How to take a urine test according to Nechiporenko correctly. Urine sample according to Nechiporenko: purpose, preparation and results of the study

Boluchevsky Dmitry Nikolaevich

Chief physician

Leading doctor

Urinalysis according to Nechiporenko is a laboratory diagnostic method that allows you to determine the condition of the kidneys and urinary tract, in particular, to identify hidden inflammation.

The Nechiporenko analysis is used not only to establish a diagnosis. It can be used to monitor the progress of treatment.

Urinalysis according to Nechiporenko: the essence of the method

Urinalysis according to Nechiporenko is usually prescribed based on the results - if the data from the general analysis exceed the norm. The Nechiporenko analysis will either confirm the existence of the disease or allow the results of the general analysis to be interpreted as a random deviation.

The main indicators of urine analysis according to Nechiporenko - leukocytes, erythrocytes, cylinders - are assessed not simply by counting these elements that are in front of the eyes at the time of the study, as in a general urine analysis. When analyzing according to Nechiporenko, their number is determined per 1 milliliter of urine (counting is carried out using a special counting chamber).

It is also important that a strictly average portion of morning urine should be taken for analysis. This allows you to exclude the influence of random factors and get a picture of the real state of the urinary system.

It is equally important that the collected material reaches the laboratory within two hours.

All this together makes urine analysis according to Nechiporenko an informative and accurate diagnostic method.

Urinalysis according to Nechiporenko: indicators and norms

Leukocytes- white blood cells. They perform a protective function by producing antibodies and absorbing bacteria. An increased number of white blood cells means that the body is reacting to an existing source of inflammation. The norm for the Nechiporenko test: up to 2000 per 1 ml of urine.

Red blood cells– red blood cells (they give the color to blood). Their function is to transport oxygen, and they should not be present in significant quantities in urine. An increased number of red blood cells is called (can be translated as “blood in the urine”). The presence of blood in the urine in some cases is obvious (that is, detected visually), but a slight increase in the number of red blood cells (hidden hematuria) can only be recognized by laboratory methods. The norm for the Nechiporenko test: up to 1000 red blood cells per 1 ml of urine.

Cylinders- these are casts, that is, stuck together, compressed elements that appear only in the presence of protein. The protein, coagulated in the acidic environment of urine, forms an adhesive base that unites other elements. Casts arise in the renal tubules. Their appearance in the urine directly indicates kidney pathology, since in a healthy person protein should not get into the urine. The norm for the Nechiporenko test: no more than 20 cylinders per 1 ml of urine.

Bacteria- Normally they should not be in the urine.

How to collect urine for analysis according to Nechiporenko

On the eve of the test, you should avoid significant physical activity, do not drink alcohol, and refrain from eating foods that can change the color of urine (beets, carrots, etc.).

The analysis is not carried out:

• during menstruation. It is recommended to wait three days after they are completed;
• within 5-7 days after cystoscopy;
• while taking diuretics.

Before collecting urine, careful intimate hygiene is necessary.

Morning urine is collected for analysis. The first portion of urine is released into the toilet, and the urine in the middle of urination is collected in a sterile container.

In order for the test results to be correct, the collected material must be delivered to the laboratory as quickly as possible (within two hours).

To diagnose diseases of the urinary system, various research methods are used, including -. The analysis makes it possible to accurately detect diseases in acute and chronic forms, which is why it is so widespread in clinical practice. Read more about interpreting the results of a urine test according to Nechiporenko and how to collect it in this article.

The author of this research method is Alexander Zakharovich Nechiporenko, scientist, Soviet urologist-oncologist, military surgeon, teacher. While examining the urine of patients, a scientist once drew attention to its “unevenness” - every day the urine was different, its quantitative and high-quality composition changed.

Therefore, he made the following proposal: urine samples should be taken taking into account its daily changes - in the morning, collecting only the middle portion for study (the first and last few milliliters were supposed to be poured into the toilet).

Why did the Soviet urologist suggest this particular method? The fact is that the first and last portions of urine may contain sediment from Bladder and urethral washings, and the doctor was interested in searching for hidden inflammations of the urinary system.

The elements found in the average portion of urine are counted using a special method, which is similar to the system for counting blood elements. The obtained indicators help to diagnose the urinary system and detect disturbances in its functioning.

Advantages of the method

• Preparing the patient for urine collection is easy, and the method does not require much labor from medical personnel.
• The research technique is simple, the results are not inferior in reliability to other methods, and the analysis is carried out relatively quickly.
• The study requires a small amount of biomaterial.
• Allows you to easily monitor the dynamics of the pathological process and monitor the effectiveness of therapy.
• Helps determine inflammation in indolent forms of diseases.

How the sample is examined

The research algorithm has not changed for many years. First, the collected biological fluid is mixed, then it is centrifuged, and the top layer is sucked off.

Leave 1 ml of sample along with the sediment for analysis, mix and begin to study using a counting chamber. The test takes several hours to complete, so results are usually ready the next day.

What is it prescribed for?

As described above, the Nechiporenko research method is used as a diagnostic one. It is usually prescribed after a general analysis (if any deviations have been identified in the indicators) in order to obtain a more detailed picture from the collected data for making a diagnosis.

Deviation from normal readings indicates the presence of a disease

This analysis is also done to monitor the effectiveness of the therapy. The data is interpreted as follows:

• The norm of leukocytes is up to 2000 per 1 ml; if there are more of them, then an inflammatory process occurs. Increased levels are observed in prostatitis, pyelonephritis, urolithiasis, and cystitis.
• The norm of red blood cells is up to 1000 in 1 ml. If the readings are higher, then there is every reason to suspect serious inflammation with bleeding.
• According to the established norm, 1 ml of urine can contain up to 20 hyaline casts. If more of them are found, then inflammation is probably actively developing in the renal pelvis.

It is important to understand that only a doctor can correctly understand the analysis. There is no point in trying to find out on your own from an analysis whether you have cystitis or not - a comprehensive examination is required to make a diagnosis. In addition, the results may be erroneous (if the patient did not know how to properly collect urine or it was transported incorrectly).

What diseases does it help diagnose?

• Pyelonephritis. There are a lot of red blood cells and white blood cells, there are bacteria and pus.

• . In the sediment, an increased concentration of leukocytes and erythrocytes, polymorphic cystic epithelium cells, and bacteria is determined.
• Acute glomerulonephritis. Hyaline casts are present, and waxy and granular casts may be observed. There are more leukocytes than red blood cells.
• Chronic glomerulonephritis. This disease is characterized by a predominance of red blood cells over white blood cells.

Many more diseases can be added to this list. If any abnormalities are identified, additional tests are usually prescribed.

Preparation

• Do not take any pills (or other medications) before collecting urine, as they may affect the results. If you cannot stop taking them, you need to inform your doctor. There are cases that cystitis due to medication cannot be determined by analysis, although there are symptoms.
• Before collecting a urine test according to Nechiporenko, you need to wash yourself warm water, otherwise bacteria that have accumulated on the external genitalia may end up in a container with urine. Because of this, the indicators may be false.
• You should not use any gels or foams for washing, especially those with an antibacterial effect. If even a microscopic part of such products gets into the container, this can lead to the death of some microorganisms. The result is that the research results are distorted. If you do use regular mild soap, you need to rinse it off very well with water and then wipe dry.
• The day before passing urine according to Nechiporenko, it is not recommended to eat foods that contain a lot of natural dyes (carrots, beets). You should also refrain from spicy and spicy foods and drinking alcohol.

If the preparation for taking the sample was not carried out, please inform your doctor. To obtain reliable results, he may postpone the test to another day.

How much urine should be collected

Of course, the volume of urine produced is different people may differ - it depends on the drinking regime, the frequency of emptying the bladder, the characteristics of the body, diseases (for example, cystitis forces a person to urinate in small portions).

Sometimes the amount of collected urine is so small that it is impossible to conduct a study - the laboratory cannot evaluate its composition, and therefore the urine has to be collected again. A reasonable question arises - how much urine is needed for analysis.

The volume required depends on the specific analysis. Typically, 50–100 ml of urine is taken for testing; a laboratory technician will be able to analyze this amount. There are studies for which urine is collected for analysis all day, then the volume of urine collected can reach 2 liters.

You can find out how much urine the Nechiporenko test requires from your doctor. As a rule, 20–35 ml is enough (the middle part is collected). Considering that urine collection according to Nechiporenko needs to be done in the morning, even children should not have any difficulties - the required amount of fluid will collect in the bladder overnight.

How much urine is needed for analysis in newborns: 5–10 ml, approximately the amount of urine a baby produces at one time. Of course, it will not be easy for doctors to work with such a volume, but it is possible to conduct research.

How to take a sample from adults

The rules for urine collection according to Nechiporenko are simple: a medium portion is given, always in the morning. It is recommended to collect it in special containers; sterile containers for delivery can be purchased at a pharmacy.

Before taking urine tests according to Nechiporenko, they wash themselves with warm water (women should wash themselves so that the movements are from front to back, this will prevent bacteria from the intestines from entering the urethra and vagina).

After completing the hygiene procedures, wipe the genitals dry with a clean towel and begin collecting urine for analysis in a prepared container. The container must not touch the body. When the patient has collected the required portion (minimum 20-35 ml), the container is tightly closed with a lid and immediately sent to the laboratory.

For the result to be reliable, the interval between sample collection and analysis should be no more than two hours, so it is recommended to deliver the collected portion to the laboratory within an hour. If biological fluid is stored longer, its pH will become higher and foreign bacteria may contaminate it. You can transport urine in the refrigerator at above-zero temperatures, but you cannot freeze it.

How to properly submit urine for analysis according to Nechiporenko, if there is no sterile container: you can take a small glass jar and a suitable lid, wash and sterilize them thoroughly, and then dry them.

Is it possible to take a sample during menstruation?

On menstrual days, urine is usually not given, as blood may get into it. It is better to take a urine test according to Nechiporenko 2-3 days after the end of your period, having warned your doctor about this. But there are times when the study cannot be postponed.

How to take a urine test according to Nechiporenko during menstrual bleeding: before taking the test, women are advised to insert a gynecological tampon into the vagina, and then urinate.

How to take a sample from children

The algorithm is the same as for adults: first you need to wash yourself thoroughly with warm water without soap.

In order not to contaminate the sample with excess bacteria, when washing, boys need to move the foreskin and expose the head of the penis, girls need to spread the labia and wash themselves so that the water flows from front to back (otherwise bacteria from the anal area can get into the urethra and vagina).

If the child is accustomed to visiting the toilet independently, he must be instructed, explaining all the rules for washing and how to correctly collect the analysis.

How to correctly test urine samples that do not yet go to the toilet on their own: as a rule, urine testing according to Nechiporenko is rarely prescribed for children under 3 years of age, since it is difficult to correctly collect urine from them. More often, the total portion is collected in special urine collection bags, which are examined.

Urine squeezed from diapers or diapers is not suitable. Also, for urine analysis according to Nechiporenko, it is not recommended to collect urine from a pot - even if you wash it very well, microorganisms may remain and distort the results.

Conclusion

Nechiporenko analysis is a valuable research method for identifying inflammation, it is used in the diagnosis of many chronic and acute diseases of the urinary system and is used to monitor the effectiveness of treatment. The algorithm for conducting it is simple, and in terms of the reliability of the results it is not inferior to other methods of studying urine.

Nechiporenko's urine test is used to detect infection if abnormalities were detected in a clinical urine test.

The analysis is carried out for: - latent inflammatory process in the kidneys and urinary tract; - hidden hematuria (blood in the urine); - monitoring the effectiveness of treatment.

What preparation is needed for the study?

The day before, you must refrain from drinking alcohol, emotional and physical stress, not eating vegetables and fruits that can change the color of urine, and not taking diuretics. It is not recommended to take a urine test within 5-7 days after cystoscopy and for women during menstruation.

How to properly collect urine for research?

Before collecting urine, it is necessary to perform a hygienic toilet of the external genitalia, then collect the average portion of morning urine excreted immediately after sleep. To do this, the first amount of urine excreted (15-20 milliliters) is passed, and the middle portion of urine is placed in a prepared, clean and dry container.

The collected urine should be delivered to the laboratory within 1-2 hours.

A urine test takes 1 business day to prepare.

What are the normal indicators of urine analysis according to Nechiporenko?

• leukocytes – up to 2000 in 1 ml;
• red blood cells – up to 1000 in 1 ml;
• cylinders – up to 20 in 1 ml.

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Features of urine analysis collection according to Nechiporenko, preparation, results

Analysis of the composition of a patient’s urine is one of the primary diagnostic tools, allowing one to establish not only kidney and bladder diseases, but also the condition of the body as a whole. If general research requires clarification, an additional urine test according to Nechiporenko is prescribed. The author of this method is a famous surgeon, oncourologist, who saved hundreds of lives during Patriotic War. The method he invented turned out to be more informative than those previously used, but at the same time very simple and fast. Currently, Nechiporenko analysis is one of the most frequently prescribed studies. Let's figure out how to take it correctly and what violations can be learned from its results.

In what cases is it prescribed

You have to take a urine test according to Nechiporenko on the direction of a general practitioner, family doctor, or specialists from the urology or nephrology department. This study is required to identify abnormalities in a general urine test, if there are discrepancies between the patient’s complaints and the data of general tests, to determine the effectiveness of treatment and monitor the course of the disease over time.

The main reasons for prescribing analysis according to Nechiporenko:

1. Detection of damage to the kidney and ureter due to urolithiasis.
2. Monitoring the effect of antibiotics in the treatment of bacterial infections.
3. Determination of the presence of infections in the genitourinary organs, including chronic and indolent ones.
4. Diagnosis of renal dysfunction due to injuries and diseases - vasculitis, diabetes mellitus, glomerulonephritis.
5. Identifying the causes of painful urination, excessive or insufficient urine output during the day, frequent or too rare urges.

How is it different from other urine tests?

A general urine test is a screening method that can be used to identify various pathologies. First, the entire collected portion of urine is examined to identify its physicochemical characteristics. Secondly, using a microscope, the urine sediment is examined, the presence of bacteria, salts, blood elements and casts in it is calculated - a kind of casts of protein and cells that form in the tubules of the kidneys. The result of the analysis will indicate how many leukocytes and red blood cells are detected in the field of view, i.e. within the field of view of the microscope. Cylinders are indicated less frequently in quantitative terms. The most common result is “no cylinders detected” or “single cylinders”, sometimes with an indication of their type.

Urinalysis according to Nechiporenko is considered a clarifying study. It is used to calculate how many red blood cells, leukocytes and casts are in 1 ml of urine. The cylinders are sorted by composition, and the quantity of each type is indicated, which allows for more accurate diagnosis. This analysis can detect disorders at an early stage, which is especially important for pregnant women and young children. Therefore, they are prescribed analysis of collected urine using the Nechiporenko method at the slightest doubt.

For kidney diseases, a Zimnitsky test is also prescribed. This is a study of the entire volume of urine over 24 hours without isolating its individual elements. Changes in the density and volume of urine after sleep and during wakefulness indicate impaired renal function.

How to properly collect urine for analysis according to Nechiporenko

For analysis, special containers are required, which must indicate their sterility. They can be purchased inexpensively at the pharmacy. Glass and plastic food jars are not recommended, as dirt or traces of detergent on their walls can distort the results. Some laboratories allow urine collection exclusively in their own containers, which are issued on the eve of the analysis for a small deposit.

It is correct to donate urine directly into a container, rather than pouring it from other containers. Exceptions are small children and bedridden patients. For them, you can use urinals, which are also purchased at the pharmacy.

The basic rule for collecting urine is that only the middle portion should end up in the jar. This means that for the first 2 seconds the stream is directed into the toilet, and only then the container is filled. The first drops of urine wash away dirt and epithelium from the perineum and urethra.

No matter how ideal hygiene is, it is impossible to avoid urine contamination, so the Nechiporenko analysis may be unreliable. The last portion of urine should not end up in the jar, because it contains sediment from the bladder.

How much urine is needed for analysis depends on the patient’s condition. If you feel normal, you will need 100 ml. If this amount is impossible to collect (for example, with frequent urination due to cystitis), it is enough to submit 20 g of urine for analysis. The analysis can be performed even in the most complex cases. If urine is not excreted, a medical facility may collect it using a catheter, even if only a few milliliters of urine has accumulated in the bladder.

How to take a urine test - algorithm:

1. Discuss with your doctor which medications you are taking may interfere with the results. Stop these medications 2 days before the test.
2. On the day before the test, exclude carbonated and alcoholic drinks, as well as food products, the dyes from which can pass into the urine - beets, blueberries, carrots. The rest of the diet should be normal, without sudden changes.
3. On the eve of urine collection, avoid strenuous physical activity.
4. The night before the test, refrain from sexual relations.
5. In the evening, wash well with detergent, and repeat the toilet in the morning. clean water no soap. Women during menstruation need to use tampons and perform toileting even more carefully.
6. Collect urine during the first urination after a night's sleep.
7. Immediately deliver the container to the laboratory. The maximum storage time for the test liquid is no more than 1.5 hours. During delivery, avoid hypothermia of urine.

If you accurately follow all the points of this algorithm, the result of the analysis will be as reliable as possible.

Decoding analysis and norms

The following indicators are considered the norm for both men, women and children, regardless of the way urine is obtained - by regular collection in a container or by medical manipulation directly from the renal pelvis.

What role do these elements play, and what processes in the body are signaled by their increase in urine:

Leukocytes

White cells circulating in blood vessels and, if necessary, penetrating into the intercellular space. Their main function– protection of the body from penetration of foreign bodies. The maximum number of leukocytes accumulates in those places where the immune system is needed. If the leukocyte count in the analysis is higher than normal, it means that an infection has settled in the urinary system and inflammation has occurred.

Urinalysis according to Nechiporenko in acute pyelonephritis shows a significant increase in leukocytes. At 30x magnification we're talking about about pyuria - detection of pus in the urine. It consists mainly of dead leukocytes that could not cope with their task. This study result indicates a serious pathology that requires urgent treatment in a hospital.

The normal number of leukocytes in children is the same as in adults. Despite this, in children, analysis according to Nechiporenko more often shows their increased level. This is explained by difficulties in maintaining hygiene, especially in the presence of diaper rash or allergic reactions, around which leukocytes accumulate.

Red blood cells

Neighbors of leukocytes in the bloodstream. These are red cells that provide transport services in the body: they carry oxygen to the tissues and return carbon dioxide from them to the lungs. Some red blood cells pass into the urine through the glomerular filters. If kidney function is impaired, the number of red blood cells in the urine increases greatly. Red blood cells can also be detected in cases of injury to the urinary system, inflammation along the path of urine from the kidney to the urethra. Women experience false positive results when taking the Nechiporenko test during menstruation.

During pregnancy, an increase in the number of red blood cells occurs due to a change in the position of the kidneys - the enlarged uterus puts pressure on them. This condition is fraught with stagnation of urine and inflammation, and therefore requires timely treatment.

Cylinders

They are formed in the tubules of the kidneys and can enter the urine in a minimal amount. In a healthy person, they should consist only of hyaline - a transparent dense protein from the blood plasma; normally, only these cylinders are shown by urine analysis according to Nechiporenko. If other types of casts are found in the urine, this indicates kidney damage, which leads to kidney failure. Hyaline casts in increased quantities may indicate proteinuria (the release of protein into the urine) or be the result of severe physical exertion.

What can bad results mean?

So, the numbers on the form are received, one of them exceeds the normal figure. Let's consider how to correctly interpret these data and what diseases the decoding of a urine test according to Nechiporenko can tell us about.

Element above normal	Possible violations
Leukocytes	Inflammation in one of the organs along the path of urine: pyelonephritis, cystitis. Urolithiasis with accompanying inflammation. Prostatitis in men, vaginitis or endometritis in women. Slight physiological growth - in adaptation to the resulting pregnancy.
Red blood cells	Fresh	Inflammation of the urinary tract, injury to the kidneys and urinary tract due to stones formed in them, trauma, neoplasms, hemophilia.
Leached	Kidney damage due to high blood pressure, toxic substances, glomerulonephritis.
Cylinders	Hyaline	Acute and chronic kidney diseases. Within normal limits - in the case of physiological proteinuria caused by prolonged hypothermia and overheating, physical fatigue.
Red blood cells	Kidney injuries, formation of blood clots in them, high pressure in the vessels, leading to damage to the renal tubules.
Grainy	Glomerulonephritis in the active phase, severe poisoning and intoxication, autoimmune diseases, extensive kidney infection.
Waxy	Severe kidney damage, fraught with organic changes and renal failure.
Epithelial	A pathological process in the kidney tubules, most often pyelonephritis or nephrosis.

How long does it take to perform a urine test according to Nechiporenko?

This analysis It is technically simple, the equipment for its implementation is available to all laboratories. How much analysis is done depends on the workload of the laboratory. Prints can usually be received the next business day. Some commercial institutions offer urine testing within 2 hours for an additional fee. For terminally ill patients in a hospital setting, the analysis takes only a few minutes.

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Urinalysis according to Nechiporenko

Among urine tests, the most common are: general urine analysis, according to Nechiporenko, according to Zimnitsky, according to Sulkovich, according to Amburge, etc. Each of these analyzes is done for a specific purpose, because the laboratory research methodology is slightly different.

In order to determine the number of red blood cells, casts and leukocytes, a Nechiporenko analysis is performed. Typically, such a need is prompted by deviations from normal values ​​in a general urine test, which requires additional research.

In addition, urine analysis indicators according to Nechiporenko can help in diagnosing inflammatory processes of the excretory system (cystitis, pyelonephritis), latent cylindruria and hematuria (when blood appears in the urine), and leukocyturia. The analysis is also done to assess the quality of treatment prescribed after the diagnosis of a particular disease.

In order to do a urine test according to Nechiporenko, an average morning portion is required, which remained in the urinary tract for at least four hours. That is, it is ideal if the patient did not urinate during the night, and after sleep collected urine for examination. In order for the results to be correct, it is necessary to thoroughly wash the genitals before collection, otherwise the cells, which naturally die within a day, may give distorted data. You need to collect urine in three containers, well washed and dried. Very little urine is needed in the first container, most of it should go into the second, and the collection ends in the third jar. The second portion is mixed and taken into a vacuum tube, which you can ask for medical institution.

To properly fill the test tube, the urine is mixed with a special holder and, without removing it from the container, the lid of the vacuum test tube is attached there without removing it from the test tube itself. After applying pressure, the needle pierces the cap and the tube fills itself, then is removed from the holder. The collected urine must be delivered to the laboratory within 24 hours. If the patient has a postoperative drainage, then it is taken through the valve and poured into a test tube.

Typically, a urine test according to Nechiporenko is done within six to eight hours.

After it is carried out, doctors evaluate the results obtained. The number of leukocytes, which primarily fight infection in the body, should not be more than two thousand units per milliliter of urine. If the white blood cell count is much higher, this indicates that the excretory system is infected. Red blood cells in the body are responsible for delivering oxygen to the cells, so if there is an excess amount of them (more than one thousand units per milliliter of urine), this indicates the possible presence of tumors or other pathologies in the excretory system. Urinalysis according to Nechiporenko also evaluates the number of cylinders. Casts are proteins that acquire their shape after passing through the kidney tubules. The urine of a healthy person should contain no more than twenty units per milliliter. Otherwise, there is suspicion of pyelonephritis and a number of other serious diseases.

Urinalysis according to Nechiporenko is an extremely important diagnostic procedure for diseases such as chronic pyelonephritis (leukocytes significantly predominate over red blood cells); acute pyelonephritis (this stage is characterized by a sharp increase in leukocytes, but the rate decreases during the sclerotic stage). If doctors suspect glomerulonephritis, then red blood cells will significantly predominate in the urine. If the patient has abnormalities in the heart (high blood pressure, heart disease, heart failure), then a urine test will show an increased number of cylinders. It is also increased during toxicosis in pregnant women.

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Urinalysis according to Nechiporenko: how to collect, what it shows, interpretation, norms

The basis for prescribing a urine test according to Nechiporenko is a suspicion of kidney pathology.

As with any responsible procedure, the collection of source material is carried out according to certain rules.

There are corresponding restrictions for women and children. The obtained indicators serve as the basis for diagnosing various diseases.

The information is deciphered by a specialist and transmitted to the attending physician, who formulates a diagnosis.

Reasons for the study

Pathologies of the kidneys and urinary tract occur for various reasons. Inflammation of the urethra, bladder and ureters can occur as a result of hypothermia or infection.

Urinalysis according to Nechiporenko allows you to identify a number of dangerous diseases.

Pathologies include the following:

• stones in the kidneys;
• pyelonephritis;
• cystitis.

Is not full list diseases that cause serious suffering to the patient. At the first pain that occurs when urinating, you should consult a doctor.

To make a correct diagnosis, you need to collect urine for analysis, observing hygiene requirements.

In adults, men and women, the first signs of kidney disease are swelling of the face and bags under the eyes.

When the temperature rises and the head hurts, the attending physician prescribes a general urine test for the patient.

If the norm for protein content in the urine is exceeded, then it is necessary to perform an additional study according to Nechiporenko.

There are a number of other conditions under which the doctor needs Additional Information. After processing the analytical material, it is deciphered.

When making a diagnosis, a specialist must take into account the patient’s age and his daily work and rest schedule.

What does the analysis show?

When it is impossible to make an accurate diagnosis based on the results of a general urine test, a Nechiporenko test is prescribed.

This research method makes it possible to obtain more in-depth data about the state of the body. The analysis is done at the cellular level.

If the norm of cell content in one milliliter of urine is exceeded, then we can conclude that a certain disease is present.

The analysis determines the concentration of the following cells:

• leukocytes;
• cylinders;
• red blood cells.

Urinalysis according to Nechiporenko during pregnancy allows you to obtain information about how the fetus develops.

Medical practice shows that leukocytes appear in the urine when an inflammatory process occurs. Most often in the kidneys and urinary tract of women and children.

In adult men, a similar pathology can occur on an infectious basis. Leukocytes are living cells that are found in the blood and perform the function of supporting the immune system.

If an infection occurs in the body, the leukocyte cells neutralize damaging factor.

When the results of the Nechiporenko analysis show an excess of leukocytes, this is evidence that inflammation of the kidneys or urinary tract has occurred.

One of the functions of the kidneys in the body is to ensure the removal of waste products. When inflammation occurs in the kidney tissue, so-called cylinders are formed as a result.

In their structure, they are bodies formed from protein and located in the renal tubules.

Urinalysis according to Nechiporenko allows you to determine the excess concentration of these substances.

Protein cylinders have different structures and appearance. Correctly performed decoding makes it possible to make an accurate diagnosis. It is important that urine collection is carried out without disturbances.

The Nechiporenko research method makes it possible to detect red blood cells in the urine. A general analysis does not allow one to obtain such results. Red blood cells are cells found in the blood.

The main function of red blood cells is to carry oxygen from the lungs to the cells of all tissues of the body. With normal metabolism, these cells should not be present in the urine.

The acceptable norm is no more than three to four red blood cells per specific volume.

When the results of the analysis record an excess of the normal concentration of red blood cells in the urine, this means that the glomerular apparatus in the kidneys is damaged or the mucous membrane of the urinary tract is inflamed.

How is urine collected for analysis?

Urinalysis according to Nechiporenko is considered a type of laboratory test in which microscopy of sediment is performed.

Urine collection is done according to a certain rule and requires accuracy from the patient. It is important to remember that the results of the study are the basis for making a diagnosis of severe kidney disease.

To perform the simplest operation, you must follow strict hygiene rules, this is especially true for children.

Parents or senior mentors must be sure to monitor how urine collection is performed, and then the patient will be prescribed the correct treatment.

Any kidney disease radically changes the quality of life. Urinalysis according to Nechiporenko is performed for an accurate diagnosis.

Preparation for the study begins one day before the scheduled date. During this period of time it is necessary to exclude physical exercise and emotional breakdowns.

You need to take the test in an even frame of mind. To collect urine of the required quality, you have to adjust your diet.

During the preparatory period, it is necessary to avoid fatty foods, juices and brightly colored drinks.

You should not take medications containing diuretics. It is very important to explain all the rules to the child and monitor their implementation.

Practice shows that the collection and delivery of urine for analysis according to Nechiporenko is accompanied by minor but significant violations. It is necessary to prepare a container in advance to collect urine.

It is convenient to use a glass jar with a capacity of one hundred grams. It must be washed properly and thoroughly, without using detergents, and sterilized (it is enough to keep the jar in the oven for 10 minutes).

The pharmacy sells special containers to collect urine and submit it for testing. This jar has a tight lid and is convenient for collecting urine for both a child and a woman.

Before submitting urine for analysis according to Nechiporenko, it is necessary to perform a hygienic procedure. The perineum and genitals are thoroughly washed with warm water and soap.

This is done to prevent squamous epithelial cells from being included in the analysis. It is important to note that morning urine must be submitted for testing.

For children and adults, 20-30 ml of moisture is taken - this volume is quite enough. The collection is performed in the middle of the urination process, the first and final parts are sent to the toilet.

After collection is completed, the jar of urine must be delivered to the laboratory. This should be done no later than two hours from the moment of collection.

Decoding the results

When performing a urine test according to Nechiporenko, it is important not only to prepare appropriately for it, but also to correctly evaluate the results obtained, the accuracy of the diagnosis and the purpose depend on this medical procedures.

Decryption is performed by a qualified specialist. When the indicators obtained from the results of the study are higher than the established norm, this fact indicates the presence of pathology in the kidneys and urinary tract.

1. leukocytes – up to 2000 pieces;
2. cylinders – up to 20 pieces;
3. red blood cells – up to 1000 pieces.

Urine may contain bacteria, protein, and epithelial cells.

When, when analyzing urine according to Nechiporenko, at least one indicator exceeds the norm, it is considered that the analysis is bad.

From this definition it follows that it is necessary to conduct research on the subject of a specific pathology.

It should also be taken into account that the results of the analysis may be affected by poor preparation.

When a diagnosis is formulated, many associated factors must be taken into account, including the patient’s well-being and other symptoms.

It must be remembered that the norms for the content of cells in the urine in children are the same as in adults. Sometimes a repeat test is required to confirm the results obtained.

When the transcript of the urine test according to Nechiporenko showed an excess of leukocytes, this indicates that there is acute inflammation in the kidneys.

Depending on how many leukocytes are found in the sample, renal pathology is determined. If the excess is too high, it is recommended to collect urine for analysis again.

A result confirmed in this way indicates the likelihood of the following diseases:

• kidney abscess;
• indolent glomerulonephritis;
• pyelonephritis;
• cystitis.

Leukocyturia, depending on the amount of excess of the norm, has varying degrees of severity.

The Nechiporenko method of urine examination gives good results, sufficient for an accurate diagnosis. Most often, protein casts accumulate in the urine due to slow metabolism.

Protein can get into the urine due to lead poisoning, a viral infection, or hypertension.

A competent interpretation of the results of a urine test according to Nechiporenko makes it possible to immediately make the correct diagnosis - by the degree of excess of the norm, kidney pathology can be determined.

When the number of red blood cells in the urine is too high, it changes color. During the study, red blood cells with irregular shape are clearly visible.

They are called leached. The presence of such cells indicates a possible renal infarction or acute glomerulonephritis. There are fresh and destroyed red blood cells.

The approach adopted in medical practice for urine analysis consists of a certain sequence of actions. Often the disease occurs in a latent form.

The Nechiporenko research method is used at the second stage, when a general analysis is made. Based on the results obtained, the attending physician is able to accurately diagnose and prescribe appropriate treatment for the patient.

In case of kidney pathologies, it is very important to identify the cause of inflammatory processes in the kidneys. early stage development. As a rule, this allows you to cure the disease.

Urinalysis according to Nechiporenko is widely used in clinical laboratories, since it is a simple and informative study that allows diagnosing inflammatory processes of the urinary system, especially hidden ones. This technique was proposed by the Soviet urologist-oncologist A.Z. Nechiporenko.

The essence of the technique

The analysis is prescribed:

• after detection in a general blood test higher level leukocytes or erythrocytes;
• if there are cylinders in;
• with pathology of the urinary system;
• to control the treatment performed.

When examining 1 ml of urine, formed elements are determined, namely leukocytes, erythrocytes, and cylinders.

• Leukocytes are blood cells responsible for immune control. An increase in their normal quantity always occurs with the development of inflammation.
• Red blood cells are blood cells that transport oxygen to organs and tissues. Normally they are not present in the urine; they appear in cases of serious pathology of the urinary organs.
• Cylinders are protein bodies formed during various pathologies in the kidney tubules.

Cylinders are classified into:

• granular, formed as a result of lysis of cells of the inner wall of the tubules;
• hyaline, which are formed from the protein of primary urine that does not have time to return to the blood;
• erythrocytes, which are red blood cells that have clogged the kidney tubules;
• waxy, which are formed from hyaline or granular as a result of their prolonged presence in the renal tubule;
• epithelial - detached epithelium of the renal tubule.

How to correctly collect a urine test according to Nechiporenko?

Correct collection of analysis is important, since the reliability of the result depends on it.

• The day before the analysis, you should refrain from eating foods that are coloring (beetroot, carrot juice), stop eating meat, alcohol, carbonated drinks, excessive amounts of sweets, confectionery, and you should not take antibiotics, antimicrobial and diuretic drugs.
• If a woman has missed her period on the day of the test, she cannot take the test to avoid getting caught.
• Night urine is collected for analysis, i.e. This is the first urination in the morning.
• Urine is collected in a special industrial container (plastic laboratory cup) or in a clean glass jar.
• Before urinating, the genitals should be thoroughly washed without hygiene products or soap.
• You should start and finish urinating in the toilet; the middle portion is collected in the container.
• Urine should be delivered for testing within 2 hours, since bacteria can multiply in it if stored for longer.

How to properly get tested for a child?

• Wash your child without soap.
• Option 1 - secure a urine bag around the external genitalia and wait for urination.
• Option 2 - put the child on an oilcloth and wait for him to start writing - place the prepared container under the stream of urine.
• You can stimulate urination reflexively: by stroking the back along the spine (for children under one year old) or by turning on the water in the tap (for children over one year old).
• Warn the doctor that the entire portion of urine has been submitted for analysis.

Normal during pregnancy

During pregnancy, analysis indicators are often close to the maximum permissible. This is explained by increased daily diuresis and is not a pathology.

Decoding

The standards for children and adults are the same. A normal urine test suggests the following indicators:

• leukocytes: up to 2 thousand in 1 ml;
• red blood cells: up to 1 thousand in 1 ml;
• cylinders: up to 20 units of hyaline are allowed in 1 ml. Other cylinders in any quantity are considered pathological.

A bad urine test is an excess of the specified thresholds of formed elements, as well as the detection of bacteria, protein or epithelium (the detection of the last three is noted in the referral for research). This analysis indicates inflammation and other pathology in the urinary system. However, do not rush to make a diagnosis - only the attending physician has the right to interpret the results of a urine test according to Nechiporenko!

Increased leukocytes>2000	Increase in red blood cells>1000
Pyelonephritis Urolithiasis disease Kidney infarction Cystitis Prostatitis	Nephrotic syndrome Acute glomerulonephritis Kidney infarction Urolithiasis disease Tumor process Purulent cystitis Kidney tuberculosis
Increase in hyaline casts >20
Pyelonephritis Hypertonic disease Acute glomerulonephritis Chronic glomerulonephritis Taking diuretics
Waxy cylinders	Red blood cell casts
Kidney amyloidosis Nephrotic syndrome Chronic renal failure	Malignant hypertension Renal vein thrombosis Kidney infarction
Epithelial casts	Grainy cylinders
Tubular necrosis in the acute phase Overdose of drugs toxic to the kidneys (salicylates, cyclosporines, lithium) Viral infection Poisoning with heavy metals or substances toxic to the kidneys (ethylene glycol, phenols, pesticides, ether)	Pyelonephritis Glomerulonephritis Viral infections Lead poisoning

There are several types of urine tests: general analysis, full daily collection, etc. Research using the average portion collection method (or Nechiporenko’s method) is perhaps the most popular and objective.

Like other tests, the study allows the doctor to accurately assess the condition and function of the kidneys, as well as the urinary tract, and prescribe adequate therapy.

Why and how to take a urine test according to Nechiporenko?

In what cases is a patient prescribed to take a sample using this method?

First of all, this can be caused by any complaints of pain during urination or disorders noticeable on a traditional general analysis. This method is often used to monitor the effectiveness of already started treatment.

The technique serves to confirm (or refute) suspected kidney inflammation. This can be indicated by an excessive number of red and white blood cells (erythrocytes and leukocytes) in a general blood test, as well as specific “cylinders” in the urine.

The collection method is quite simple: some of the urine (about 20 ml) flows freely past a sterilized container, then about 50-90 ml is collected into it, and the rest of the portion is also passed past the collected one.

About a milliliter of liquid is examined from the collected portion. The fundamental difference between this method and the general one is that the biomaterial is examined not within the visibility of the eyepiece, but based on the entire volume of the sample taken.

Study results (if It’s correct to give urine according to Nechiporenko ) are more objective, however, the risk of violation of the collection technique increases, which is unlikely when collecting the entire morning portion of liquid.

Particularly difficult in in this case is taking tests from infants.

Normal values. What do the numbers say?

Question “How to donate urine according to Nechiporenko ? occurs mainly in those who have already undergone general tests. Considering the above, it is worth finding out the normal indicators in advance and comparing with them those indicated in the results.

In any case, it is not worth panicking in advance and diagnosing the most dangerous disease on the list yourself. An accurate diagnosis can only be made by a competent nephrologist.

The standard analysis result according to Nechiporenko for adults and children looks like this:

• Red blood cells - up to 1 thousand units per milliliter;
• Leukocytes - up to 2 thousand units per milliliter (according to some sources, the norm has been increased to 4,000);
• Cylinders - up to 20 units per milliliter.

An increase in the level of leukocytes indicates the onset of inflammation, because white blood cells perform a protective function.

The cause may be cystitis, pyelonephritis, urethritis and other diseases.

An excess of leukocytes may also indicate insufficiently thorough hygiene before collection. To avoid getting false results, you need to read the recommendations, how to properly take a urine test according to Nechiporenko.