids;
collection of urine for diaper rash on the child’s body;
the baby’s tendency to allergic reactions and their intensification on the eve of urine collection;
prolonged abstinence of the child from urination.

To enhance natural urges, you can turn on the water in the tap or make appropriate sounds. Children under 1 year of age are recommended to be stroked on the back along the spine. If all urine was collected for research, the pediatrician must be notified about this.

Analysis according to Nechiporenko: decoding

It’s easy to independently decipher the results obtained and assess how well the analysis corresponds to the norm - it is sufficient to know information about the acceptable content of the main indicators.

During normal functioning of the body and the urinary system, the renal glomeruli do not allow large quantities of formed elements to pass through. With the development of infectious and inflammatory diseases, the renal barrier is disrupted. This leads to changes in the composition of urine, in which the levels of leukocytes, red blood cells and cylinders increase. If bacteria or epithelial cells are found in the liquid, this must be indicated on the form with the result of the analysis.

The norm is calculated per 1 milliliter, and it is the same for adults and children. A normal analysis contains:

the norm of leukocytes is not more than 20,000;
hyaline cylinders up to 20 units;
the norm for red blood cells is up to 1,000.

White blood cells in the human body are responsible for controlling immune system. In inflammatory diseases there is always increased level leukocytes. How higher level leukocytes, the more serious the inflammatory process. When white blood cell counts are as high as possible, a diagnosis of pyuria is made, which means the presence of purulent discharge in the urine. This liquid is very visually different from normal urine:

has an unpleasant odor;
cloudy;
There may be inclusions in the form of flakes or threads.

An increase in the level of white blood cells is characteristic of diabetes, when there is an increase in blood sugar levels. As a rule, urination is complicated and accompanied by an unpleasant burning sensation. In men, elevated white blood cell levels may be associated with prostate disease. The most common diseases in women with elevated white blood cell levels are:

vaginitis;
thrush;
endometritis;
trichomoniasis.

Red blood cells are responsible for delivering oxygen to organs and tissues. Normally, such elements should not be in the urine, so their presence in the urine signals the development of pathology of the urinary organs. In most cases Elevated levels of red blood cells are associated with the following diseases:

cystitis;
urolithiasis disease;
gout.

Cylinders are protein bodies that form in the kidney tubules when pathological changes occur. Depending on the identified species it is possible to identify the nature of pathological changes:

According to the transcript, the presence of hyaline cylinders up to 20 units is considered normal, but the presence of all other types is considered a deviation.

In a state of pregnancy Nechiporenko analysis indicators often turn out to be very close to the maximum permissible. There is no need to panic or get upset, as this situation is normal. During pregnancy, increased daily diuresis is observed, so increased levels are not considered a bad result.

In other cases, a poor urine test always suggests elevated levels of elements. In such an analysis, bacteria, protein or epithelium can be identified, and if identified, additional diagnostic methods are prescribed. This analysis signals inflammatory processes or pathological changes in the urinary system.

It is not worth making a diagnosis on your own based on the results obtained., since only a qualified specialist can correctly assess the overall clinical picture. When making the final diagnosis, all urine indicators are taken into account in conjunction with other studies, patient complaints and the main symptoms of the disease.

According to Nechiporenko, it is quite widely used in urology, nephrology, and therapy. This study is accessible, low-cost and informative, allows you to diagnose hidden inflammatory processes and other pathological conditions in the organs of the genitourinary system.

First time used this method examinations by oncourologist A.Z. Nechiporenko.

What does urine analysis according to Nechiporenko show?

We list the indications for performing the test:

asymptomatic increase in temperature reaction;
the need for condition dynamics during treatment;
the appearance of cylinders in;
developmental abnormalities of the urinary organs;
borderline values of elements in a general urinalysis;
increased levels of creatinine;
pre-pregnancy examination;
clinical observation of a patient with urological or nephrological pathology;
pathological changes diagnosed by ultrasound examination;
no changes in urine at the appropriate urological clinic.

When examining 1 ml of urine, the number of red blood cells, leukocytes, and casts is calculated.

Leukocytes - blood cells that provide the body’s immune defense, and they are also the main markers of the inflammatory process. An increase in leukocytes in the urine indicates inflammation in the urogenital tract.

Normally, leukocytes in a general urine analysis are single, i.e., they do not exceed 2 - 3 per field of view in men, and 4 - 6 in women.

If the number of leukocytes in a man’s urine is 5–7 or higher, a Nechiporenko test and a smear from the urethra are examined.

Red blood cells in urine may be a consequence of any vascular damage due to crystalluria, tumor disintegration, or occur with immune lesions structural apparatus kidneys, for example, with hematuria syndrome.

Cylinders - protein bodies that appear during pathological processes in the renal tubules.

The following cylinders are distinguished:

grainy(appear against the background of tubule lysis);

hyaline(formed from the protein of primary urine);

erythrocyte(appear against the background of erythrocyte occlusion of the renal tubules),

waxy(based on hyaline or granular casts stagnant in the renal tubule);

epithelial(desquamated epithelium of the renal tubule).

Note that hyaline casts can be present in the urine in quantities of up to 20; if other casts are detected, this is considered a deviation from the norm.

How to correctly collect a urine test according to Nechiporenko

note

It should be noted that the results of a urine sample according to Nechiporenko will be unreliable if a woman has (inflammation of the vagina). In this case, leukocytes from the vagina enter the urine, which does not allow a correct diagnosis to be made.

In doubtful situations, to confirm or exclude an inflammatory process in the urinary tract, urine is collected for analysis using bladder catheterization on an outpatient basis. Some experts advise simply inserting a sanitary tampon into the vagina.

If it is present in a man, there is no point in confirming the obvious (leukocyturia) using the Nechiporenko test.

To get the most reliable results, you should stop drinking alcohol, carbonated drinks, excessive consumption of protein products (meat, milk, fish, eggs), and smoked foods for about 24 hours. From intense workout and visiting the sauna should be avoided.

When taking anti-inflammatory drugs, there is a possibility of incorrectly assessing the condition of the urinary tract: the process of inflammation itself will develop, but there will be no pathological changes in the urine.

During menstruation, you should not examine urine according to Nechiporenko, since if blood gets into the urine, microhematuria will be false, and such a result has no diagnostic value.

To increase accuracy, it is better to take urine for analysis 3 to 4 days after the end of menstruation.

The result will also be unreliable if there is bleeding from the genital tract, for example, after childbirth or as a result of ovarian dysfunction.

Before collecting the analysis, it is necessary to toilet the external genitalia, soap intimate area soap and rinse with water. Then blot your genitals with a towel (do not rub), flush about 1/3 of the urine into the toilet, then into a specially prepared container (can be bought at a pharmacy), and back into the toilet.

Before collecting urine, men must retract the foreskin and wash off the smegma.

You should not store collected urine for a long time, as pathogenic bacteria can multiply in it. Ideally, the container is delivered to the laboratory no later than 2 hours from the moment of collection.

How to properly collect urine from a child

Before collecting, carry out hygiene procedures, and it is important to wash the girl from front to back so as not to spread the intestinal microflora.

There are 2 options:

First - attach a urinal bag purchased from a pharmacy to the child’s genitals and wait for the natural act of urination.

Second - put the baby on a diaper, using reflex stimulation (stroking the spine, the sound of pouring water) to stimulate the act of urination. A container for collecting urine must be prepared in advance.

Warn your pediatrician that the entire urine is being submitted for analysis.

How the Nechiporenko test is deciphered: norm and pathology

Normal values in children and adults are identical.

Leukocytes up to 4000/ml (according to some sources - up to 2000/ml);

Red blood cells up to 1000/ml;

Cylinders 0 - 1 for 4 Goryaev cameras, or 0 - 1 for Fuchs - Rosenthal camera.

Even if you receive the result of the Nechiporenko test with data different from the norm, do not rush to make a diagnosis yourself, only a doctor can judge what is normal and what is pathology.

What does an increase in elements in the Nechiporenko sample indicate?

note

It should be noted that some practicing urologists consider the number of leukocytes of 4000/ml in the Nechiporenko test in men to be overestimated and does not exclude an inflammatory process, which requires further examination or follow-up.

We present to your attention the nosologies in which changes in urine appear according to Nechiporenko.

Elevated red blood cells:

Increased leukocytes:

inflammatory diseases of the kidneys, bladder, urethra, prostate gland;
in women, improper collection of urine against the background of prolapse of the anterior vaginal wall;
systemic diseases;
secondary inflammatory process against the background of nephrolithiasis, tumor, diverticulum, etc.

We all give up often different tests. They are necessary for the doctor to understand the picture of the health status of the patient who contacts him. If in the general analysis the doctor observes changes indicating pathology, a specialized study is prescribed - a urine test, proposed by urologist A.Z. Nechiporenko.

Urinalysis according to Nechiporenko

Urinalysis according to Nechiporenko is perhaps the most popular after general analysis. This method is simple and at the same time quite reliably shows problems in the human urinary system. This technique helps the laboratory assistant determine the number of specific formed elements contained in the donated fluid, and then the urologist, assessing the results, can guess what disease has begun to develop in the kidneys or bladder.

What is the purpose of diagnosis?

Urinalysis according to Nechiporenko suggests that the patient previously took a routine urine test, and the doctor discovered certain pathologies in it:

red blood particles - erythrocytes;
the presence of inflammation, indicated by an increase in the level of leukocytes;
various kinds of cylinders, which should not be in the urine at all.

It is equally important to regularly test urine according to Nechiporenko for those patients who are undergoing treatment for chronic kidney diseases in order to monitor the progress of therapy, as well as for people with systemic diseases that have a negative impact on the functioning of the urinary system.

What will the analysis show?

The analysis shows only the presence of three elements found in 1 ml of urine, namely:

leukocytes;
red blood cells;
cylinders

The detection of leukocytosis will be clear evidence of an existing inflammatory disease of the bladder, kidneys or urethra.

Inappropriate for healthy body the number of red blood cells indicates that there are quite a few reasons for this, including the development of severe kidney pathologies.

The presence of cylinders in the urine is always evidence of serious impairment of the functional capacity of the kidneys. Such patients require urgent examination in order to make an accurate diagnosis.

How to assemble correctly?

Usually people do not think about how the test is taken, but the results largely depend on the correct collection of urine samples.

In fact, the purity of the study and the maximum reliability of the results depend on many factors:

Absolute sterility of the analysis container. Of course, it would be better to use a sterile jar purchased at a pharmacy, but in the absence of one, you can collect urine in a small glass container with a volume of no more than 100 ml with a wide neck. The jar must first be washed with warm soda solution and sterilize in microwave oven 2-3 minutes.
Approximately one day before collecting a portion of urine, you should avoid eating foods that color: beets, rhubarb, carrot juice, as well as sweets, soda and any alcohol. You should not get carried away with heavy meat foods, as this puts additional stress on the kidneys.
Taking antibiotics, diuretics, as well as intensive physical exercise and stress the day before.
Immediately before taking the test, you should wash your genitals with water in order to cleanse them of excess dead cells that may get into the jar.
During menstruation, women must refuse to take the Nechiporenko test, or, in case of urgent need for research, close the vagina with a tampon.
For analysis, the most indicative is the average portion of urine. To collect it, you should urinate in the toilet for some time, then in a glass container, and put the last portion back into the toilet.
The analysis is collected early in the morning, and must be submitted to the laboratory within one to two hours. 1-2 days - as long as the analysis is done in the laboratory.

Scheme for proper urine collection according to Nechiporenko

Decoding the results

Analysis according to Nechiporenko is prescribed to all categories of patients - adult men and women, the elderly, children and pregnant women. The norms are the same for everyone, the only exception is made for pregnant women: their indicators may approach the upper limits of the norm, since daily diuresis usually exceeds the permissible limit. Such numbers do not indicate pathology, and the doctor will not prescribe any therapy.

The norm for children and adults in the table:

In the video about urine testing according to Nechiporenko, rules for collecting material, indicators:

Bad results

Any deviation from established standards in the direction of exceeding them is considered a pathology. Improper kidney function or an inflammatory disease is also indicated by the presence of protein, epithelial cells or bacteria in the urine. However, you should not panic ahead of time and prescribe yourself strong medications; remember that only a specialist can interpret the results!

An increase in red blood cells in the Nechiporenko study may be evidence of incipient diseases:

glomerulonephritis;
kidney infarction;
chronic renal failure;
pyelocystitis;
nephrotic syndrome;
kidney tuberculosis;
tumor of the urinary tract;
stones in the kidneys or ureter.

A urologist can make any of the listed diagnoses if more than 1000 units of red blood cells appear in the urine in 1 ml of biological fluid.

An increased number of leukocytes of more than 2000 units may indicate the development of pathologies such as:

kidney infarction;
cystitis;
prostatitis;
urolithiasis disease;
pyelonephritis.

During pregnancy, women's leukocyte counts in the urine may slightly exceed the established standards; however, if there is a significant deviation from the established standards, then this is hallmark the presence of any inflammation in the woman’s genitourinary system.

As for cylindruria, that is, the number of cylinders exceeding the established norm of 20 units, the situation here should be considered in more detail. If casts appear in the urine, the laboratory technician will be sure to indicate their type, since this is important for diagnosing kidney disease.

Hyaline casts can appear in the urine of a completely healthy person, but in small quantities.

An excess of hyaline casts indicates diseases in which proteinuria is observed - the appearance of protein in the urine:

pyelonephritis;

In addition, an increased number of hyaline casts may be evidence of hypertension or a consequence of taking diuretics.

There are no granular casts in the urine of a healthy person.

Their appearance always indicates damage to the renal tubules in the following diseases:

acute and chronic glomerulonephritis;
kidney amyloidosis;
pyelonephritis;
viral diseases, especially those accompanied by high fever.

Waxy casts appear in the urine with severe kidney damage:

late stages of renal amyloidosis;
severe renal failure;
subacute malignant glomerulonephritis.

The prognosis for the treatment of these complications is quite unfavorable.

Red blood cell casts should not be present in the urine at all.

Their appearance indicates that the patient’s hematuria is associated with kidney disease:

glomerulonephritis;
tumor processes in the kidneys;
kidney infarction;
renal vein thrombosis.

If acute pyelonephritis develops, leukocyte casts may appear in the urine.

In cases of serious kidney disease, epithelial casts settle in the urine. Their appearance becomes a reason to suspect the development of the following pathologies:

acute tubular necrosis;
acute nephritis;
severe poisoning causing toxic kidney damage (phenols, pesticides, cyclosporines, lithium, etc.).

Epithelial casts may be lost in the urine due to severe viral infection.

Often women in recent months During pregnancy, protein appears in the urine in the form of cylinders. It's always danger sign development of late gestosis in pregnant women, which can cause premature delivery, and in severe cases, death of the mother and fetus. In combination with an increased number of leukocytes, the appearance of protein is evidence of kidney inflammation, and this is very dangerous for a pregnant woman and her unborn baby. Therefore, gynecologists observing women during pregnancy try to refer them to urine tests as often as possible in order to prevent the development of possible abnormalities in their health.