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Chemical Analysis The chemical examination measures several features of the urine. The kidneys regulate this acid-base chemistry by reabsorbing sodium and secreting hydrogen and ammonium ions.
When the body retains excess sodium or acid, urine becomes more acidic i. Highly acidic urine can occur with uncontrolled diabetes, diarrhea, starvation, dehydration, and certain respiratory diseases. This can occur with urinary tract infections and certain kidney and lung conditions. Certain foods can also alter the pH of your urine. For example, eating excessive protein or cranberries can make your urine more acidic, whereas eating a low-carbohydrate or vegetarian diet can make your urine more basic.
Sometimes people are asked by their doctors to regulate the pH of their urine through diet in order to manage certain diseases or medications.
For example, kidney stones can occur if urine pH is too high or too low. Protein : Excessive protein in the urine proteinuria is a sign of kidney involvement in lupus. Usually, your kidneys prevent protein from passing from your blood into your urine: loops of capillaries glomeruli that filter blood allow small particles to pass into the urine while retaining larger particles, such as protein, and kidney tubules reabsorb the smaller proteins that were able to escape.
Large amounts of protein in the urine suggest that these glomeruli and tubules are inflamed or damaged in some way. If there is a large amount of protein in the urine, your doctor may request that you give a hour urine sample or obtain a random protein to creatinine ratio. These two tests are used to monitor lupus affecting the kidneys lupus nephritis. Glucose : Your urine should not contain glucose. If it does, your doctor will order further bloodwork and urine tests to determine the cause.
Glucose in the urine is called glucosuria; it can occur in people with diabetes that is not properly regulated with insulin, in people with kidney problems that affect the absorption of glucose, in pregnant women, and in people with liver abnormalities or hormonal disorders. Ketones : Ketones in the urine ketonuria indicate that your body is metabolizing its fat reserves instead of carbohydrates to obtain energy. This can occur in people on low-carbohydrate diets, people who are malnourished, or people who have a problem properly metabolizing carbohydrates e.
It can also occur with excessive exercise, loss of carbohydrates due to vomiting, or exposure to cold. In people with diabetes, ketonuria may indicate insufficient management with insulin. Blood : The chemical examination of urine also measures the amount of red blood cells in the urine sample.
The presence of red blood cells in the urine is known as hematuria, and the presence of hemoglobin from red blood cells is known as hemoglobinuria. Usually people have very small amounts of red blood cells in their urine, but even a minute increase can indicate a problem, such as a disease of the kidney or urinary tract, trauma, medications, smoking, or intense exercise e.
When the chemical test for blood in the urine is negative but the microscopic assessment shows the presence of red blood cells, the laboratory will usually check for the presence of vitamin C, which can interfere with test results.
Therefore, it is very important to tell your physician if you are menstruating or are experiencing any other condition that could contaminate your urine sample. It is also very important that you speak to your lab technician about proper aseptic technique when giving a urine sample. Therefore, the presence of this substance in the urine indicates the presence of white blood cells leukocyturia.
For similar reasons we see white spots on the throat when we have a sore throat and white heads on our skin when we suffer from infected acne — the white areas are collections of white blood cells, which form pus. If you notice any visible blood in your urine , it is important that you see your doctor urgently. Inflammation is another reason white blood cells may be present in your urine, and this could be caused by kidney stones, immune disorders, allergies or growths anywhere along the genitourinary system.
What symptoms are associated with white blood cells in urine? This all depends on the health condition causing them to appear. Should a bladder infection be to blame, you may experience pain in your lower tummy, feel tired or unwell, or have a pain when you pass urine, explains Dr Brown.
Kidney stones , another possible cause, can bring about similar symptoms, along with severe back pain, nausea, vomiting or fever. If you do have white blood cells in your urine, your doctor may ask you some questions to find out what has caused it, explains Dr Brown.
If they suspect an infection, they may prescribe you antibiotics and send a sample of urine away for culture and sensitivity to identify any microorganisms.
They may prescribe antibiotics and send a sample of urine away for culture and sensitivity. Symptoms include :. If kidney stones travel to the ureters, they can disrupt the flow of urine. If a blockage occurs, bacteria can collect, and an infection can develop. The number of white blood cells in the urine can go up if there is a kidney infection.
Kidney infections often start in the lower urinary tract but spread to the kidneys. Occasionally, bacteria from other parts of the body reach the kidneys through the bloodstream.
An obstruction can result from a traumatic injury, kidney stones, tumors, or other foreign material. If urine accumulates in the bladder, the presence of bacteria increases the risk of an infection. These are just a few of the common causes, but there are others. The following can also cause raised levels of leukocytes in the urine:.
Leukocytes in the urine cause different symptoms for different people, but there are a few symptoms or signs that suggest leukocytes may be present in the urine. One of the most visible signs is cloudy or foul-smelling urine. Other signs include frequent urination, a pain or burning sensation when passing urine, or the presence of blood in the urine.
A urine analysis urinalysis is used to screen the urine for abnormalities and may be enough to detect any problems. People who suspect leukocytes in the urine provide a urine sample that their doctor can analyze in three ways: Visual exam, dipstick test, and microscopic exam.
If blood or other substances are present in the urine, the physician may perform more tests to identify the cause of the problem. The problem may be any of the conditions listed above or a more serious noninfectious illness, such as a blood disorder, autoimmune disease, or cancer. The doctor will order additional tests as needed. It is possible to have white blood cells in the urine without a bacterial infection.
Sterile pyuria refers to the persistent presence of white blood cells in the urine when no bacteria are found to be present by laboratory examination. Certain sexually transmitted diseases , viral or fungal infections, or even tuberculosis can cause sterile pyuria.
Treatment for leukocytes in the urine depends on the cause and if there is an infection. For some conditions, such as a bacterial UTI, antibiotic therapy will clear up the infection relatively quickly.
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