PRACTICUM III MICROSCOPIC EXAMINATION OF URINE 3.1 Urine sediment Practice : Sediment examination Microscopic examination is needed to observe cells and other particle-shaped objects. Many kinds of microscopic elements can be found, both those related to infection (bacteria, viruses) and those not due to infection, for example bleeding, endothelial dysfunction and kidney failure. Objective: to find the presence of organic and inorganic elements in urine sediment. Principle: urine contains residual elements resulting from metabolism in the body, Some of these elements are normally excreted in the urine, but some are excreted under certain circumstances. These elements can be separated from urine by centrifuging. The elements will precipitate and the precipitate can be seen under a microscope. Tools & Materials: - Test tube - Glass objects - Cover glass - Centrifuge - Urine sample - Microscope - Drop pipette Procedure: 1. Put 7-8 ml of urine into a centrifuge tube 2. Turn on the centrifuge at a speed of 1,500-2,000 rpm within 5 minutes 3. Discard the top liquid/supernatant until the sediment suspension remains 0.5 ml 4. Place 1 drop of urine on the glass object 5. The precipitate is first examined under a microscope at low magnification using a 10x objective lens, or called a small field of view (LPK) to identify large objects such as cylinders and crystals 6. Next, the examination is carried out with a 40x objective lens, or what is called a large field of view (LPB) to identify cells (erythrocytes, leukocytes, epithelium), yeast, bacteria, trichomonas, mucus filaments. 7. How to report a urine sediment examination: - Leukocytes and erythrocytes are reported as the average number per LPB with a 40x objective lens - Epithelium and cylinders are reported as the average number per LPK with a 10x objective lens - Other elements and crystals are reported per LPK with description - ( - ) = not present - ( + ) = present - ( ++ ) = many - ( +++ ) = a lot Normal value: - Erythrocytes 0 – 1 per LPB - Leukocytes 1 – 5 per LPB - Epithelium: negative - Cylinders: 0 – 1 per LPK - Crystals in urine are normal: - In acidic urine: uric acid, sodium urate, calcium sulfate In acidic/neutral/ - slightly alkaline urine: calcium oxalate, hippuric acid In alkaline/neutral/ - slightly acidic urine: triple phosphate, dicalcium phosphate - In alkaline urine: calcium carbonate, calcium phosphate, ammonium biurate