Is the level of leukocytes in urine high 15. Increased leukocytes in urine: what does this mean, what disorders does leukocyturia signal? What is the norm of leukocytes in urine

Leukocytes in urine analysis are one of the main indicators of the study. A pathology in which the number of leukocytes rises is called leukocyturia. Most often, this means that an inflammatory reaction develops in the body. How are leukocytes indicated in urine analysis, and what can deviations of their indicators from the norm indicate?

Leukocytes in urine

Leukocytes are white blood cells involved in immune and inflammatory responses. Leukocytes are formed in the lymph nodes and red bone marrow. In the analysis of urine, there are different designations of these cells - LEU and WBC (white blood cells - white blood cells).

An increased content of leukocytes, especially in repeated urine tests, requires a detailed examination of the patient.

There are five types of leukocytes, each of which differs in its physical and functional characteristics:

Leaving the bloodstream, leukocytes penetrate into any organs and tissues. In healthy people, white cells enter the urine through the mucous membrane of the ureters and Bladder, departments of the renal glomeruli and the tubular system in small numbers. With the development of an inflammatory reaction due to the destruction of the tubules and cell infiltration, conditions are created for the excessive release of leukocytes from the focus of inflammation into the urine. In this case, the presence of white blood cells is detected in the urine during laboratory tests.

Leukocytes in the general analysis of urine

The day before the study, significant physical activity should be excluded, try to limit stress. Baths and saunas are contraindicated. Fatty and fried foods, as well as any foods that can change the color of urine (carrots, beets and other brightly colored vegetables and fruits, synthetic vitamins) should be excluded from the diet 1-2 days before the analysis. Also, do not consume alcohol, coffee, sugary and carbonated drinks. Taking any medications, if possible, should be suspended (in this regard, you should consult your doctor). If you cannot take a break in admission, you need to make full list the drugs taken and inform the doctor about it, who gives a referral for the analysis. Women who are menstruating are advised to reschedule their urine test for a few days.

The material is collected on an empty stomach, at least 12 hours should have passed since the last meal. For a general analysis, the first morning urine is required. To ensure that the biomaterial is not contaminated with secretions, thorough hygiene of the external genital organs must be carried out before urine collection. You should take care of the capacity in advance. It must be sterile, no residue detergents... It is best to use special disposable containers that are sold at the pharmacy. Some laboratories issue such containers when registering for a study.

When collecting material, you need to lower not a large number of urine into the toilet, and then, without stopping urination, substitute the container and collect 100-150 ml, and the container should not touch the skin. This is done so that bacteria from the external genitalia do not get into the material. The collected urine for analysis can be stored in a cool place for no longer than 1.5–2 hours.

To detect latent leukocyturia, additional research methods are used - the Amburge and Addis-Kakovsky tests.

In urine healthy person leukocytes are found in no more than 10 in the field of view. The norm of leukocytes in adults in a single portion of urine is no more than 7 in the field of view in men, and no more than 10 in women. To determine normal results in children, you can use the table of white blood cell counts in urine by age.

The level of white blood cells in urine can increase during teething in infants and children 5-6 years old.

Normal leukocyte counts in urine with different samples

The Amburge test helps to determine the number of blood formed parts excreted in the urine in 1 minute. To obtain reliable data, 5-10 ml of urine collected in 3 hours is analyzed. Normally, the urine in the study according to Amburge contains up to 2000 leukocytes.

Addis-Kakovsky samples - a method for the quantitative determination of formed elements in the daily volume of urine. In a healthy patient, no more than 2,000,000 leukocytes per day are excreted in the urine.

An increased content of leukocytes in urine analysis (especially in repeated ones) requires a detailed examination of the patient. Usually, additional studies are prescribed: ultrasound of the abdominal cavity and organs of the genitourinary system, radiography chest, cystoscopy, excretory urography, general and biochemical blood tests, etc.

Many factors can influence the composition of urine and distort the test results. These include the drinking and eating regimen, medication, physical and emotional stress.

An increase in the number of leukocytes in the urine

An increase in leukocytes in the urine, i.e., leukocyturia, can be true and false. When true, white blood cells are formed in the urinary system, when false, the result of the analysis is affected by the contamination of the collected biomaterial with secretions from the external genital organs.

Depending on the presence of the pathogen, an infectious, or bacterial and non-infectious, or abacterial (sterile) leukocyturia is isolated. The latter is characterized by an increased number of leukocytes in the absence of bacteria in the urine.

By the number of detected leukocytes, the following types of leukocyturia are distinguished:

insignificant- up to 40 in the field of view;
moderate- up to 100;
significant- the entire field of vision is covered with leukocytes.

With 100 or more leukocytes in the field of view, they speak of pyuria - the discharge of pus in the urine. The number of leukocytes in this condition can reach 500 or more.

Depending on which types of white blood cells are predominant, leukocyturia is:

neutrophilic- with inflammation of the kidneys, bladder, ureters or urethra, at the initial stage of acute glomerulonephritis, with pyelonephritis and tuberculosis;
lymphocytic- with infectious lesions of the kidneys and urinary tract, autoimmune diseases;
mononuclear- with interstitial nephritis, in the late stages of glomerulonephritis;
eosinophilic- eosinophils are elevated in cystitis and abacterial glomerulonephritis and indicate the attachment of allergy to the inflammatory process.

Causes of leukocyturia

An increased content of leukocytes in urine is characteristic of the following diseases:

pyelonephritis;
glomerulonephritis;
interstitial nephritis;
rejection of a kidney transplant;
kidney tuberculosis;
cystitis;
Symptoms accompanying leukocyturia

Depending on the accompanying symptoms, it can be assumed which pathology caused the increase in the level of leukocytes in the analysis of urine.

The development of an infectious pathology of the urinary system is evidenced by:
- violation of urination;
- burning, pain when urinating;
- painful sensations in the lower abdomen or in the lumbar region;
- strong smell of urine;
- discoloration of urine, the appearance of mucus, flakes, blood streaks;
- fever, symptoms of intoxication.
Kidney stone disease is accompanied by the following manifestations:
- clouding of urine (possibly the appearance in it of an admixture of blood, pus);
- sharp pain in the lower back with spread along the ureter;
- increased urination;
- violation of the outflow of urine;
- nausea, vomiting;
- temperature increase;
- increased blood pressure.
In acute pyelonephritis, leukocyturia is accompanied by:
- gradually increasing or acute pain in the lumbar region on one side;
- painful urination;
- change in the color and odor of urine;
- clouding of urine, the appearance of an admixture of pus in it;
- nausea, vomiting;
- chills, increased body temperature;
- joint pain.
- pyuria;
- regular and situational dull back pain of low intensity;
- cloudy urine;
- transient dysuria;
- muscle pain;
- weakness, decreased appetite.
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- these are white bodies that perform an important function - they protect the body from the ingress of pathogens. They absorb and break down foreign cells. It is produced by the bone marrow and the immune system. In a small amount, leukocytes are present in the blood and urine, but a large number of them indicates an inflammatory focus in the body.

Determine the quantity by passing a general analysis and. The Nechiporenko test allows you to assess the content of formed elements in the middle portion of urine. This laboratory test helps differentiate inflammatory from non-inflammatory diseases.

In addition, it can be performed to detect bacteria and their sensitivity to antibiotics.At high content white blood cells are diagnosed with leukocyturia.

The norm of leukocytes in urine:

Normally, a woman's leukocyte count should be within 5 units in the field of view.
Men have no more than 3 units.
The number in children is slightly higher and amounts to 8-10 units.

When diagnosing, a quantitative count of leukocytes is carried out and, taking this into account, three degrees of leukocyturia are distinguished:

Light degree. The number of white cells is slightly higher than normal.
Moderate degree. Diagnosed when leukocytes are detected in the amount of 50-90 units.
High degree. In this case, pyuria is diagnosed, the number of cells significantly exceeds the norm.

At a high level, dynamic control of leukocytes is shown, therefore, tests are taken within 2-3 days.

The reasons for the increase and possible pathologies

The main reasons for the increase in the content of leukocytes in urine:

Weakening of immunity
Urolithiasis disease
Neoplasms in the small pelvis
Inflammatory processes in the bladder
Infectious foci of inflammation in the vagina
Urogenital candidiasis
Ischemia
Infectious mononucleosis
In addition, leukocytes above normal can be observed with frequent catheterization procedures.

A high content of leukocytes may indicate the development of cystitis, prostatitis,. Leukocyturia may indicate the following diseases: phimosis, nephritis, hydronephrosis, glomerulonephritis, renal polycystic. You should be aware that the inflammatory process can affect other organs of the genitourinary system and lead to serious pathologies.

Useful video - leukocytes for pyelonephritis:

Leukocyturia can be infectious or aseptic:

With infectious leukocyturia, pathogenic bacterial microorganisms are present in the urine.
Aseptic leukocyturia is characterized by the absence of pathological microorganisms.

With a pathological increase in leukocytes, the following symptoms are observed:

painful sensations when urinating
frequent urge to urinate
increased body temperature
back pain and lower abdomen
cloudy urine

If the listed symptoms appear, you should consult a doctor and pass urine for research. Based on the results, the necessary treatment will be prescribed.

Reduction methods

Treatment of leukocyturia (pyuria) is complex and consists in the use of antibacterial drugs. This is the main part of the treatment of inflammatory processes of the genitourinary system. Of antibiotics, Amoxicillin, Erythromycin, Ampicillin, Ciprofloxacin, etc. are often used.

The duration of taking antibacterial drugs should be at least 7 days. If you feel better, you should not stop taking antibiotics, as this can lead to a relapse. It is possible to exclude re-infection and reduce the risk of inflammatory processes if, for prophylactic purposes, antibiotic therapy is carried out within a week, a month after the main treatment.

Leukocyturia is a sign of inflammatory diseases of the urinary system, therefore, treatment is aimed at eliminating the cause of this phenomenon.

With aseptic leukocyturia, treatment is local and consists in performing irrigation and douching.To activate the immune process, immunomodulators are prescribed: echinacea tincture, Polioscidonium, Immunal, etc.Diuretics are prescribed for difficulty urinating and in the presence of edema. Of the diuretics, Minitol, Furosemide, Torasemide, Hydrochlorothiazide, etc. are usually used.

In order to avoid the development of inflammatory processes in the urinary system, it is necessary to take preventive measures:

Genital hygiene should be observed regularly.
After urinating, it is recommended to use antibacterial or dry wipes to remove any remaining urine on the genitals.
The diet should contain foods that increase immunity.
To lead healthy image life: eat right, exercise, etc.
Avoid promiscuous sex.
Consult a doctor in a timely manner if there are signs.

High levels of leukocytes in urine in pregnant women

At the beginning of pregnancy, a slight increase in leukocytes in the urine is the norm. This is due physiological characteristics... The immune system activates the protective functions of the body and tries to get rid of the antigenic load.

If leukocyturia lasts a long time, then this is a clear signal of pathology. Due to the increased load on the kidneys, pyelonephritis, an inflammation in the kidney tissue, often develops. This negatively affects not only the condition of the pregnant woman, but also the development of the baby.

If the concentration deviates greatly from the norm, then the treatment is carried out in a hospital. This will eliminate the development of preeclampsia - a dangerous condition for both the mother and the child.

The presence of not only leukocytes in the urine, but also for a pregnant woman is extremely dangerous.

This may indicate kidney, bladder, or urinary tract disease. With erosion of the cervix, an increase in leukocytes is also possible against the background of its bleeding.can also lead to leukocyturia. Blood can enter the urine or remain inside. As a result, there will be serious inflammation and the woman needs to be urgently hospitalized.

The level of leukocytes can exceed the norm in case of improper preparation for the delivery of a urine test, non-observance of personal hygiene, etc. Often, leukocyturia can be asymptomatic and can only be detected during the delivery of urine. Of the visible signs, only clouding of urine can be noted.Pregnant women are prescribed drugs of the new generation cephalosporin group. Such drugs do not cause serious adverse reactions and only their use is permissible during pregnancy.

Content

Suspecting a medical condition, doctors often send the patient for a urine test. This kind laboratory research allows specialists to diagnose the state of the immune, cardiovascular systems, kidneys and other organs. If a large number of leukocytes are detected in the urine, you should be alert. Find out why.

What are leukocytes in urine

The so-called white blood cells, whose task is to suppress infections, protect the body from harmful microorganisms. The photo shows that these large blood elements have no color, differ in structure, purpose, and are the main elements of the immune system. Cells are able to pass into all organs, tissues, and can move independently thanks to pseudopods.

If a person has an increase in the number of bacteria, viruses, foreign particles, leukocytes destroy them, die themselves and are excreted in large volumes in the urine. According to the analyzes, the doctor diagnoses the inflammatory process. The presence of leukocytes in urine is not a pathology, if the norm is not exceeded (according to the table). An alarm should be sounded if a certain threshold is exceeded.

How to take a urine test correctly

This type of diagnostic study is very important, it is prescribed if you suspect the most different diseases, as well as for the purpose of tracking the effectiveness of treatment. If the leukocytes in the urine analysis are increased, there is a high probability of the presence of pathology, an inflammatory process. To get reliable results, you should not go to the doctor if your temperature is high, your period is on, and your blood pressure is high. Recommendations for taking the analysis:

The day before the delivery of the biomaterial, food should be avoided that can affect the color of the liquid secreted by the kidneys: beets, brightly colored fruits, marinades. It is not recommended to drink coffee, dietary supplements, alcoholic beverages.
It is advisable not to visit the sauna or bath, to exclude strong physical activity.
Before delivery, you need to spend hygiene procedures, to take a shower.
If the collection of biomaterial will take place at home, you should buy a disposable container in advance. The liquid must be collected a few seconds after the start of urination, and brought to the laboratory in a maximum of 2 hours.
The procedure is done in the morning, before meals.
When collecting, the container should not touch the skin, genitals.

The rate of leukocytes in urine

Many are interested in the question - how many leukocytes should be in urine? Any doctor will explain that the amount is influenced by a person's age, gender, and other important factors. For example, increased rates are observed due to treatment with certain medications in pregnant women. White blood cells are large, larger than red blood cells. In a healthy person, the norm is considered to be from 0 to 5 in women and from 0 to 3 in men. When the number of described cells in the analyzes exceeds 6, the volume of red blood cells is increased, a similar condition is called leukocyturia.

How to determine the rate of white blood cells? Independently - no way. If there is a suspicion of a serious illness, you need to go to the doctor and get tested, following the recommendations. The study of the biomaterial is carried out by specialists. For analysis, it is centrifuged in a graduated test tube, the resulting sediment is examined under a microscope or an automatic apparatus is used.

The child has

For babies and children, doctors regularly issue directions for urine examination in order to identify problems in time and prevent the development of inflammatory processes and pathologies. An ideal general analysis should show a white blood cell count close to zero. A single excess is permissible, depending on the age of the child, baby. For example, the norm of leukocytes in the urine of male children can vary at the level of 0-7 leukocytes, in girls - from 0 to 10. The more white cells are found, the more acute the disease is in infants.

Leukocytes in urine during pregnancy

Women expecting a baby are assigned a regular diagnostic urine test, the procedure is mandatory. The purpose of the analyzes is to see and eliminate possible malfunctions and failures in time. As a rule, in the first trimester, the study is prescribed once every 3-4 weeks, in the second - with a frequency of 2 weeks, for more later dates- even more often. White cell levels in pregnant women are initially high. The reason is the increased protective properties of the body due to antigenic load. The norm of leukocytes in urine during pregnancy is from 0 to 3 units.

Among women

If the leukocytes are normal, in women the indicator is not higher than 6 units. If the leukocyturia has a pronounced degree, it can be seen visually: the secreted fluid acquires a cloudy color, includes lumps, mucus, and various threads. An increased number of white blood cells may indicate inflammation of the genitals, kidneys, and urinary tract. To get an accurate diagnosis, the doctor may order a second test, with the fluid taken from the bladder.

In men

It is considered normal if a urine test for leukocytes shows up to 3 cells in the field of view. If the indicator is higher, we are talking about excess and the presence of any pathology. Poor analysis can be caused by inflammation of the urethra, infections of the genitourinary system, the presence of kidney stones, ureter, connective tissue abnormalities, tumor diseases, and so on.

According to Nechiporenko

If the general analysis shows an increased number of blood cells, the doctor may prescribe an analysis according to Nechiporenko to clarify the diagnosis. The method helps to identify the amount of protein content, erythrocytes, leukocytes, cylinders. In a healthy person, leukocytes in urine according to Nechiporenko should not exceed 2000 per 1 ml. If there are more of them, comparing all the information received, the doctor will be able to identify diseases of the kidneys, urinary tract.

Elevated leukocytes in urine

If a person has elevated white cell levels, they often have bad smell urine, cloudy color, painful sensations. Why are there a lot of leukocytes in urine? What caused this condition and what does it mean? The reasons for the increase in leukocytes:

pregnancy;
stagnant urine;
kidney infections;
appendicitis;
taking medications, for example, cephalosporins, diuretics;
chronic heart failure;
oncological diseases;
infectious diseases;
insufficiency of the thyroid gland;
angina;
infestation with helminths;
autoimmune processes;
leukemia;
bronchial asthma;
the ingress of bacteria into the urinary system;
allergy;
hematuria;
venereal diseases;
cystitis;
pyelonephritis.

How to lower leukocytes in urine

It is helpful to change your diet, lifestyle, if the increase in white blood cells is negligible. It is recommended to avoid excessive exertion, overwork, take a small amount of food evenly throughout the day. It is important to exclude dehydration, refuse heavy meals. You can also try folk methods treatment, for example, a month to drink a decoction of horsetail or more often use linden tea.

How to reduce leukocytes in urine if they have a pathological origin? The method is selected individually, depending on the cause of leukocytosis, the specific case, the patient's age. Treatment options for an adult and a child may differ. As a rule, the following methods are assigned:

taking antibiotics if the disease is associated with the ingress of bacteria, infections;
taking non-steroidal drugs to eliminate foci of inflammation;
the use of complex therapy for pathologies internal organs;
the appointment of antihistamines if the increased rates are due to allergies;
chemotherapy, surgery for cancer manifestations;
withdrawal of drugs if leukocytosis is caused by taking them;
if the indicators are very high, leukapheresis is used - a transfusion of purified blood.

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Attention! The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment... Only a qualified doctor can diagnose and recommend treatment based on individual characteristics specific patient.

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Update: October 2018

Receiving a form with the result of their own analyzes in their hands, few people refrain from comparing the obtained indicators with the normal numbers indicated next to them. Some differing results are simply surprising, while others are frightening, even to the point of panic.

Today we'll talk about what elevated leukocytes in the urine can mean: how scary it is and what kind of algorithm of actions a person should have in order to find the cause of this condition.

Where do leukocytes come from?

The basis of the urinary tract is made up of 2 types of cells: various epithelial and muscle. Their vital functions are supported by capillary blood, which brings oxygen and nutrients. In the blood, there are also immune cells - leukocytes. They "bypass the patrol" of the urinary tract, comparing the "identification marks" - antigens - displayed on each cell with a kind of "list" of such "allowed" molecules.

When leukocytes see antigens of bacteria, viruses or fungi, as well as "signs" of cancer cells, they rush to the "compromised" place and begin to destroy foreign agents. After performing their function, they go out into the urine, where they are detected using laboratory tests:

general (general clinical) analysis- the usual portion of urine collected in the morning. This analysis is the simplest to perform, and it is from it that they usually learn that the content of leukocytes is increased (this is called leukocyturia);
samples according to Nechiporenko- an average portion of morning urine. It is considered more informative for determining the number of leukocytes, as well as red blood cells and casts in the urine. It better specifies the number of these cells, which helps in the diagnosis of various inflammatory diseases of the urinary tract;
Amburge samples... This analysis is performed from 10 ml of urine sampled from a container where urine was collected in 3 hours;
Addis-Kakovsky samples- counting urinary cells in urine collected 24 hours.

The last tests are needed to detect latent leukocyturia (when in the general analysis the leukocytes are normal) or when, with repeated examination, the leukocytes are either increased or normal. They will help not to miss, but to detect a disease in a person even at the stage when an ultrasound scan does not show anything.

Leukocyte rate

Normally, there may be several immune cells in the urine: these are the sentinels who checked organs for infection or cancer. In women, a little more of such cells is allowed: in their urine, those leukocytes that "check" the genitals can also get into the urine.

So, the norm of leukocytes in urine (according to general clinical analysis of urine):
- in women: 0-6 in the field of view;
- in men: 0-3 in the field of view.
If we talk about the Nechiporenko test, then a level above 2000 cells in 1 ml will be considered elevated leukocytes (in women, up to 4000 cells are allowed).
Amburzhe's sample rate is also up to 2000 leukocytes.
According to Addis-Kakovsky, the norm is considered to be above 2,000,000 leukocytes in daily urine.

So, what does "high leukocytes" mean? Depending on what kind of urine test they are determined, these are:

or more than 3 in men and 6 in women (according to the general analysis);
or more than 2000 (according to Amburzha and Nechiporenko);
or more than 2 million (according to Addis-Kakovsky).

The norm in children

In infants, in terms of the volume of "work" performed, the leukocytes are somewhat "weaker". This determines that the rate of leukocytes under the age of one year is different: from 1 to 8 cells / field of view. This amount in the urine of infants can increase during periods of teething, when a non-microbial inflammation of the tooth socket occurs, and many leukocytes are forced to enter the urine.

In older children, the norms are close to those in adults. To assess whether your child's score is normal, there is a table by age. You just need to compare the received general urine analysis with it:

Thus, the fewer leukocytes in the urine, the better. Some practicing urologists are of the opinion that if in the urine of a child of any age more than 3 leukocytes in the field of view are determined by the general clinical method, then it should already be examined according to the algorithm given in the section "What to do with an increase in leukocytes in urine".

Types of leukocyturia

By origin, leukocyturia is:

true when the causes of increased leukocytes in the urine are in diseases of the urinary system;
false when leukocytes enter the urine from the genital tract (to determine inflammation in the genitals, leukocytes are determined in a smear from them). This can occur in both males and females of any age. The reason for this condition can be both poor hygiene of the genitals before the test, and inflammation of the external genital organs in women (vulvovaginitis) or the skin of the penis and its head (balanoposthitis).

There is another classification, taking into account the sterility of urine, in which a large number of leukocytes are found. In this case, leukocyturia is:

infectious... Caused by inflammation of the urinary tract. With bacterial culture or PCR analysis of urine, some kind of microbe is determined.
non-infectious (aseptic). It is caused either by non-infectious processes (for example, autoimmune glomerulonephritis or allergic cystitis), or by inflammation in the organs near the urinary tract, or by taking the drugs listed below.

Depending on the quantitative results shown by a general urine test, leukocyturia is:

insignificant: 7-40 leukocytes in the field of view;
moderate: 41-100 cells per field of view;
pronounced(it is also called pyuria, that is, "pus in the urine"), when more than 100 cells / per point of vision is determined.

Depending on which leukocytes prevail in the visual field (leukocytes are a collective term for several types of cells), leukocyturia can be neutrophilic, lymphocytic, eosinophilic and mononuclear. Each of them is characteristic of certain diseases. To determine the type of leukocyturia, an additional urine test is required: this indicator is not determined by a standard general clinical analysis.

Causes of an increase in leukocytes in urine

An increased level of leukocytes can be determined not only with an illness. This can be due to insufficient hygiene of the genitals (read how to properly prepare for the delivery of urine, further), as well as due to the intake of certain medications. The latter include:

diuretic drugs;
anti-tuberculosis drugs;
some antibiotics;
drugs that suppress immune system(used in the treatment of autoimmune diseases, tumors, as well as after organ transplantation);
non-steroidal anti-inflammatory drugs, which are usually used to treat pain syndromes of various localization.

Consider when more than 6 leukocytes appear in the urine in the field of view of both sexes:

With cystitis - acute and chronic

An acute illness is difficult to miss: it is manifested by intense pain in the lower abdomen, strong urge to urinate and painfulness (especially at the end), sometimes even blood flow with urine and fever. And chronic cystitis can be asymptomatic, only in some cases letting you know about yourself by frequent urination and slight discomfort with it. In chronic cystitis, exacerbations periodically occur, which are manifested by the symptoms of an acute process.

With urethritis - acute and chronic

Acute inflammation is manifested by pain, especially severe at the beginning of urination, its frequency and clouding of urine. In chronic urethritis, these symptoms appear only occasionally, after hypothermia, large amounts of alcohol and intercourse. The rest of the time, the disease may not show any symptoms.

Pyelonephritis, pyelitis

With pyelonephritis and pyelitis, which are acute and chronic; have the same manifestations. Acute inflammation of the renal tissue is characterized by high temperature, symptoms of intoxication and back pain. Chronic pyelonephritis can only manifest itself with faster fatigue, recurrent headaches and rises in temperature to numbers below 38 ° C. A more rapid freezing of the lower back may also be felt.

Urolithiasis, tumors

Leukocytes can be determined when blood enters the urine (it contains all the blood cells), which happens with urolithiasis (when a stone injures the urinary tract), after a kidney injury or a descending urinary tract, with a tumor in the kidneys, prostate or descending urinary tract ... And if urolithiasis usually manifests itself as symptoms of renal colic (sharp and intense pain in the lower back, radiating to the genitals), and the very fact of the injury is difficult to forget, then tumors of the genitourinary system have no symptoms for a long time.

Glomerunonephritis

With glomerulonephritis, that is, inflammation of the renal glomeruli, which does not occur due to infection of the renal tissue (as in pyelonephritis), but with a strongly "active" immune response to the microbial inflammation present in the body. Glomerulonephritis can also be autoimmune in nature, when the cells of their own immune system begin to attack the glomeruli of their own kidneys. Acute glomerulonephritis is manifested by an increase in temperature, weakness, decreased appetite, nausea, the appearance of edema on the face, which is more in the morning and less in the evening. In some cases, blood appears in the urine, which gives it a brown, black or dark brown color.

With pyonephrosis

This is the name of the melting of the kidney tissue when an abscess is formed; is a complication of pyelonephritis. It manifests itself as weakness, sleep disturbance, excessive sweating, pain in the lumbar region.

With paranephritis - inflammation of the perineal tissue

It is a complication of pyelonephritis, bacterial inflammation of the colon, which comes into contact with this fiber, as well as purulent pathologies of other organs, from where bacteria with blood spread throughout the body. It is manifested by an increase in temperature, pain in the lower back and half of the abdomen.

With renal cysts

They do not manifest themselves for a long time, until the cyst interferes with the outflow of urine. As soon as urine flows out badly, it begins to stagnate in the kidney, a bacterial infection joins here. This is manifested by an increase in temperature, back pain, weakness.

With amyloidosis of the kidneys

This is a disease characterized by the deposition of a special protein - amyloid - first between the main "working elements" of the kidney, and then - with the replacement of these structures. As a result of this pathology, normal renal tissue is largely replaced by non-working pink shiny tissue. The disease occurs due to hereditary disorders of certain genes. It also develops in chronic infections, tumors, autoimmune diseases.

Renal amyloidosis does not manifest itself for some time (3 years or more), then protein, erythrocytes and leukocytes begin to be lost in the urine, as a result, edema appears, the skin becomes pale. At the next stage, the protein is lost even more, because of this, the edema on the body also increases, and stops responding to diuretics. Blood pressure can be increased, normal, or decreased. Shortness of breath, dizziness, weakness develop; the work of the heart is disrupted, the amount of urine decreases.

With kidney tuberculosis

It can develop as a complication of pulmonary tuberculosis or without changes in the lungs. It manifests itself as weakness of varying degrees, an increase in temperature to low numbers, pain in the lower back, clouding of urine, in which blood is sometimes visible to the naked eye. If tuberculosis of the kidneys is complicated by tuberculosis of the bladder, the same symptoms are observed as with non-tuberculous cystitis.

Appendicitis

With appendicitis, when the inflamed appendix lies on the bladder, leading to reactive inflammation of the latter. By the way, appendicitis is not always acute, which is very difficult to miss. In some cases, the disease takes on a chronic course, manifested by periodic pains in the lower abdomen and on the right, which intensify with physical exertion; nausea, bloating; constipation or diarrhea.

For allergic diseases

With diabetic nephropathy

If a person has diabetes, he needs to monitor not only blood glucose levels, but also a general urine test. The appearance of leukocytes here indicates that due to the long-term maintenance of a high concentration of sugar, the vessels supplying the kidneys were damaged, due to which the tissue of the latter suffers. This is diabetic nephropathy.

With systemic lupus erythematosus, then this complication is called lupus nephritis

Systemic lupus erythematosus can be suspected by the appearance on the face of characteristic redness in the cheeks and nose bridge (resembles a butterfly), "strange" rises in temperature, muscle and headaches, hair loss in areas, brittle nails. The fact that nephritis has developed is indicated by edema that appears on the face, legs and feet, the appearance of lower back pain, and increased blood pressure.

With rheumatoid arthritis

In this case, the joints are affected first in various numbers and combinations. The joints on the hands are almost always affected. Kidney damage is manifested by edema on the face, legs, a decrease in the amount of urine, an increase in temperature.

With dehydration

Then there is either excessive sweating (including at high body temperature), or diarrhea, or blood loss, or the separation of large amounts of urine.

For diseases accompanied by severe intoxication

This is mainly infectious diseases: severe tonsillitis, pneumonia, leptospirosis.

Increased leukocytes in urine in women

In addition, leukocyturia in women develops due to "false" reasons, that is, associated not with the kidneys and not with the body as a whole, but with diseases of the female genital organs. This:

Vulvovaginitis(inflammation of the vagina and external genital organs), including candidiasis. It usually manifests itself as discomfort in the vulva and vagina, sometimes itching; discharge of various colors and nature appears from the vagina, which depends on the pathogen. So, with candidiasis (thrush), these are usually cheesy leucorrhoea.
Bartholinitis(inflammation of the Bartholin gland at the entrance to the vagina). The acute process is manifested by the appearance of edema and pain in the genital area, which intensifies when sitting, walking, intercourse, going to the toilet; it becomes extremely painful to touch one labia majora. Also, with acute bartholinitis, the body temperature rises to high numbers, weakness and chills appear. In chronic bartholinitis, periods of remission without symptoms are replaced by the appearance of a painful, indurated area in the labia majora, which is accompanied by pain when moving. Body temperature may rise, but - to low numbers.
Adnexitis- This is an inflammation of the uterine appendages, which can be both unilateral and bilateral. Acute adnexitis is difficult not to notice. This is pain on one side of the abdomen, radiating to the rectum and sacrum, fever, weakness, the appearance of purulent or profuse mucous discharge from the vagina. If the disease is not treated, it becomes chronic. Then menstrual irregularities come to the fore, periodically the same symptoms appear as in the acute process, but less pronounced.

An increase in leukocytes in the urine during pregnancy above 9-10 cells in the field of view cannot be a sign of the norm. It suggests that one of the pathological processes discussed above has appeared in the woman's body. Most often, pregnant women may develop cystitis (often exacerbated by chronic cystitis) or pyelonephritis. Both of these pathologies are associated with the fact that the urinary tract is compressed by the growing uterus, and stagnation of urine occurs in them.

Leukocytes in urine during pregnancy can also increase due to genital thrush, which often worries a woman due to the natural decrease in immunity for pregnancy. But the most formidable reason for such a change in the general analysis of urine is gestosis in the 2nd half of pregnancy, when the kidneys suffer from the fact that the body perceives the fetus as a foreign organism. In this case, not only leukocyturia is necessarily noted, but also an increase in protein in the urine. In this case, hospitalization in an obstetric hospital for further diagnosis and treatment is mandatory, since gestosis is dangerous to the life of both the mother and the child.

Elevated leukocytes in urine in men

If a man has more leukocytes in his urine than necessary, then in addition to the reasons listed above, characteristic of both sexes, it may be:

Prostatitis. When this is an acute process, it manifests itself as painful urination, while the pain is localized in the sacrum and perineum, and intensifies during bowel movements. The temperature rises, and with a far-reaching process, the outflow of urine becomes difficult, erectile function suffers. In chronic prostatitis, there may be only slight discomfort or mild pain when urinating; the temperature periodically rises to very low figures. Most often, the disease is asymptomatic.
Phimosis- clogging of the opening of the foreskin - it is difficult not to notice: in an erect state, the head is not completely exposed or cannot be exposed at all. In a severe stage, urination is also disturbed: urine first inflates the stuck together foreskin, and then, drop by drop, flows out of the formed "bag".
Balanoposthitis- inflammation of the skin covering the penis, usually extending to the glans. It manifests itself as painful sensations in this area, itching and burning, fever, discharge, increased libido due to irritation of the head, high body temperature.
Prostate adenoma does not appear for a long time - until the prostate enlarges enough to begin to block the outflow of urine. Later, its symptoms are a decrease and interruption of the urine stream, forced tension at the beginning of urination, which is later replaced by pain. When, due to compression of the enlarged prostate, the bladder stops emptying completely, the man is worried about the frequent and strong urge to urinate; you have to get up to use the toilet several times even at night. If complications join, blood appears in the urine, or urinary incontinence develops, or its complete retention.
Prostate cancer the symptoms do not differ from prostate adenoma. If a man does not undergo routine examinations by a urologist or ultrasound, and the cancer reaches the stage when metastases appear, pains in the bones or spine, cough (if metastases in the lungs), weakness and icteric staining of the skin (if metastases in the liver) appear.

Increased leukocytes in urine in children

When a child's urine contains more leukocytes than normal, these can be the same reasons as in adults, with the exception of processes such as prostatitis, adenoma and prostate cancer in boys. A rarity for childhood is amyloidosis, tumors (benign and malignant) and cysts of the urinary tract.

Each child's age is characterized by a different set of diseases accompanied by leukocyturia:

Up to a year some severe congenital malformations of the urinary tract, drug damage to the kidneys, vesicoureteral reflux (reflux of urine from the bladder into the ureters) begin to appear. Leukocyturia can also appear with diaper rash, as well as when a child has diathesis (in children with diathesis, the norm of leukocytes in urine is 2 cells more than in peers without this allergic disease). In girls at this age, vulvitis may already occur, then even with the naked eye, parents can notice redness and swelling in the area of the labia minora and the vestibule of the vagina.
When the child is a year old, leukocytes speak of enterobiasis (pinworms), inflammation in the urinary tract: urethritis, cystitis, vesicoureteral reflux, less often glomerulonephritis. In girls, this may be a sign of vulvitis.
Up to 3 years the main causes of leukocyturia are: enterobiasis, kidney injury, vesicoureteral reflux, urinary tract infections, including pyelonephritis. They, appearing for the first time at this age, often acquire a chronic course, and if improperly treated, they can be complicated by pyonephrosis. Phimosis debuts in boys at this age.
From 3 to 5 years old leukocyturia can mean enterobiasis, urolithiasis, urethritis or cystitis (more often), pyelonephritis (less often), kidney injury, glomerulonephritis. Girls have vulvitis, boys have balanoposthitis.
Age from 5 to 11 years old typical for urolithiasis, urinary tract infections, acute appendicitis, kidney injury, glomerulonephritis. If there was mild vesicoureteral reflux, then at 6-7 years old, on the contrary, it can heal on its own. At this age, enterobiasis can also occur, causing leukocyturia.
In children over 12 years of age the causes of leukocyturia can be all those diseases that are characteristic of adults. As already mentioned, with the exception of tumor diseases, diabetic nephropathy, amyloidosis.

What to do with an increase in leukocytes in urine

There is a special algorithm of actions that must be followed in order to establish the cause of leukocyturia:

Perform a thorough toilet of the external genitals as described in the section below, and only then have a general urine test again.
If in the second analysis it is the norm, doctors recommend not to calm down, but, by prior agreement with a nephrologist or urologist (especially if it concerns a child), to collect urine during the day for the Addis-Kakovsky test. Only if there is a norm, you can do nothing further.
If in the second urine analysis the number of leukocytes is again increased, even if it is a figure of 3-5 cells, 2 analyzes are needed: urine culture (for this urine must be surrendered after the hygiene of the genitals and necessarily in a sterile jar) and a three-glass sample. According to the bacterial culture data, it is possible to establish which pathogen caused the inflammation, and according to the three-glass test, to establish its localization.

The three-glass test is most often performed in a hospital, in order to avoid errors, but it can also be performed at home. It requires 3 identical clean containers, which are numbered accordingly: "1", "2", "3". After hygiene of the genitals, you need to start urinating, but do it so that very little urine gets into the first glass (1/5), in the second - the maximum amount (3/5), in the third - the last few drops (1/5 of the volume) ...

if the maximum number of these cells is in jar # 1, then this is urethritis, vaginitis or enterobiasis;
if the maximum number of leukocytes is in sample 3, then this indicates prostatitis or inflammation of the deeper tissues in the small pelvis;
if there are many cells in all three samples, then there is inflammation in either the kidneys or the bladder.

Moreover:

If, when carrying out a three-glass test, leukocytes are increased in all samples, an ultrasound of the kidneys and bladder is performed. Next, it is determined in which organ the inflammation is. If, according to the ultrasound, it is the bladder, an X-ray cystography is performed. If, according to ultrasound data, this is the bladder, you need to do urography or renoscintigraphy.
If, when carrying out a three-glass test, the maximum number of leukocytes is in the first portion, the following tests are needed: print for enterobiasis in persons of both sexes; for men, a smear from the urethra, and for women, a smear from the vagina. Both the one and the other smear must be sent to the bacteriological laboratory.
During a three-glass test or a separate study, it is necessary to determine the shape of leukocytes:
- if the majority of leukocytes are neutrophils, it says: about pyelonephritis, about cystitis, about urethritis, about acute glomerulonephritis, or about exacerbation of chronic glomerulonephritis. To distinguish pathologies, special staining with gencial violet and saffronin will partly help. It can detect Sternheimer-Malbin cells (active leukocytes). If there are many of them, this speaks in favor of pyelonephritis;
- if the majority are mononuclear cells... They are determined in the later stages of glomerulonephritis, as well as with insterstitial nephritis;
- when there are many eosinophils, then with a negative bacterial culture of urine, this is an excellent help to the doctor. So he learns that the cause of leukocyturia is allergic diseases;
- if the majority of cells are lymphocytes, this indicates lupus or rheumatoid nephritis, glomerulonephritis.

Before all these studies, you should not self-medicate: both antibiotics and alternative methods can be used only on the basis of an established diagnosis.

How to donate urine correctly

In order to prevent leukocytes from the genital tract from entering the urine, be it a child or an adult, he needs to prepare for the study. To do this, you need to buy a sterile jar for urine at the pharmacy, and for a baby - also a urine bag that is glued to the genitals (they are different for boys and girls).

The day before the test, exclude sorrel, game, chocolate from the diet, and red wine for adults. You also need to consult with your doctor whether it is possible to cancel Prednisolone, Dexamethasone, other hormonal or antibacterial drugs for 2-3 days before this laboratory test.

Immediately after waking up, you need to wash yourself with soap, and wash everything: inguinal folds, genitals, external anal sphincter with movements directed from front to back. Next, carefully open the lid of the can and collect the urine there. For a general analysis, not an average, but a full portion of urine is needed: at least 5 ml (in infants) and not more than 150 ml in adults.

Leukocytes in the urine of women are an alarming sign, signaling that unfavorable processes have begun in the body.

More often, this symptom indicates problems with the kidneys and the genitourinary system.

Read about the causes and symptoms of an increased level of leukocytes in urine in women, methods of treating diseases that caused an increase in their number, read this review.

What are they responsible for and how to find out their level

These white blood cells that protect the body from bacteria, viruses and pathogenic cells, are designed to identify and destroy the threat.

Leukocytes instantly react to the appearance foreign bodies, destroy them, but along the way they themselves perish, and then are excreted from the body, including with urine.

The result is an increase in the level of leukocytes in the urine, or leukocyturia.

Find out what is the level of leukocytes in the rest of the urine, it is possible only with special equipment.

Only urine analysis in a medical institution will unambiguously indicate on whether the level of leukocytes is increased, and by how many units.

Ideally, leukocytes are not found at all in the urine, but this happens only in 1% of women.

Therefore, in a normal woman, the level of leukocytes in the field of view during microscopic examination should be up to six.

If there are seven or more leukocytes in the field of view, then we are talking about leukocyturia.

When the white blood cell count exceeds 60 in the field of view, this condition is called pyuria, which indicates the presence of pus in the urine.

If the urine collection procedure is performed incorrectly (without observing hygiene rules), then the analysis may give inaccurate results. So the jar must be sterile, and before collection it is necessary to wash.

Factors

Leukocyturia and pyuria (an increased level of leukocytes in the urine in women) are caused by the following reasons:

Depending on the accompanying symptoms, it can be assumed what caused the leukocyturia or pyuria.

For instance, with kidney disease, severe cutting pains in the lower back, abdomen occur, and with genital infections - the corresponding vaginal discharge, itching.

It will not be possible on your own to reliably determine the cause that caused the increase in leukocytes, therefore medical examination is a mandatory procedure.

During pregnancy and after childbirth

White blood cell levels naturally rise slightly during pregnancy, since the body is rebuilding for the successful bearing of a child, and providing powerful protection against infections is one of the stages of this restructuring.

Therefore, in the urine of pregnant women the norm is the content of leukocytes within 10... If this number is exceeded, it is likely that inflammation has begun.

A significant excess of the norm of leukocytes in the urine of a woman during pregnancy may indicate the following diseases:

cystitis;
candidiasis (thrush), which often affects pregnant women;
pyelonephritis;
urolithiasis.

Often pregnancy causes an exacerbation chronic diseases, as well as the accelerated development of diseases that were not previously identified.

This is why doctors strongly advise planning a pregnancy. and in preparation for it, take all the necessary tests.

It should also be remembered that if the rules for collecting urine are violated, the analysis may show inadequately high rates.

In 90% of cases, the detection of elevated leukocytes in the analysis of urine in pregnant women is due to the fact that vaginal discharge gets into a jar of urine.

Therefore, the analysis is always repeated after two to three days. Immediately after childbirth, leukocyturia if it is not caused by pathological reasons, it goes away on its own.

Symptoms

There are not many symptoms of deviation, but they are obvious.... It is worth thinking about going to a doctor if one or more signs of leukocyturia are found:

the urine became dark, cloudy, with sediment (sometimes even flakes) and an unpleasant, pungent odor;
discomfort and / or pain in the lower abdomen and / or in the lumbar region;
the urge to urinate becomes more frequent;
there is a burning sensation, itching during urination;
body temperature rises;
pressure rises;
in some cases, an admixture of blood is observed in the urine.

The main criterion is a change in the state of urine, therefore, even if there are no other symptoms, it is necessary to see a doctor.

What is the danger

The main danger of leukocyturia and pyuria lies in the very diseases that cause such conditions.

An exceeded level of leukocytes in urine is a consequence of other, more formidable deviations.

High white blood cell counts are especially dangerous during pregnancy., since it threatens not only the health of the mother, but also the life of the baby, because some diseases characterized by leukocyturia or pyuria lead to miscarriage, premature birth, congenital diseases.

When and to which doctor to contact

If a woman has one or more signs of possible leukocyturia, you should urgently contact a doctor.

The first doctor that a woman will have to face at the stage of finding out the reasons for the deviation is therapist (for pregnant women - obstetrician-gynecologist).

He will examine the patient and send her for tests (in addition to urine analysis, blood sampling, smear, ultrasound may be needed), and based on their results, he will decide on the woman's further actions.

Different specialists can deal with the treatment of the underlying disease. If leukocyturia or pyuria are caused by kidney disease, then treatment will be taken nephrologist.

If the deviation is caused by diseases of the bladder, the issue will be dealt with urologist, and if inflammation occurs in the genitals - gynecologist.

Therapy and its features

The doctor chooses treatment based on the cause (disease) that caused the increase in leukocytes, and the individual characteristics of the woman.

If kidney or bladder disease is found, herbal anti-inflammatory drugs (usually Canephron N) and mild antibiotics (Amoxil) are prescribed for pregnant women to minimize possible harm to kid.

Also, diuretic and renal preparations, herbal teas can successfully complement the therapy.

If the woman is not pregnant then for get well soon she may be prescribed antibiotics (Tetracycline, Ceflox), which must be taken within a week.

The treatment is supplemented by diuretic pharmaceutical preparations and herbal preparations.

Diet

Nutrition with leukocyturia and pyuria is given increased attention, because the diet helps to quickly normalize the level of white blood cells in the urine.

The diet implies the implementation of the classic recommendations of nutritional therapy.

You need to exclude from the diet: