Isolated urinary syndrome in children and doctor’s tactics in a clinic. Urinary syndrome as a sign of kidney disease

In the global understanding, changes in urine characteristic of certain pathologies are called “urinary syndrome.” Moreover, this term denotes both a violation of urination and the manifestation of qualitative and quantitative changes in urine analysis.

But in a narrower sense, urinary syndrome refers to the manifestation urinary syndrome in the urine - the appearance of protein in the urine (proteinuria), the appearance of blood in the urine (hematuria), the appearance of leukocytes in the urine (leukocyturia), and the appearance of special casts, bacteria and manifestations of pathological salt sediment in the urine. If urination is impaired, changes in urine volume, rhythm or frequency of urination, as well as dysuria, may be detected.

Urine volume abnormalities

Daily urine volumes in healthy babies can fluctuate depending on age, diet, salt intake, volume of fluid drunk, physical activity, body temperature and environment, as well as air humidity or dryness. In addition, the rhythms of urination may depend on the time of day - maximum urine is separated in daytime from 15 to 19 hours, the least urine is excreted at night in the period from three in the morning to six in the morning. On average, the ratio of daytime to nighttime urine volume is approximately three to one. If babies are premature and are on artificial nutrition, their urine volumes may be slightly larger than that of full-term infants. Among the pathologies, several typical disorders can be identified that require detailed discussion.

Nocturia, or the predominance of the volume of nighttime diuresis over the daytime, can form in many of the pathological conditions and diseases of the urinary system; this is one of the manifestations of tubular abnormalities (defects in the renal tubes). Often, such changes occur during the development of acute or exacerbation of chronic pyelonephritis (inflammation renal pelvis), may occur as a result of eliminating edema, especially if it is nephrotic syndrome, which is treated with glucocorticoids. There may also be a persistent and long-term predominance of nocturnal diuresis over daytime diuresis, which can occur with progressive damage to the collecting ducts of the kidney, which as a result progress to the development of chronic kidney failure.

A decrease in daily urine volume or oliguria is a state of reduction in daily urine output by less than a quarter or a third of age standards. A physiological decrease in the volume of urine can be observed in children aged two to three days, when the mother begins lactation and the child loses a large amount of moisture from the surface of the skin. The manifestation of oliguria may be one of the most important symptoms acute renal failure or at the final stage of development of chronic renal failure, this is observed with congenital pathology, hereditary pathology or with severe acquired kidney pathologies.

Polyuria- this is a sharp increase in the amount of urine excreted per day, which exceeds the daily norm by two times or more, amounting to more than one and a half liters of liquid for every square meter of body area. The increase in urine volume may be due to increased water or salt diuresis, that is, excess fluid in the body or excess salts. With polyuria, there may be a parallel condition of pollakiuria - frequent urination. But this symptom can also be a manifestation of hypothermia, cystitis, neurotic disorders, while urine can be released a lot or just a little, drops, there may be pain, burning, false urge to urinate. There may also be frequent attacks of urination when the urethra is irritated by salts dissolved in the urine or by inflammatory processes.

A separate variant of frequent urination is dysuria - frequent and very painful urination - it can occur during an acute inflammatory process in the lower urinary tract (urethritis and cystitis), as well as in the external genital area with balanoposthitis (inflammation foreskin) or vulvitis (inflammation of the girl’s genital organs). In addition, pain may occur as a result of passage through the urinary tract blood clots or large salt crystals.

Changes in general urine analysis

Changes in urine tests are one of the most important signs of kidney pathology, and therefore, based on the results of urine tests, a preliminary diagnosis can be made, which is then only confirmed by additional studies. Changes in urinalysis may include changes in color and clarity, urine reaction and density, and glucose and protein levels, and microscopy examination of urine sediment is also used.

A general urine test is usually recommended to be performed immediately after the child urinates, this will be perfect option analysis to which we must strive. But it is necessary to take into account the possibility of taking the test within two hours from the moment the test is collected. In the future, the information content of urine analysis becomes less indicative.

Changes in urine color and clarity

The color of normal urine can be from light yellow to amber; it is due to the presence in the urine of coloring pigments of bile metabolism and bilirubin metabolism - urochromes, urobilin and its other analogues. In children in the neonatal period, up to the third to fifth day of age, and in rare cases up to two weeks of age, a slightly reddish tint of urine may be observed due to high content uric acid salts. This is called a state of uric acid diathesis, and in some conditions it has the character of a uric acid infarction. These salts can easily crystallize on the diaper, leaving brick-red colored salts on the diaper.

In more late dates In children who are breastfed, the urine may have a very pale yellowish color, since the kidneys have a low concentration ability. Some foods can color your urine, such as beets, rhubarb, pumpkin or kiwi. Many medications also change the color of urine, some dyes, antibiotics and sulfonamides. Urine may darken when standing, especially when treated with nitrofurans.

With pathologies, the color of urine in children can change dramatically, especially the color of urine can change in the presence of salts when standing. Fresh urine in healthy children is transparent, salts can be white, red, and the color of urine can change in the presence of blood, leukocytes, fats and casts, and mucus.

Turbidity of urine from salts is considered conditionally pathological, since the amount of salts strongly depends on the type of diet and the volume of fluid consumed, the reaction of urine and the volume of urine excretion. But if the urine becomes cloudy constant sign or the child’s salts are deposited on the walls of the pot - examination and treatment of nephropathy is necessary.

Acidity or pH of urine

The urine reaction under normal conditions can vary significantly depending on the type of diet and fluid intake, the range of urine fluctuations can be from 4.0 to 8.0 - that is, from acidic to alkaline, the average acidity of urine is from 6.4 to 6.4 - approximately neutral. When consuming predominantly plant foods, the urine reaction will be alkaline; nighttime urine portions may be the most acidic, dropping to 5.0 or even lower. When protein foods predominate, the reaction is mainly slightly acidic.

The release of acid and alkali ions by the age of the newborn is already quite mature, and on the first day of life the acidity of urine is about 5.6, but in premature infants the acidity is lower, which is associated with the birth crisis and stress. Gradually, by the end of the first week of life, acidity decreases, urine becomes slightly acidic or neutral while the baby eats mostly breast milk.

Determining the acidity of urine is necessary for diagnosing many pathological conditions, although it does not provide an accurate diagnosis and level of lesions, nor does it reflect general changes acidity in the body. Constantly acidic urine is usually observed with acidosis during the period of rickets at its height, with acute fevers, with the formation of cardiac, renal and respiratory failure, with diabetes mellitus. Neutral and alkaline reactions of urine can occur during vomiting, during the passage of edema, and during infections of the urinary system due to the breakdown of ammonia by microbes and alkalization of urine.

Often, urine acidity indicators can reflect general trends in the acid-base state of the body; acidosis is especially acute in urine. But with some kidney damage, with damage to the tubules, the urine is usually persistently alkaline or neutral, and can also be when taking diuretics.

Urine density and osmolality

The density or specific gravity of urine reflects the degree of dissolution in it. various substances, the ability to concentrate primarily urea and salt sediment. The normal density of urine can vary depending on the food and volume of fluid the child drinks, as well as the degree of fluid loss from the skin and intestines. The density of urine can quite clearly characterize the ability of the kidneys, their ability to dilute or concentrate urine, and this depends on the needs of the children’s body. The density of children's urine can range from 1007 to 1025, although the range of fluctuations can generally be from 1001 to 1039. early age, in the first weeks of life, the specific gravity of urine is usually small, averaging about 1016-1019.

The main reason that sharply increases the density of urine may be the appearance of glucose in the urine; every one percent of glucose increases the density of urine by 0004. Also, the specific gravity of urine increases every three grams of protein by 0001. Some kidney diseases can sharply increase the density of urine - so density high with oliguria stage acute glomerulonephritis, then the density of urine reaches 1030. But in most kidney diseases, the density of urine decreases depending on the degree of damage to the kidney tubules.

Urine may have a monotonous rhythm of urine density, with little or no fluctuation in density during the day and night. This condition may be called isthenuria - constant density of urine. If fluctuations in the density of urine have a range of less than 1010, this is called a violation of the concentration function of urine, which is called the state of hyposthenuria.

Physiological hypotenuria can be observed in young children, especially those who are breastfed; this happens in children throughout the first year of life. This condition can also occur when various kinds chronic kidney diseases - with acute glomerulonephritis in the stage of polyuria, as well as with symptoms of acute or chronic interstitial nephritis, with a condition of renal or pituitary diabetes mellitus.

Abnormalities in urinalysis are far from limited to this, and in addition to physicochemical factors, the urinary sediment may also change the indicators of blood cells - both typical for a normal urine analysis and normal analysis and not dating. If there are any changes in the urine test, it is necessary to conduct a repeat, control urine test - perhaps the changes were temporary.

If the changes are persistent, a detailed examination by a nephrologist and treatment are necessary. With early diagnosis and initiation of treatment, many kidney diseases are quite easily curable and put into long-term remission.

The urinary syndrome is based on physical, chemical and microscopic changes in urine. Microscopic changes in urine are assessed by centrifuging urine and examining the urinary sediment under a microscope. In the sediment, typical and atypical changes can be distinguished, changes that are more or less pronounced. Based on microscopic sediment data and its changes, a preliminary diagnosis can often be made quite accurately.

Sediment microscopy study

There is a distinction between the organic part of the sediment and the inorganic components in the urinary sediment. Organic parts in the sediment can be represented by casts, erythrocytes, leukocytes and epithelial cells.

Epithelial cells in the urinary sediment can be of different nature - they can enter the urine as it passes through the urinary tract, starting from the renal pelvis, then the ureters, Bladder and urethra. Flat, round and cylindrical epithelial cells can be distinguished. As a result of the change physical and chemical properties urine may have a significant impact on appearance epithelial cells and this can make it very difficult to distinguish them from each other, and by the type of epithelium one can quite accurately determine the level of damage to the urinary tract by the inflammatory process.

Tubular epithelium or urinary tract epithelium may be detected. It is worth remembering that a small amount of squamous or columnar epithelium in a urine test is quite normal, a certain number of cells are exfoliated and are constantly renewed. A definitive pathology is the appearance of renal epithelium in a urine test (these are cells of the renal tubules, which means there is kidney damage). In appearance, tubular epithelial cells are difficult to distinguish from the epithelium in the deep layers of the bladder, but the presence of epithelium should be given importance when protein, blood elements and casts appear, if there are signs of fatty or protein degeneration. If epithelial cells are present in the urine in very large quantities, which indicates desquamation of the mucous membranes in the urinary tract area, when they are injured or inflamed due to salt crystals or infection.

Cylinders- these are a kind of casts from the kidney tubules, which are based on protein. In combination, protein with other elements in the urine can be visualized as hyaline, granular or erythrocytic. The protein that forms the basis of the cylinders can be folded into cylinders only when special conditions. One of the conditions for protein coagulation inside the renal tubules is a change in the reaction of urine in the acidic direction. If the urine reaction changes to alkaline, under such conditions protein coagulation does not occur and cylinders are not formed, or they quickly collapse in this alkaline environment, and they can only be detected in a stream of freshly released urine.

The casts may be true or false, and true casts may be granular, hyaline, or waxy. Hyaline cylinders may have a delicate and uniform structure; elements from urinary sediment may adhere to the surface of these cylinders. If epithelial cells stick together, epithelial casts can form, but if they stick together shaped elements- these will be erythrocyte or leukocyte cylinders. Such casts can occur with any kidney problems that result in renal proteinuria (protein in the urine) or the appearance of protein of extrarenal origin.

Granular casts can be a protein base that is saturated with degenerated or destroyed cells and from the kidney tubules, which always speaks in favor of severe kidney damage. They can occur with all types of glomerulonephritis, especially with chronic form or rapidly progressing, may indicate damage to the inrestitium and renal tubules.

Wax casts are rough formations from wide-lumen renal tubules, which are formed as a result of flattening of epithelial cells during chronic inflammation. They can occur with severe kidney damage with damage and serious degeneration of the epithelium of the kidney tubules. This indicates dystrophic processes and degeneration of kidney tissue, especially in the tubular region. This happens with renal amyloidosis, with a mixed form of glomerulonephritis with the formation of renal failure.
False cylinders are the formation of cylinders from organic or non-organic organic matter, which are areas of accumulation of ammonium urate salts, drops of fat, leukocytes, fibrin or mucus; such formations do not indicate kidney damage, but may be evidence of damage to any part of the urinary tract.

Manifestations of hematuria

Hematuria- this is the manifestation of blood in the urine (in the morning portion or in all daily portions) in various quantities - from microscopic to visible to the eye. Microscopic manifestations of red blood cells in the urine are called microhematuria, changes that are visible to the eye in the form of meat slop are macrohematuria.

With hematuria, the number of red blood cells in the field of view does not exceed more than 100 in the field of view, and when the number of red blood cells increases above one hundred or the field of view is completely covered with red blood cells, it is called macrohematuria.

In this case, the color of urine may become reddish or brownish, the color of meat slop. In addition, a brownish tint to the urine may indicate the presence of free hemoglobin in the urine. This is possible with manifestations of intravascular breakdown of red blood cells (hemolysis), but usually red blood cells are destroyed within the urine itself. Gross hematuria can occur with acute streptococcal glomerulonephritis, with immunoglobulin nephropathy and with some urological diseases.

Microhematuria with a small number of red blood cells in the urine occurs with less severe and serious kidney pathologies and urinary tract.

Hematuria is classified as true or false. True hematuria occurs as a result of blood entering the urine from the kidneys or from the urinary tract; with false hematuria, blood enters the urine from the genitals. In true hematuria, the cause of the blood is severe inflammation or tumor processes; it can also be caused by structural changes in the area of the glomeruli of the kidneys, with congenital or hereditary kidney pathology. This is typical for hereditary nephritis and renal dysplasia. In addition, blood in the urine can occur when there is significant excretion of crystals in the urine or when stones damage the urinary tract.

Hematuria is a common manifestation of pathology of the kidneys and urinary tract; it is the most common symptom of disease. It may be short-lived when passing small pebbles or salts. Blood in the urine can be recurrent with immunoglobulin lesions and persistent if there is permanent damage to the kidney tissue ( hereditary pathologies, renal dysplasia or glomerulonephritis).

The assessment of hematuria is carried out taking into account what symptoms are accompanied by blood in the urine. The presence of pain is especially important because severe pain may occur with renal colic, with urolithiasis, when blood clots or pus are released through the urinary tract - this can happen with kidney tuberculosis, with tumor processes, at papillary necrosis or thrombosis of the renal vessels. If blood appears in the urine without pain syndrome, this may indicate congenital or acquired nephropathy.

Hematuria is often manifested by the release of protein, the release of urates or oxalate salts. In a third of children, blood in the urine manifests itself in dysmetabolic nephropathy, when salts are excreted in the urine, which later develop into urolithiasis. Most often, difficulties in the manifestation of hematuria with diagnosis arise if the hematuria occurs without any other symptoms. Sometimes hematuria can occur during fevers, severe physical activity or as a reaction to toxic effects medicines.

Why does blood appear in urine?

Early hematuria childhood manifests itself as a result of infectious pathology, sepsis, intrauterine infections, polycystic lesions of the kidneys, Wilms tumor, thrombosis in the vessels of the kidneys, nephropathy, toxic damage kidneys during treatment, metabolic disorders congenital and acquired. At an early age, the manifestation of hematuria, especially massive and visible to the eye, can be a very unfavorable sign for health and life.

The preschool and school periods change the causes of hematuria - mainly secondary and primary phenomena of glomerulonephritis, nephritis, dysmetabolic nephropathies. Congenital or hereditary pathologies are also relevant, especially in combination with developmental disorders. Urolithiasis has also become relevant for children.

How is hematuria determined?

The presence of blood in the urine itself can be determined using special test strips. The technique is based on determining urine hemoglobin, but the test can react to other components in the urine. If the test is positive, further research is necessary, which is carried out quantitatively - by counting the number of red blood cells. This is done by microscopying a morning urine sample. Hematuria is understood as an increase in the number of red blood cells of more than 2-4 in the field of view, although other doctors say that there should be no red blood cells in the analysis at all.

With a single urine test, it is not always possible to identify pathology and detect the presence of red blood cells in the urine. The disease may proceed certain time hidden, and therefore changes in urine analysis may not be in every analysis. In addition, testing your urine for the presence of red blood cells can help evaluate the effectiveness of treatment. It is difficult to assess the presence and amount of blood in the urine in single tests, so it is necessary to estimate the daily number of red blood cells in the urine. A quantitative research method is the Amburger or Addis-Kakovsky method, but they are very labor-intensive and complex. The Nechiporenko method and the study of 24-hour urine will also be used. Urine analysis is calculated per 1 milliliter of urine.

If there are no red blood cell casts in the urine, there are no signs of kidney disease or damage renal tissue, there is a manifestation of dysuria (pain when urinating), and blood is released in clots from the urethra, then doctors can assume the sources of bleeding are not in the kidneys, but in the lower parts of the urinary system - in the bladder or urethra.

In severe cases, with serious kidney damage, urine may take on an unpleasant appearance and the color of meat slop, and this indicates heavy loss of blood from the urinary system. In such cases it is necessary immediate appeal see a doctor or call an ambulance. It is necessary to note the presence of concomitant manifestations - pain in the lumbar region or abdomen, pain in the projection of the bladder, nausea and vomiting, fever and profuse sweating, tachycardia and pressure fluctuations (this can be a sharp decrease in pressure, up to shock, or sharp increase– arterial renal hypertension).

Usually, the first thing that is done when blood appears in the urine is to be hospitalized in the nephrology or urology department of a children's hospital. A detailed examination is carried out there - repeated blood and urine tests, ultrasound and x-ray examinations, and, if necessary, magnetic resonance scanning. This will help identify the causes of blood in the urine and plan treatment.

Changes in urine tests in a child

Urinalysis is one of the main studies carried out from a very early age of the child. Despite the seeming primitiveness of the analysis, the methodology of which has been known for decades, a general urine test remains the “gold standard” in examining children with diseases not only of the kidneys, urinary system and problems of the genital organs, but also with many other diseases. Along with a general blood test, a general urine test is taken during almost any examination and during any medical examination. In a urine test, almost any indicator can change, but most often, a urine test looks at the presence of inflammation in the body, both inside the kidneys and in the body as a whole. What can changing indicators of a general urinalysis say, especially changes in the number of leukocytes, salt or protein in urine.

If there are leukocytes in the urine

Leukocytes– these are special blood and tissue cells that are responsible for the body’s antimicrobial defense and fight against inflammation. They are found in large quantities in the blood, transported to organs and tissues where foci of inflammation occur. With the development of inflammation, leukocytes are able to leave blood vessels and directed to the area of inflammation to fight infection and restore tissue. Under normal conditions, there may be very few leukocytes in the urine; they are acceptable as single in the field of view in boys (0-2 in the visual field), and up to 6-8 leukocytes in the field of view in girls due to the peculiarities of the structure and functioning of the reproductive tract. In cases of allergies or exudative-catarrhal constitutional abnormalities in children, the number of leukocytes may be slightly increased, and leukocytes are always higher in children at an early age due to difficulties in the procedure for collecting urine and treating the genitals. The acceptable maximum when we can talk about normal urine values is up to 4-6 in the field of vision in boys, and up to 8-10 in the field of vision in girls. During the phenomena inflammatory processes in the genitals of children, the number of leukocytes may increase not due to a urinary infection, but due to the entry of leukocytes from the area of inflammation into the area of the head of the penis of boys or the labia of girls. An increase in the number of white blood cells is usually accompanied by an increase in the number of epithelial cells.

Pathologies associated with the number of leukocytes

An increase in the number of leukocytes in the urine is called the condition of leukocyturia - the presence of leukocytes in the urine, and when the number of leukocytes increases to the point where they cover the entire field of view when examining urinary sediment under a microscope, this is called pyuria - pus in the urine. Leukocyturia may be the result of inflammation in the kidneys and urinary system of a microbial (bacterial) nature, but it may also be a sign viral infection, as well as leukocytes in the urine can also be a sign of non-microbial damage to the kidneys and urinary organs. This is the so-called true leukocyturia, that is, leukocytes are released directly from the urinary system. There may also be a condition of false leukocyturia, which occurs not due to the presence of inflammation in the urinary system, but in the presence of inflammatory or allergic processes in the area of the external genitalia of children of both sexes.

Types of leukocyturia, causes

An increase in the number of leukocytes in the urine can occur with various nephrological and urological diseases - with acute pyelonephritis or exacerbation chronic process Leukocyturia occurs, which is accompanied by the presence of moderate proteinuria (the appearance of protein in small quantities in the urine).

In this case, manifestations of pyelonephritis will occur against the background of a violation of the child’s condition, general intoxication with high fever and pain in the abdomen. But pyelonephritis is not the only pathology that occurs with symptoms of leukocyturia. With leukocyturia, urological diseases such as cystitis (inflammation of the bladder) and urethritis (inflammation of urethra).

At the same time, one of the leading symptoms of cystitis and urethritis are symptoms of dysuria - urination disorders with symptoms of pain, disturbances in the volume of urine output and the rhythm of urination.

If a child experiences manifestations of non-microbial nephritis (inflammation caused not by infection, but by other factors), then leukocyturia is accompanied by microhematuria (excretion of blood in the urine in a small amount) and moderate symptoms of proteinuria.

Moderate excretion of leukocytes in the urine is characteristic of initial stages development of acute glomerulonephritis, or during the period of primary exacerbation of a chronic process, which will reflect the body’s reaction to the fact that antigen-antibody complexes are deposited in the glomeruli of the kidneys, which causes acute or chronic inflammation. If the course of the disease is favorable, after a week of illness, leukocytes from the urine gradually disappear. If leukocytes in the urine remain unchanged, or their level increases, these symptoms of glomerulonephritis should be regarded as an extremely unfavorable factor in the development of this disease.

Sometimes, in various types of acute processes, the mere presence of leukocytes in the urine is not enough; it is necessary to identify leukocytes using a urocytogram, examining the urine sediment after staining it with special dyes. With infectious lesions of the kidneys or urinary tract, neutrophil types of leukocytruria can be observed, these are those blood cells that form pus in the urine. Under such conditions, up to 95% of leukocytes in the urine will be neutrophils, and only about 5% will be lymphocytes. In the initial stage of glomerulonephritis - be it acute or chronic, in the acute stage, in the urocytogram the neutrophilic component of leukocytes will also predominate over the lymphocytic one, but this difference will be less pronounced. In the dynamics of the development of the disease, changes in the urine may be different - lymphocytes in the urine can be equal to neutrophils, and even exceed their number. Another typical change in the urocytogram during glomerulonephritis is the presence of mononuclear cells, special cells, in the urine. With non-microbial (abacterial) glomerulonephritis, leukocyturia may be of an eosinophilic nature, which indirectly indicates the allergic nature of kidney damage and the involvement immune mechanisms. The number of lymphocytes in urine sediment changes with hereditary nephritis, salt metabolism disorders and nephropathies, as well as with dysplastic processes in the renal tissue.

Bacteria in urine

U healthy child urine must be sterile, that is, there should be no microbes in it, but periodically, non-pathogenic or opportunistic flora from the genital tract can be sown from the urine in an analysis in such an amount that cannot be called diagnostically significant. All this occurs due to the fact that microbes from the genital tract or perineal skin can enter the urine due to defects in urine collection, especially in very young children. Also, pathogenic microbes can penetrate into the urine during some general infectious processes in the body. But they cannot exist for a long time in the aggressive environment of a child’s urine and are quickly eliminated from it; this condition is called transient bacteriuria.

The appearance of bacteria in urine often indicates infectious lesion urinary tract and may indicate a causative agent of infections of the urinary and reproductive system. Therefore, urine culture is called the gold standard in diagnosis. genitourinary diseases in children. But the only difficulty in carrying out this analysis is the difficulty in collecting urine correctly - the ideal collection is bladder catheterization, but it is used extremely rarely in children and only in a hospital.

In general conditions, urine is collected in the morning, after a thorough toilet of the genitals with free urination from the middle portion of urine, the analysis is collected in a special sterile container, which is given to the parents by the laboratory that will conduct the analysis. The morning urine sample will be the most indicative, since it will have the highest concentration of microbes.

In small children, it is permissible to collect urine for analysis from a free stream when the baby urinates, and if it is not possible to collect urine strictly in the morning after waking up, they take any convenient portion from morning urination. Before taking the analysis, you need to thoroughly wash the child according to all the rules with soap, girls - from front to back under running water, boys - as you prefer. Collect the urine sample immediately into a container and immediately close the lid; it must be delivered to the laboratory within an hour after collection, otherwise the urine will be lost diagnostic value. If it is not possible to immediately transport the urine, you must place it in a tightly screwed container on the bottom shelf of the refrigerator.

The results of the analysis can be considered positive if more than 10 to the fifth degree of microbial bodies per 1 ml of urine were sown in the urine test, and for newborns - 10 to the 4th degree. To control the analysis, it is necessary to repeat the analysis once or twice in order to determine the causative flora and eliminate defects in the collection of the analysis.

When assessing the degree of bacteriuria (the presence of bacteria in the urine), it is necessary to study the specific type of microflora. Typically, microbial lesions of the kidneys or urinary tract are caused by special gram-negative microbes living in the intestines or on the skin - coli, Proteus, Klebsiella, Enterobacter or Pseudomonas. Enterococci and staphylococci, streptococci are less often sown. For each microbe, its diagnostic titer per milliliter of urine is diagnostic. The detection of some of the microbes in the urine is in itself a reason for treatment, regardless of their titer.

If there is salt in the urine

There is always a certain amount of dissolved salts in urine; sometimes, in a certain environment, they can precipitate. The amount and type of salts precipitated in a urine sample depends on many factors - the type of diet and type of food, the acidity of urine, the condition of the epithelium of the urinary tract itself and even the time of year and drinking regime. In the urinary sediment of children, oxalate, urate or phosphate salts are usually found; they can precipitate with calcium, ammonium, this depends on the characteristics of metabolism.

The most common precipitated salts are oxalates - they can precipitate even in newborns. In some conditions, in the first days after birth, uric acid salts, urates, may precipitate; this condition is called uric acid infarction of the kidneys; these salts color the urine brick-red.

The occasional appearance of oxalate and urate salts in the urine is not dangerous, but if these salts appear in every or almost every urine test, they are excreted in large quantities or have large crystals, this is most likely a state of dismetabolic nephropathy - a special functional impairment in the functioning of the kidneys, leading to disruption of the filtration processes of inorganic and organic substances. This condition is dangerous in terms of further development urolithiasis. Sometimes salts appear in children with fever, after taking certain drugs, after excessive intake special products– chocolate, sorrel, meat.

But the detection of tripelphosphates and phosphates in the urine should always alert the doctor - they are usually formed in conditions of urine infection. Phosphate salts settle on microbial bodies and form crystals. Usually, when phosphates are detected in the urine, a large number of microbes, leukocytes and even red blood cells are also detected in parallel with them.

Release of large amounts of salts- this is a reason to conduct a detailed examination of the kidneys for abnormalities, since urolithiasis today is very young and can occur even in children at an early age. Kidney stones cause serious violations in well-being, and disrupts the child’s life processes.

Urinary syndrome is a disturbance in the functioning of the urinary system, which is manifested by changes in the composition of urine, its quality and quantity. In such a situation, problems with urinary frequency as well as other symptoms may also appear. At the initial stage of development of the syndrome, a person does not show any symptoms, which makes the pathology dangerous.

Urinary syndrome can be caused by many reasons. The main ones include the following:

systematic nervous overstrain;
various infectious diseases;
benign neoplasms of the urinary system and neighboring organs;
urolithiasis disease;
oncological tumors;
various types of injury or overextension;
multiple sclerosis;
depression;
Parkinson's and Alzheimer's diseases;
congenital developmental pathologies;
encephalitis;
exposure to bad habits;
diabetes.

Urinary syndrome is a disorder of the urinary system.

These are not all the pathologies that can provoke urinary syndrome. In order to find out the exact cause, it is necessary to seek help from a doctor as soon as possible and undergo a series of examinations. Treatment should begin immediately, since even the slightest delay can lead to the development of complications. As for treatment, it should be selected only by the attending physician. Self-medication is strictly prohibited. In order to get rid of the pathology, among other things, you should follow all the recommendations of your doctor.

What abnormalities does urinary syndrome indicate?

From medical practice it follows that urinary syndrome may indicate various renal abnormalities and pathologies of the urinary tract. Such pathologies include:

Hematuria – this pathology consists in the presence of blood in the urine. Such impurities can have varying degrees of severity from noticeable naked eye presence until detected only by microscopic analysis. In this case, the urine may have a brownish or reddish tint. If a person is diagnosed with hematuria, this may indicate the development of tumor formations in the urinary tract, as well as urolithiasis or some kind of infection.
Cylindruria - in this case, various processes occur in the human body that lead to an increase in the acidity of urine. This pathology indicates inflammation of the kidneys, their damage, as well as damage to the urinary tract or glomerulonephritis.
Leukocyturia - this pathology indicates viral inflammation of the urinary tract or kidneys. With such a deviation in urine analysis, the number of leukocytes increases and this may indicate pathologies such as pyelonephritis in acute or chronic stage. In addition, an increase in white blood cells may indicate diseases such as urethritis. In addition to an increase in white blood cells, with all the pathologies listed above, the patient may experience symptoms such as pain when urinating, as well as possible deviations in the process. Among other things, leukocyturia may indicate that in human body inflammation occurs in the glomeruli of the kidneys.
Bacteria - their detection in urine indicates the presence of infections in the urinary tract.
Salts - in small quantities, some types of salts are present in the body of even a completely healthy person, but despite this, sometimes they settle; this can occur due to poor nutrition, changes in drinking habits, and also the acidity of urine. If salts are not systematically found in urine analysis, then there is nothing to worry about, otherwise this may indicate serious abnormalities in kidney function, and may also indicate the presence of stones in the kidneys.

The most common forms of urinary syndrome that provoke various disorders in the body, there are the following deviations:

Blood in the urine, which can be present in varying amounts and affect the color of the urine. If such a symptom appears, you must immediately seek help from a medical facility. Since the appearance bleeding indicates diseases such as stones in the ureter and bladder, infections genitourinary system, damage to the renal papillae or hereditary diseases kidney If a person has bloody impurities in his urine, then additional symptoms are of great importance to make an accurate diagnosis and order additional studies. For example, if such deviations are accompanied by pain when urinating, then a person may develop diseases such as tuberculosis, renal colic, necrosis or thrombosis of the renal vessels. If even minor pain does not appear, then the situation may indicate congenital or acquired nephropathy.
Protein in the urine - this pathology is also called isolated proteinuria. This manifestation does not always indicate kidney disease, but must be fully diagnosed, since deviations can have both benign and malignant forms. Protein appears in the urine in situations where a person develops diseases such as glomerulonephritis, Balkan endemic nephropathy, diabetes mellitus, cystinosis or amyloid dystrophy. If one of the listed diseases occurs, treatment should be started immediately, as otherwise the pathology can lead to the development of serious complications.

In addition to everything else, there is also small urinary syndrome, let’s try to find out what it is right now. Small urinary syndrome is a quantitative decrease in urine output.

Changes in urine indicate the development of pathology

IN medical practice There are also situations where blood in the urine is found in children, especially infants. In this case, immediate hospitalization is required. This is explained by the fact that pathology indicates at this age about dangerous diseases such as sepsis, thrombosis or various shapes neoplasms.

Another manifestation of the bladder is such a deviation as shy bladder syndrome. The peculiarity of this deviation is that a person suffering from such a deviation cannot go to the toilet in an unfamiliar environment, and even more so if strangers are present. Such a deviation from medical point vision is not a disease, but most likely refers to psychological deviations and disorders.

Shy Bladder Syndrome is a Psychological Problem

Many doctors believe that the cause of the development of bladder syndrome is the use of certain medications, and nervous overstrain can also provoke its development. As a therapy in such a situation, patients are recommended to undergo a course of psychological correction. During treatment, the patient is not prescribed any medications, since in this case they cannot have the desired effect and help get rid of the syndrome.

Urinary syndrome is not classified as a disease and is just an indicator that a pathological disease is developing in the human body.

Such a deviation in the human body as urinary syndrome is diagnosed during a urine test. If, after laboratory tests, any deviations from the norm are detected in the urine, then the patient is given exactly this diagnosis and a number of additional studies are prescribed, which also take into account the accompanying symptoms. Only everything taken together makes it possible for the doctor to put the correct and correct accurate diagnosis, as well as prescribe effective treatment.

Testing is mandatory for diagnosis.

After the diagnosis is made, a course of therapy is prescribed and if it does not bring any results, then the patient is prescribed procedures that will ensure the patient feels better.

Note! Urinary syndrome indicates pathological processes occurring in the human body, and in order to find out which ones, a number of numerous additional examinations are required.

After the pathology is diagnosed, treatment is prescribed, which should be aimed at eliminating the factors that provoked the development of this disease. In no case should such changes be left without diagnosis and treatment, as they can provoke very serious complications.

Conclusion

The occurrence of urinary syndrome can be provoked completely for various reasons, which may be the most elementary and indicative of small deviations in the human body, and, conversely, in some situations arise as a result serious pathologies internal organs. Regardless of the reason that triggered the development of urinary syndrome, you should immediately undergo a number of additional examinations and accurately determine the diagnosis. After this, it is necessary to begin immediate treatment and strictly follow all the recommendations of the attending physician.

Any inflammation in the urinary system and kidneys is a dangerous manifestation and can lead to serious consequences. The treatment method is chosen individually in each case.

Urinary syndrome is a change in the volume, composition and structure of urine that occurs when various diseases urinary system. This clinical symptom complex, associated with urination problems and accompanying various urination disorders. It is manifested by changes in the color and character of urine - bacteriuria, hematuria, leukocyturia, cylindruria, proteinuria.

With urinary syndrome, the daily volume of urine and the frequency of emptying the bladder changes, which is clinically manifested by nocturia, polyuria, and oliguria. Such changes are often not accompanied clinical symptoms, proceed latently and are detected only with the help of laboratory diagnostics. If urinary syndrome is manifested only by dysuria - painful urination, it is called isolated.

Urinary syndrome is an indicator not only of diseases of the urinary system in children and adults, but also of other abnormalities in the body.

Changes in urine composition

Hematuria- the presence of red blood cells in the urine, the number of which determines its color: if there are few red blood cells, the urine has pale pink color, if there is a lot - dark brown. In the first case they talk about microhematuria, and in the second about macrohematuria.

The causes of isolated hematuria are:

Neoplasms of the urinary organs,
Urolithiasis disease,
Bacterial nephritis - renal tuberculosis,
Nephropathy of various origins,
Congenital anomalies - renal dysplasia,
Sepsis,
Thrombosis of renal vessels.

Hematuria in almost all of these cases is accompanied by pain. If there is no pain when urinating, then the cause of erythrocyturia is a genetic pathology of the kidneys.

In newborns and infants The cause of the pathology may be intrauterine infection, thrombocytosis, or kidney cancer. In older children, blood in the urine is often found with pyelonephritis or glomerulonephritis.

Proteinuria - clinical sign, characterized by the appearance of protein in the urine and has two forms: benign and malignant.

Benign pathology has a good prognosis. It happens:

Transient idiopathic - one-time detection of protein in the urine,
Functional - the protein is detected in patients with fever, hypothermia, stress, cardiac pathology,
Orthostatic - with prolonged standing position.

Persistent or malignant proteinuria is a symptom of glomerulonephritis, diabetes mellitus, renal amyloidosis, and heavy metal intoxication. The prognosis of proteinuria in such cases is more serious.

Cylindruria- presence of microprints of renal tubules in urine. They are formed when the filtration process of the kidneys is disrupted and are indirect signs of inflammation of the urinary system.

Cylinders are:

Hyaline - have protein origin and appear in the urine in various kidney diseases accompanied by proteinuria,
Waxy - formed from hyaline and granular cylinders, which are retained in the kidney tubules in severe renal pathology of an inflammatory nature,
Granular - protein casts of kidney tubules, found in glomerulonephritis or diabetic nephropathy,
Erythrocyte - consist of protein and red blood cells and are a sign of hematuria,
Leukocyte - consist of protein and leukocytes in pyelonephritis,
False - a symptom of urinary tract pathology.

Normally, the presence of single hyaline cylinders in urine is allowed - no more than 1-2 in the field of view. The presence of other types of cylindrical bodies in urine is unacceptable.

Leukocyturia- the appearance of a significant number of leukocytes in the urine due to bacterial inflammation of the kidneys, bladder, and urethra. The combination of leukocyturia with hematuria and proteinuria indicates inflammatory diseases kidneys of various origins.

Leukocytes - cells immune system, acting as a protector of the body from foreign agents. Normally, single cells can be detected in the field of view. Under certain conditions or inflammation, the number of leukocytes in the urine increases sharply.

Causes of sterile leukocyturia:

Rise in body temperature to febrile levels,
Hormone therapy and chemotherapy,
Injuries of the genitourinary organs,
Pregnancy,
Donor kidney rejection
Aseptic inflammation of the urethra and other urinary organs.

Causes of infectious leukocyturia:

Tubulointerstitial nephritis,
Tuberculosis infection,
Infections of viral, bacterial, fungal origin.

Leukocyturia in combination with proteinuria, erythrocyturia and cylindruria is a sign of severe inflammation of all renal structures.

Normally, urine is a sterile substrate. Bacteriuria is a sign of infectious inflammation various departments urinary system caused by Escherichia, Proteus, Klebsiella, Pseudomonas aeruginosa or Haemophilus influenzae, cocci.

Bacteria can enter the urine from the lower urethra. In this case, diagnosis can be difficult, since such microbes do not have any etiological significance. Infection can also penetrate into the urine during general systemic diseases. The introduction of microbes is carried out hematogenously or lymphogenously. These microbes are also not uripathogenic, since the aggressive alkaline environment of urine quickly destroys them. Such processes in the human body are called transient bacteriuria. To make a diagnosis bacterial inflammation organs of the genitourinary system, it is necessary to submit urine for bacterial culture. The reliability of the results is determined by the correct collection of biomaterial. Before emptying the bladder, wash the perineum thoroughly. warm water without hygiene products. The sample for testing should be delivered to the microbiology laboratory within 2 hours of collection.

Salts in urine are found in small quantities in healthy people. Typically, specialists determine oxalates and urates. If salts constantly precipitate, then the patient has dysmetabolic nephropathy, which can lead to urolithiasis. Salts in urine are a sign of long-term treatment with certain drugs. pharmacological drugs or eating certain foods. If phosphates are detected in the urine, treatment should be started, since this is a symptom of an acute infection, often combined with bacteriuria.

Change in urine color

In healthy people, urine is yellow. Its shade ranges from light yellow to amber. The color of urine is due to the presence of special bile pigments in it. The color of urine can change under the influence of external and internal factors.

Physiological causes of atypical urine color:

Elderly age,
Taking medications
Food products,
Drinking regimen
Times of Day,
Features of metabolism.

In newborns, a reddish tint to the urine is a sign of a high urate content; in infants, the urine is pale yellow, almost transparent. Intense coloration of urine in the morning is associated with the nighttime production of the hormone vasopressin, which reduces diuresis and concentrates urine. Cloudiness and darkening of urine is also a sign of pathology that requires urgent treatment. Cloudiness is often combined with changes in the acidity and density of urine.

Determining the color of urine is a mandatory diagnostic criterion when performing a general analysis. In the laboratory, color is usually determined by visual inspection in a transparent vessel on a white background.

Changes in urine volume and frequency of bowel movements

In an adult, the frequency of urination is 4-6 times a day. It can change under the influence of various factors:

Age characteristics,
nature of nutrition,
Physical activity
Drinking regimen
Consuming salt
Season.

Urinary disorders that arise from diseases of the urinary system and are manifested by a change in the volume of urine excreted:

Another symptom of urinary syndrome is classified into a separate group - paruresis. This condition occurs when a person is unable to empty the bladder in front of strangers or in an unusual environment. The causes of this disorder are: infectious diseases, organic and functional lesions of the central nervous system, as well as taking medications that cause stagnation of urine or disrupt the transmission of nerve impulses from the bladder to the brain. As the syndrome progresses, the condition of patients worsens: they cannot relieve themselves normally even at home in peace and quiet. If paruresis occurs in an absolutely healthy person, then there are psychological disorders. In this case, you will need to consult a psychotherapist. This mental disorder can seriously complicate people's lives, keeping them away from home for long periods of time.

Diagnosis and treatment

Urinary syndrome is diagnosed based on anamnestic data and the results of laboratory methods. Additional clinical guidelines Diagnosis of urinary syndrome consists of carrying out excretory urography, cystoscopy, renal arteriography, tomography. If signs of urinary syndrome appear, you should immediately consult a doctor who will correctly diagnose and prescribe adequate treatment.

Urinary syndrome occurs with life-threatening diseases that require therapeutic activities. Treatment of pathology is aimed at eliminating the cause that caused it. If etiotropic therapy is not possible, a set of procedures is carried out to alleviate the patient’s condition and eliminate the main symptoms.

Patients are prescribed drug therapy:

Antibiotics from the group of penicillins, macrolides, fluoroquinolones, cephalosporins - Amoxiclav, Azithromycin, Ciprofloxacin, Ceftriaxone.
Dehydration - intravenously "Hemodez", "Reopoliglyukin", saline solution, glucose.
Diuretics - Furosemide, Veroshpiron, Hypothiazide.
Immunomodulators - “Timalin”, “Likopid”, “Ismigen”.
NSAIDs - Voltaren, Indomethacin, Ortofen.
Glucocorticoids - Prednisolone, Betamethasone.
Cytostatics - Cyclosporine, Methotrexate.
Antiplatelet agents - “Dipyridamole”, “Curantil”, “Pentoxifylline”.
Multivitamins.

In each specific case, the choice of drugs and their dosage are determined strictly individually, taking into account the pathological orientation and general condition body. In addition to drug therapy, patients with urinary syndrome are prescribed physical exercise, diet, physiotherapeutic procedures, psychotherapy, surgical treatment.

Video: urinary syndrome in children

Urinary syndrome is a phenomenon in which there is a change in the nature of bowel movements, the composition of biological fluid, as well as the consistency of urine against the background of pathological processes occurring in the organs of this system. Condition does not count separate disease, but acts as a complex symptom.

Against this background, patients experience the presence of bacteria and blood particles in the biological material, and the level of leukocytes, protein and casts increases. Problems with urination are expressed in the form of changes in the daily volume of excreted fluid (nocturia, polyuria, oliguria). It is often detected during laboratory diagnostics, since it has a hidden course.

In medical practice, urinary syndrome is a common condition that is diagnosed in patients of different age groups and gender. Since it is characterized as a symptom complex, its detection requires further examination of the patient, which helps to determine the true cause of such disorders.

The main manifestations of urinary syndrome. Source: ppt-online.org

Often, after careful laboratory and instrumental diagnostics, problems with the kidneys, ureters, and lower sections urinary excretion organs. Fortunately, timely identification this symptom allows you to carry out quality treatment pathologies at an early stage and achieve full recovery patient.

This urinary disorder occurs in approximately 50% of people who have a history of chronic diseases kidney There are two types of the condition: isolated and combined syndrome. In the first case, only this sign indicates disturbances in the urogenital tract; in the second, symptoms of intoxication of the body are also present.

Causes

At present, it has not been possible to establish exactly why people develop this type of urinary disorder. However, experts in the field of urology identify three main provoking factors that can contribute to the occurrence of various changes in the nature and composition of biological fluid.

First of all, various inflammatory processes affecting the organs of the genitourinary system are considered. This category includes cystitis, urethritis, pyelonephritis, glomerulonephritis and nephritis. The main provoking factor in their appearance is pathogenic bacteria that penetrate the human body. Associated symptoms is lower back pain, nausea and vomiting, increased body temperature, urinary syndrome.

Next come tumor-type formations. They are formed as a result of the fact that normal cells of the urinary organs are replaced by atypical ones. There are frequent cases of detection of oncological pathologies when tumors grow inside the bladder or affect the kidneys. The danger lies in the fact that the pathology can develop asymptomatically for a long time, without any disorder of the urination process.

Tumors in the kidneys provoke the occurrence of urinary syndrome. Source: 24medicine.ru

Experts call the third provoking factor urolithiasis, in which stones can be deposited both in the bladder and in the filtration organs. Their appearance is almost always associated with poor nutrition and, as a consequence, impaired metabolism. Often, ICD first manifests itself as an attack of renal colic.

Changes

Most urinary problems are related to certain diseases kidneys, urethral canal, bladder and ureters. The syndrome in question as a symptom complex can be pronounced or determined exclusively after laboratory testing of urine. Let us consider in more detail what changes in biological material indicate it

Hematuria

Normally, in a healthy person, urine has a straw-yellow hue, which gives it a specific pigment. If a large number of red blood cells enter the bladder during bowel movements, it becomes red or pale pink, depending on the level of their concentration. In this case, doctors diagnose hematuria (macro or micro).

Isolated urinary syndrome can occur against the background of the following diseases:

Sepsis;
Renal vascular thrombosis;
Nephropathy;
Tumors.

If pathological condition in an advanced stage, then the syndrome becomes combined, and pain is added to it. However, if it is absent, there is a possibility that the patient has developed erythrocyturia as a result of a genetic kidney problem.

If such a condition is detected in recently born or infant children, there is a high probability that hematuria was the result of an infection in the baby’s body, but the presence of blood clots or tumors cannot be ruled out. In older age, provoking diseases are: glomerulonephritis and pyelonephritis.

Proteinuria

Problems with urination can also be expressed in increased protein content, which is detected during the study of biological fluid. This condition can be a benign or malignant process. In the first case, the prognosis for recovery is favorable.

Indicators of severe proteinuria. Source: ppt-online.org

Particular care must be taken when handling malignant form, which is also called constant. In this case, the patient always has an increased protein concentration. This indicates serious diseases, including diabetes mellitus, kidney amyloidosis, and heavy metal poisoning.

Cylindruria

The term painful urination is used by many patients. But few of them know that this condition occurs in a situation where a study of the composition of urine reveals the presence of a certain number of renal tubules in it. Against this background, an inflammatory process often develops in the filtration organs.

There are several types of cylinders:

Hyaline - appear in urine when a person has various kidney diseases, causing the appearance of proteinuria;
Waxy - are a complex of hyaline and granular particles, while they remain partially in the kidney tubules (appear as a result of progression serious illnesses filtration organs against the background of inflammation);
Granular - indicate the development of glomerulonephritis or diabetic nephropathy in the patient, act as protein casts;
Erythrocyte - the main components are red blood cells and protein, indicating the presence of hematuria;
Leukocyte - diagnosed in case of progression of pyelonephritis, and consist of protein and leukocytes;
False – characterize the progression of diseases of the urinary system.

As you can understand, it is almost impossible to independently interpret the result of a laboratory urine test. But at the same time, it is worth knowing that the presence of cylinders, if there are no more than one or two units (hyaline), does not indicate pathology, and accordingly, is considered the norm. Otherwise, the presence of these elements is unacceptable

Leukocyturia

Innervation of the bladder and urinary disorders are always present in people whose urine analysis revealed a high content of leukocytes. An increased concentration of white blood cells indicates the development of a severe inflammatory process in the kidneys, bladder and urethra.

Indicators of leukocyturia in humans. Source: myslide.ru

Normally, leukocytes are the “defender”. These are immune cells whose main task is to suppress the activity of pathogenic bacteria. Accordingly, a small amount of them in urine is not considered any deviation. However, if there are too many of them, then it is necessary to look for the disease that provoked this.

The main causes of sterile type leukocyturia are:

Febrile body temperature;
Taking hormonal medications;
Treatment with chemotherapy;
Injuries of the genitourinary system;
Carrying a child;
Rejection of a donor kidney;
Inflammatory process of aseptic type.

An infectious type of leukocyturia is also isolated. The main pathologies in which it develops are: tubulointerstitial nephritis, the presence of tuberculosis infection, as well as infection of the body with viruses, bacteria, and fungi. Enough dangerous condition There is a combination of leukocyturia with proteinuria or hematuria.

Color

If there are no pathological processes in the human body, in particular in the urinary and excretory system, then he will bring urine for analysis yellow color. The presence of an amber tint is also considered acceptable. A specific pigment is responsible for this, the concentration of which increases or decreases under the influence of certain factors.

Normal and pathological color palette of urine.

Urinary syndrome is a predominantly asymptomatic condition in which clinical and laboratory studies show changes in the composition of urine. Due to the absence of external signs, the pathology may not be diagnosed immediately, which complicates subsequent treatment.

Causes

Urinary syndrome is a symptom complex indicating the presence of a disease of the urinary system. In itself, it does not manifest itself externally in any way and does not cause discomfort to a person. Diagnosed if present concomitant pathology when the patient is sent for analysis, the results of which show qualitative changes in the composition of urine. If deviations in indicators are the only sign of kidney disease, then we are talking about isolated urinary syndrome.

A urine test for the described condition shows an increased number of leukocytes, red blood cells, the presence of protein, and the presence of a certain amount of blood.

The main causes of the development of the syndrome are bacteria and salts; depending on the pathogenesis, the manifestations and signs of the underlying disease will vary.

Bacteria

Normally, there are no bacteria in the urine of a healthy person. A small amount of them can enter the test substance from the external genitalia in the absence of hygiene procedures before collecting the analysis. In addition, pathological microorganisms that have entered there as a result of an infection occurring in the body and not affecting the genitourinary system can be found in urine. Such pathogenic microorganisms, however, do not live long in an environment unusual for them and are quickly eliminated.

Bacteria in the substrate can be found in large numbers in diseases such as pyelonephritis and cystitis. Against the background of these pathologies, in some cases women develop urethral syndrome, which is most often asymptomatic, which complicates diagnosis and leads to a chronic form of the disease.

Under the influence of microbes, men can develop bacterial prostatitis. As a rule, the condition is not limited to changes in the composition of urine, but is characterized by clearly expressed symptoms, especially when it comes to the acute course of the disease.

Sometimes a general analysis may show increased amount leukocytes in connection with the bacterial course of glomerulonephritis.

Salts

Normally, salts should be absent in the urine of an adult. In a child, they can be detected due to the weak ability of the kidneys to dissolve them.

If salts are detected in the substrate of an adult patient once, they are not detected in additional samples, and accompanying indicators are within normal limits, this is regarded as a non-hazardous case.

Elevated levels of certain compounds, for example, oxolates, may indicate the development of pyelonephritis. Crystals that precipitate are the first signs of gout, kidney failure, and nephritis.

Salts in the urine can lead to irritable bladder syndrome, which manifests itself as frequent urges to urination.

All of these diseases lead to qualitative changes in urine, which characterize urinary syndrome.

Main features

Since the described condition is not expressed externally in any way, we can talk about symptoms only in the context of laboratory and clinical studies. The substrate is characterized by:

the presence of blood in it;
increased levels of leukocytes;
an increase in the number of red blood cells;
presence of protein.

Blood in urine

The presence of some blood in the test substance is called hematuria. Urine takes on a reddish or brownish tint.

Blood in the substrate is a sign of pathologies such as tumor formations of the urinary tract, nephropathies, the presence of stones, kidney dysplasia, nephritis, tuberculosis. Each diagnosis is accompanied by its own symptoms: painful urination, discomfort in the lower abdomen, increased body temperature.

Leukocytes

Leukocytes are blood cells of heterogeneous structure white. Normally, their content in urine ranges from zero to three units in the field of view for men and up to six, respectively, for women and children.

An increased content of these blood cells indicates pathologies of the genitourinary system, namely cystitis, urethritis, pyelonephritis, cancer, tuberculosis, urolithiasis, prostatitis and many others.

Due to the fact that a large number of pathologies are characterized by an increase in the level of leukocytes, differential diagnosis for urinary syndrome requires additional examinations.

Red blood cells

Leveling Up Reds blood cells called erythrocyturia. The norm is the presence of up to three units in the field of vision in women and single indicators in men. A condition where the number of red blood cells is higher than normal is caused by:

urolithiasis;
acute glomerulonephritis;
heart attack, kidney cancer;
malignant tumors in the kidney, bladder, prostate.

The criterion for the level of red blood cells is only one of the signs of the development of the disorders and diseases described above.

Protein

Protein should not normally be detected in urine; its maximum permissible density is no more than 0.033 grams per liter. With urinary syndrome, this indicator is increased, which may indicate abnormalities of a renal or other nature.

Among common reasons leukemia, heart failure, epilepsy, allergic reactions, pregnancy, poor physical development in children seven to sixteen years old can be distinguished.

Renal factors for increasing protein levels include acute and chronic glomerulonephritis, pyelonephritis, and nephrosis.

Diagnostic methods

Since the described syndrome may indicate various diseases, the choice of examination method is based on the specifics of the patient’s complaints about the underlying pathology. Since the signs described above were determined as a result of a general (clinical) urine test, further diagnosis includes:

Anamnesis collection.
Visual examination, palpation.
Additional types of urine tests: biochemistry, according to Nechiporenko, Zimnitsky test and others.
Ultrasound examination of the urinary system. Allows you to determine the presence of inflammatory processes, tumor formations, study the structure of the affected organs, and find out the volume of residual urine.
Radiography. Since the kidneys are visible in the form of shadows in the image during a normal examination, a contrast agent is used intravenously or oxygen is injected into the perinephric area or into the retroperitoneal space. X-rays make it possible to judge the presence of stones, the structure and location of the kidneys and ureters.
Cytoscopy. Examination of the bladder using a device. Shows changes in the mucous membrane of the organ, the presence of tumors, stones.
Catheterization. It is carried out to collect urine for analysis.
Radioisotope renography. Determines the functional capacity of the kidneys. It is performed for pyelonephritis, glomerulonephritis and some other conditions.
Kidney biopsy. It is prescribed in case of a tumor to determine its nature (malignant or benign).

The choice of a specific research method depends on the patient’s complaints, based on the results of anamnesis and clinical analysis urine, which showed the presence of urinary syndrome.

Traditional and folk methods of treatment

It is impossible to formulate general methods of therapy for a condition such as urinary syndrome. This is due to the fact that it characterizes more than a dozen diseases of the urinary system. When treating, it is necessary to take into account the diagnostic results, the symptoms of the underlying disease and influence its pathogenesis.

The range of drugs prescribed for the described syndrome is wide both in nomenclature and pharmacodynamics. The doctor’s choice of a specific remedy depends on the totality of signs of the underlying disease.

corn silk;
burdock;
flax seeds;
St. John's wort;
bearberry.

Decoctions, infusions and teas are prepared from herbs and their combinations, which must be taken regularly, but under the supervision of a doctor, since in some cases such drugs may be contraindicated, as they can cause harm to health.