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Microscopic examination Held on clean urine sediment, maximum 4 hours after excretion.
The purpose of microscopy is to determine the quality and quantity of leukocytes, erythrocytes, epithelial cells, salts, bacteria, cylinders, fungi and other inorganic substances.
The result of laboratory tests is not a sufficient basis for diagnostics. Interpretation of results and further diagnostics should be performed only by a physician-specialist.
Erythrocytes. Red blood cells in the urine can be found in any part of the urinary tract. In women it can also be the result of menstrual pollution.
It is very important to note the presence of microscopically dysmorphic (deformed) erythrocytes (> 30% indicate glomerular origin of hematuria.
Leukocytes. A small number of them are also found in normal urine. An increased number of leukocytes indicates an inflammatory process in the urinary tract or surrounding areas. When their numbers are very high and have a degraded appearance or appear in groups, acute urinary tract infection is suspected. Occasionally, pyuria (pus in the urine) is also found for acute non-renal causes such as appendicitis or pancreatitis. It can also develop in non-infectious conditions such as glomerulonephritis (e.g. SLE), renal tubular acidosis, dehydration, stress, and damage to the urethra, bladder, or urethra; Increased lymphocyte and plasma cell counts indicate acute renal transplant rejection, while increased eosinophil counts are associated with tubular-interstitial nephritis and hypersensitivity to penicillin.
Epithelial cells. Can occur in any part of the urogenital tract. They are usually found as a result of physiological shedding of aging cells in the urine. A significant increase indicates inflammation in the area of the urinary tract from which these cells originate. There are 3 types of epithelial cells:
Salts. Most of them, which can be found in urine, have low clinical significance, except in cases of metabolic imbalance, stone formation, or drug regulation.
Cylinders. Arises in the lumen of the renal tubules. The origin of the cylinders is always renal and is an indicator of kidney disease. Cylinders are classified according to their composition, appearance, and cellular components. The width of the cylinders indicates the size of the renal tubules in which they form; Large cylinders are formed in the collecting tubes of the kidney; Their presence usually indicates a marked decrease in the functional capacity of the nephron and the late stage of kidney disease.
Bacteria. Found in fresh urine and is accompanied by a large number of leukocytes. Usually indicates a urinary tract infection.
Fungi. May be found in urine during urinary tract infections, especially in diabetic patients, as well as as a result of skin or vaginal contamination. Candida Albicans is the most common fungus.
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