Microscopic Examination

Microscopic examination of urine sediment is an important part of general urinalysis, allowing detection and quantitative assessment of formed elements and other components that are insoluble in urine and settle after centrifugation. The study is performed on freshly collected morning urine, which is centrifuged to separate the sediment. During microscopy, the following elements are evaluated:

• Erythrocytes – red blood cells; their presence may indicate urinary tract damage, inflammation, trauma, or kidney diseases.
• Leukocytes – white blood cells; increased numbers indicate inflammatory or infectious processes.
• Epithelial cells – cells lining the urinary tract; moderate amounts are normal, large amounts may indicate inflammation or mucosal damage.
• Casts – proteinaceous clumps formed in the renal tubules; their type and quantity help diagnose kidney diseases (e.g., hyaline, granular, waxy casts).
• Crystals – salts precipitated in sediment; their type and amount help assess the risk of urolithiasis and metabolic disorders.
• Bacteria and fungi – indicate possible urinary tract infection.
• Mucus – may be present with inflammation or irritation of the mucous membrane.

Urine sediment microscopy helps detect hidden pathologies such as infections, inflammations, metabolic disorders, and kidney diseases. For more precise quantitative determination of formed elements, methods such as Nechiporenko and Amburge are used, as well as modern automated analyzers with high sensitivity. Proper collection and timely examination of urine (within 1.5 hours after collection) are mandatory conditions for reliable results. Microscopic urine examination often complements physicochemical analysis and helps the physician make an accurate diagnosis and prescribe effective treatment.