Elements In Urine

Elements In Urine Examination Mikrospkopis needed to examine microscopic examination of cells and particles shaped object lainnya.Banyak kinds of microscopic elements can be found either in connection with an infection (bacterial, viral) or are not due to infections such as bleeding, endothelial dysfunction and renal failure. Normally sibagi organic elements into the two groups, namely; elements of organic and inorganic elements. 1. Erythrocyte Theoretically, should not be found of the erythrocytes, but the match 0-3 urinenormal cells / LPK. Hematuria is an increase in the number of erythrocytes dalamurin because: glomerular damage, tumors which erode the urinary tract, kidney trauma, stones salurankemih, infection, inflammation, renal infarction, acute tubular necrosis, infection of the upper and lower urinary tract, nephrotoxins, dll.Hematuria divided into hematuria macroscopic (gross hematuria), and hematuria can be seen clearly mikroskopik.Darah that visually indicates bleeding from the urinary tract bagianbawah, while microscopic hematuria is more meaningful to glomerulus.Dinyatakan damage if microscopic hematuria was found in the urine of more than 5 erythrocytes / LPK. Microscopic hematuria is common in diabetic nephropathy, hypertension, and polycystic kidney. Hematuriamikroskopik may occur persistent, recurrent or transient and come from throughout the kidney-salurankemih. Persistent hematuria often found in the glomerular bleeding ginjal.Eritrosit can see as normal, swollen, krenasi, shrink, shadow or ghost cellsdengan light microscope. Fresh specimens with specific gravity 1.010 to 1.020, cakramnormal shaped erythrocytes. Erythrocytes appear swollen and almost colorless in dilute urine, seemed shrunken (crenated) are concentrated in the urine, and seemed to shrink once the urine is alkaline. Besides the occasional erythrocyte looks like yeast. Dysmorphic erythrocytes appears on the size of the heterogeneous, hypochromic, distorted and often seem small clumps scattered in irregular dysmorphic sel.Eritrosit membrane has a strange shape distorted due time through yangabnormal glomerular structure. Presence of dysmorphic erythrocytes in urine indicate glomerular disease sepertiglomerulonefritis 2. Globular leukocytes leukocytes, nucleated, granular, measuring approx 1.5 - 2kali erythrocytes. Increase in the number of leukocytes dalamurine (leukosituria or pyuria) generally indicate a urinary tract infection either under section atasatau, cystitis, pyelonephritis, or acute glomerulonephritis. Leukosituria can also be found padafebris, dehydration, stress, leukemia in the absence of infection or inflammation, as speed increases ekskresileukosit which might be due to changes in the permeability membranglomerulus or changes in leukocyte motility. 3. Epithelial cells Epithelial cells are round or oval larger than leukocytes, round or oval nuclei containing large, granular and biasanyaterbawa into urine in small amounts. However, the nephrotic syndrome and in conditions yangmengarah to degeneration of the urinary tract, the number could rise. Tubule cell count ≥ 13 / LPK or the discovery of fragments of tubular cells may indicate the presence of active renal disease or injury to the tubules, such as nephritis, acute tubular necrosis, viral infections of the kidneys, kidney rejection transplnatasi, salicylate poisoning 4. Oval fat bodies Oval fat bodies can be found in the nephrotic syndrome, diabetes mellitus further, tubular epithelial cell damage due to severe ethylene glycol poisoning, mercury. In addition to tubular epithelial cells, oval fat bodies can also be macrophages or hisiosit. 5. Squamous epithelium squamous epithelium is generally low and the number yanglebih derived from the skin surface or from outside the urethra. Theiris major significance as an indicator of contamination. 6. Cylinders Cylinders (cast) are cylindrical protein mass formed in the kidney tubules into the urine dandibilas. Cylinder is formed only in the distal tubule complex atausaluran collector (distal nephron). Proximal tubule and the loop of Henle is not untukpembentukan cylinder location. Cylinder classified by morphologic description and komposisinya.Faktor-factors that support the formation of the cylinder is a) a low flow rate, high salt concentrations, b) low urine volume, c) and low pH (acid) which menyebabkandenaturasi and precipitasi protein, especially mukoprotein Tamm-Horsfall. Mukoprotein Tamm-Horsfall protein is a sticky matrix that consists of a glycoprotein produced olehsel renal epithelium. All objects in the form of particles or cells contained in the tubules yangabnormal easily attached to lengket.Konstituen cellular matrix proteins that are generally attached to the cylinder are erythrocytes, leukocytes, and epiteltubulus cells, either intact or in various stages of disintegration. a. Hyaline or hyaline cylinder Cylinders cylinders protein consists primarily of mucoprotein (Tamm-Horsfall protein) issued by the tubular cells. The cylinder is homogeneous (without structure), fine texture, clear, parallel sides and rounded edges. Tamm-Horsfall protein secretion forming a hyaline cylinders in line hyaline pengumpul.Silinder not always show clinical disease. Hyaline cylinders can be seen even in healthy pasienyang. Normal urine sediment may contain 0 -1 hyaline cylinders per LPL. Higher numbers besardapat associated with proteinuria kidney (eg, glomerular disease) or extra-renal (eg, overflow proteinuria as in myeloma). Cylinders protein with a long, thin tail is formed at the intersection of the loop of Henle's and tubulusdistal complex called silindroid (cylindroids). b. Leukocyte cylinder or cylinders Cylinder leucocytes pus, occurs when leukocytes enter the matriksSilinder. Their presence indicates inflammation of the kidneys, because the cylinder is not akanterbentuk except in the kidney. The most typical cylinder leukocytes to acute pyelonephritis, but also dapatditemukan in glomerular disease (glomerulonephritis). Glitter cell (neutrophil phagocytic) akanmenyertai usually cylindrical leukocytes. The discovery of leukocytes cylinder that mixes with bacteria have artipenting for pyelonephritis, pyelonephritis can remember running without complaint despite telahmerusak progressive kidney tissue c. Cylinders Cylinders erythrocytes erythrocytes containing hemoglobin are granular and erythrocyte darikerusakan. The existence of cylinders erythrocytes with microscopic hematuria strengthen diagnosisuntuk glomerular abnormalities. Severe glomerular injury with leakage of erythrocytes or severe kerusakantubular cause erythrocyte cells attached to the matrix protein (mukoprotein Tamm-Horsfall) and form a cylinder erythrocytes. d. Granular granular cylinders Cylinder is a mobile cylinder having degenerasi.Disintegrasi cells during transit through the urinary system produces changes in the cell membrane, nucleus fragmentation, and cytoplasmic granulation. Coarse granular disintegration results initially, then menjadibutiran smooth. e. Candle wax cylinders Cylinder is an old cylindrical cylindrical granular results that mengalamiperubahan degenerative further. When the cylinder cellular nephron remain for some waktusebelum they issued to the bladder, the cells can turn into coarse granular cylinders, then into a smooth cylindrical granular, and ultimately, become slick as wax cylinders (waxy). Wax cylinders commonly associated with severe renal disease and renal amyloidosis. Kemunculanmereka shows the severity of the disease and dilation of nephrons and therefore visible on stage renal akhirpenyakit kronis.Yang called telescoped urinary sediment is one in which erythrocytes, leukocytes, oval fat bodies, and all types of cylinders are found more or less equally abundant. Dapatmenyebabkan conditions telescoped urinary sediment are: 1) lupus nephritis 2) malignant hypertension 3) diabetesglomerulosclerosis, and 4) progressive glomerulonephritis cepat.Pada end stage renal disease from any cause, urinary sediment often becomes sangatkurang because the remaining nephrons produce dilute urine . 7. Bacterial Diagnosis of bacteriuria in cases of suspected urinary tract infection requiring bacteria culture test (culture). Colony count can also be done to see if the number of bacteria present signifikan.Umumnya, more than 100,000 / ml of one organism reflects significant bacteriuria. Beberapaorganisme reflect contamination. Nevertheless, the existence of any organism in spesimenkateterisasi or suprapubic 8 should be considered significant. Bacteria Thrichomonas vaginalis parasite Trichomonas vaginalis is a sexually transmitted urogenital dapatberasal of men and women. This organism size varies between 1-2 times diameterleukosit. These organisms are easily identified quickly by looking at the presence of flagella and erratic movements. 9. Yeast cells could be a yeast or fungal contaminants sejati.Mereka often difficult to distinguish from the red blood cells and amorphous crystals, difference is bahwaragi have a tendency to sprout. The most common is Candida, which can invade kandungkemih, urethra, or vagina. 10. Crystals Crystals are often met by crystalline calcium oxallate, triple phosphate, uric acid. An excess and a predisposition among other infections, allowing the emergence of urinary stone disease yaituterbentuknya kidney-urinary tract stones (lithiasis) along the kidney to the urinary tract, causing injury, and can cause epithelial cell fragments chipped. Disertaikristaluria stone formation can be, and should not be accompanied crystalluria discovery of stone formation. a. Calcium oxalate crystals are common in urine specimens even in patients with healthy yangs. They can occur at any pH of the urine, especially at acidic pH. Bervariasidalam crystal size from very small to quite large. Crystal ca-oxallate vary in size, colorless, and bebentuk envelope or halter. Crystals may appear in the urine specimen setelahkonsumsi certain foods (eg, asparagus, cabbage, etc.) and ethylene glycol poisoning. Presence of 1-5 (+)-Ca crystal oxallate per LPL was otherwise normal, but if found more than 5 (+ + or + + +) was declared abnormal. b. Triple Phosphate Crystals visible rectangular prism shaped like a coffin lid (also sometimes leaves or star shape), colorless and dissolve in vinegar encer.Meskipun they can be found in any pH, their formation is preferred at neutral pH kebasa. Crystals may appear in the urine after the consumption of a particular meal (fruits). Salurankemih infection with urease-producing bacteria (eg, Proteus vulgaris) can support the formation of crystals (and urolithiasis) by raising urine pH and increased free ammonia. c. Uric acid crystals uric acid appear yellow to brown, shaped belahketupat (sometimes needle-shaped or rose). With rare exceptions, the discovery of urate in the urine slightly kristalasam provide clinical value, but rather a normal metabolic waste substances; amount depends on a) the type of food, b) The number of food c) The speed of metabolism d) Concentration of urine. d. Cystine (Cystine) Cystine hexagonal shaped and thin. The crystals appear in the urine as a result of a genetic defect or serious liver disease. Cystine crystals and stones can be found in cystinuria and homocystinuria. Formed at acidic pH and when the concentration is> 300mg.Sering confusing with uric acid crystals. Cystine crystalluria or urolithiasis is indikasicystinuria, which is a congenital metabolic disorder involving defective reabsorption of certain tubulusginjal including amino acid cystine. e. Leucine and tyrosine Tyrosine TirosinLeusin and appear as needles are arranged sebagaiberkas or roses and yellow. Leucine show up greasy ball with radial and concentric striations. Leucine crystal is seen as a yellow sphere with radial concentric. These crystals can sometimes be mistaken with the cells, with a central nucleus resembles. Crystals of acid tyrosine aminoleusin and very rarely seen in the urine sediment. These crystals can be observed in some penyakitketurunan like tyrosinosis and "Maple Syrup disease". More often we find these same crystals in patients with severe liver disease (often terminal). f. Cholesterol crystals of cholesterol crystals appear regular or irregular, transparent, tampaksebagai thin rectangular plate with one (sometimes two) of the square corners have notches. The presence of cholesterol crystals are very rare and are usually accompanied by proteinuria Source: http://www.scribd.com/doc/102222320/Analisa-Mikroskopis-Pada-Urine