Urine test by Nechiporenko
Why this test?
For the diagnosis of acute and chronic inflammatory diseases of the urinary tract (pyelonephritis, glomerulonephritis, cystitis, urethritis).
To evaluate kidney damage in certain systemic diseases (eg, diabetes, systemic lupus erythematosus, amyloidosis, vasculitis, and trauma).
For differential diagnosis of diseases of the urinary tract.
To control the treatment of diseases of the urinary organs.
In what cases is it prescribed?
With symptoms of pathology of the urinary tract (change in color, smell, transparency and quantity of urine, frequency of urination, pain in the area of the kidneys, lower abdomen, during urination).
With questionable results or deviations in the general analysis of urine.
In case of systemic diseases with a high risk of kidney function damage.
When observing the effectiveness of treatment of diseases of the urinary tract.
Urine analysis according to Nechiporenko allows more accurate determination of the quantitative content of erythrocytes, leukocytes and cylinders than a general clinical analysis of urine. Both studies are conducted using microscopy, but in Nechiporenko's test, elements are counted per unit volume of liquid, and not by the number of cells or cylinders in the field of view.
Normally, the kidney glomeruli do not pass the formed elements of blood and albumin, but in some diseases the kidney barrier is damaged, which is reflected in changes in the composition of urine. The presence of a large number of erythrocytes in the urine (hematuria) may indicate damage to the glomerulus. It should be taken into account that the formed elements of blood in the urine are detected in case of damage, stones, inflammatory diseases or neoplasms at all levels of the urinary tract - blood gets there from the renal bowls, ureter, bladder or urethra. The renal origin of hematuria is indicated by the detection of erythrocyte cylinders or leached erythrocytes.
Normally, leukocytes are present in urine in small quantities. Their content can increase with inflammatory diseases of the urinary system, infection of the genitourinary tract and some acute inflammatory systemic diseases. Leukocytes are able to penetrate to the site of inflammation through intact tissues. In case of their excessive secretion - leukocyturia - it is necessary to carry out a bacteriological examination of the urine to clarify the etiology of the disease and prescribe adequate therapy.
In clinical practice, the determination of leukocyturia or hematuria is often used in the differential diagnosis of glomerulonephritis and pyelonephritis.
Cylinders are protein conglomerates that are produced from cells and cellular detritus when the physical and chemical properties of urine change. They are formed in the renal tubules and take their shape. Epithelial cells of tubules form epithelial cylinders, when epithelial cells and leukocytes are destroyed, granular cylinders appear, wide waxy cylinders are formed from regenerating granular cylinders. Their detection indicates severe kidney damage, the development of kidney failure and an unfavorable prognosis of the disease. Hyaline cylinders are formed from proteins and often indicate proteinuria. The Tamm-Horsfall protein is involved in their formation, which is normally present in the renal tubules in a dissolved form and is important in the immunological protection of the organ against infection. Hyaline cylinders can also be detected in a healthy person after intense physical activity or with minimal pathological changes in the kidneys.