Urinalysis in Children - An Insight

What Is Urinalysis in Children?

Pediatric urinalysis is a diagnostic procedure that analyzes a child's urine sample. It is a crucial part of pediatric healthcare and is frequently carried out to evaluate the urinary system's general health and identify different diseases or anomalies of the urinary tract.

The urine sample is normally assessed for several factors during a urinalysis, such as:

• Physical Attributes: This involves evaluating the urine's color, transparency, and smell. Deviations from these traits could point to underlying medical conditions.

• Chemical Composition: Urine is tested chemically to see if it contains glucose, protein, ketones, bilirubin, or blood. These examinations can illuminate illnesses like renal disease, diabetes, and urinary tract infections.

What Are the Various Types of Urine Sample Acquisition?

The process of obtaining a urine sample from a person for diagnostic or medical testing is called urine sample acquisition. The patient usually provides a urine sample in a sterile container during this process. The sample is then examined in a laboratory to determine the presence of specific substances (e.g., drugs, proteins, or metabolites), diagnose medical conditions (e.g., kidney diseases, urinary tract infections), or track treatment efficacy. The collection of urine samples can occur in various settings, including homes, clinics, or other locations, based on the particular needs of the test or inquiry being carried out.

• Midstream Urine: Urine from a child with urinary continence can be collected from midstream urine. Urine contaminated with periurethral organisms and leukocytes can be reduced by washing the genitalia and perineum with soap and water before voiding.

• Urine Collection Bag: After inspecting, cleaning, and drying the genitalia, a self-adhesive urine collection bag is firmly affixed. After receiving fluids, the child should ideally urinate, and the urine sample should be processed immediately. Bag urine is not good for culture since contamination often yields false-positive results.

• Urine Sample From a Catheter: A female infant or toddler can have a urine sample suitable for culture collected via a one-time catheterization (not from an indwelling bladder catheter).

• Suprapubic Bladder Puncture: If pyelonephritis is suspected, especially in a newborn, this straightforward (albeit infrequently used) and noninvasive method of collecting a urine sample is advised. When bag urine is expected to be polluted, vesical puncture is advised.

How Is the Collected Urine Analyzed?

Urine collection is commonly indicated for the assessment of fluid and electrolyte excretion, the evaluation of proteinuria, and the estimation of endogenous creatinine clearance. Rather than the total amount of time spent collecting urine, the precision of the test is the primary factor determining its validity. Urine needs to be collected in a sterile container and kept cold. The final spontaneous voiding before collection is thought to be the beginning of the collection, and the last collected voiding is thought to be the end. Ten to twenty milliliters of the mixed urine samples are tested, and the time and total amount of urine collection are recorded.

What Are the Various Medical Conditions Diagnosed in Urinalysis?

Isolated Leukocyturia: When white blood cells (leukocytes) or bacteria are found in the urine without any further urinary tract infection (UTI) signs or symptoms, the condition is known as isolated leukocyturia or bacteriuria. Leukocytes or bacteria in the urine may or may not be a conclusive sign of a urinary tract infection.

In addition to urinary tract infections, kidney stones, inflammation of the urinary system, and other non-infectious diseases can also cause isolated leukocyturia. Similarly, non-infectious factors such as urinary tract colonization leading to no infection or contamination during urine sample collection might result in isolated bacteriuria.

Bacteriuria: It describes the existence of bacteria in urine. Although urinary tract infections (UTIs) are frequently linked to bacteriuria, they can also happen in other situations. Numerous routes exist for bacteria to reach the urinary tract: they can spread hematogenously, climb from the urethra, or even get contaminated when a urine sample is collected.

There are two types of bacteriuria:

• Asymptomatic: When bacteria are found in the urine but do not produce any signs of an infection of the urinary tract, this condition is known as asymptomatic bacteriuria. Asymptomatic bacteriuria is not uncommon, especially among some groups of people, like the elderly and those who have indwelling urinary catheters.

• Symptomatic: When there are signs of a urinary tract infection, such as fever, urgency, frequency, or dysuria (painful urination), the condition is referred to as symptomatic bacteriuria.

Proteinuria: One sign of tubular or glomerular dysfunction is proteinuria or increased protein excretion in the urine. School-age children are evaluated using a midstream urine sample; for infants and toddlers, it is based on a bagged urine sample. A urine sample taken during the day and the early morning urine is used to diagnose orthostatic proteinuria.

Haematuria: Children can experience hematuria or blood in the urine in the same way as adults can. Parents may find this concerning, but it's crucial to know that there are several possible causes for children's hematuria, some of which may be harmless and others of which may call for medical intervention.

The following are some typical reasons why children get hematuria:

• Urinary tract infections (UTIs): Hematuria can result from infections of the bladder, kidneys, or urinary tract. Children, especially girls, are comparatively susceptible to UTIs.

• Trauma: Hematuria may result from wounds to the kidneys, bladder, or urethra. Sports injuries, falls, and accidents could all lead to this.

• Urinary Stones: Hematuria can result from urinary tract irritation and bleeding caused by kidney or bladder stones.

Conclusion

A child's urinalysis is an invaluable diagnostic tool that offers crucial information about the health of their urinary system. By analyzing urine samples, healthcare professionals can identify several anomalies, including kidney illnesses, urinary tract infections, structural anomalies, and other underlying problems. Certain substances, such as proteins, bacteria, or blood cells, can be signs of possible health problems that need to be looked into further and treated appropriately if found in the urine.

Early detection and intervention are essential for children to have the best possible urinary tract health and general well-being. Consequently, routine urinalysis, in addition to clinical examination, is essential for detecting and treating probable urinary tract abnormalities in pediatric patients.