Urine analysis by Nechiporenko: what it shows and how to read the result

A referral for a Nechiporenko test often raises questions: why another urine test if a general one has already been done. The difference is that a general analysis shows whether there is protein, glucose, nitrites and cells in the urine, while the Nechiporenko test counts leukocytes, erythrocytes and casts per 1 milliliter. Below — what the numbers in the report mean and when to see a doctor with them.

What the Nechiporenko urine analysis is

The method was proposed by the Soviet physician A. Z. Nechiporenko (1916–1980). The idea is simple: the urine is centrifuged, the sediment is examined in a counting chamber and the cells are recalculated per 1 milliliter. This way you get not a "small amount" but a specific number — it can be compared with the norm and with a previous result.

A morning midstream portion is collected into a clean dry jar, at least 50–100 milliliters. There is nothing to be embarrassed about here: the laboratory sees urine every day, it is routine. Before collection, the external genitalia are washed.

• container — clean and dry;
• portion — midstream, morning;
• volume — from 50 to 100 milliliters;
• before collection — wash yourself.

In the report you will see three numbers per 1 milliliter.

Why the Nechiporenko analysis is prescribed and when to see a doctor

There are two indications. First — there are symptoms of urinary tract disease but the general urine analysis is normal: in this case the Nechiporenko test is prescribed. Second — the person has already had inflammation of the urinary system, and it is necessary to see whether the changes have resolved.

You should see a doctor if there is pain or burning during urination, urges more often than usual, including at night, urine is cloudy or bloody, there is pain in the lower abdomen or in the back under the ribs, fever has risen and there are chills.

What is assessed in the analysis: leukocytes, erythrocytes, casts

Leukocytes are immune cells; their number in urine rises when there is inflammation in the urinary tract. Erythrocytes are red blood cells; in a small amount they are acceptable (up to 1000 per 1 milliliter), an excess indicates an admixture of blood. Hyaline casts are casts of the renal tubules made of protein; they are counted to assess the condition of the kidneys.

Norms and interpretation of results

Reference points for adults: leukocytes — up to 2000 per 1 milliliter, erythrocytes — up to 1000 per 1 milliliter, hyaline casts — up to 20 per 1 milliliter. Ranges in different laboratories differ slightly, so the report is read together with the reference values of that particular laboratory. A single deviation by itself is not a diagnosis.

Elevated leukocytes in the Nechiporenko analysis: what it may mean

One of the possible causes is a urinary tract infection. Cells in the urine also appear in other conditions: kidney stones, kidney disease, poorly controlled diabetes, tumors of the bladder and kidneys. Therefore the number is a reason for examination, not a ready-made diagnosis. The doctor correlates it with symptoms and, if necessary, prescribes other examinations.

Elevated erythrocytes mean an admixture of blood. The causes are urinary tract infection, kidney stones, kidney disease, tumors of the bladder or kidneys; the doctor determines this.

Nechiporenko analysis in children and features of the result

Symptoms of infection in a child are not always obvious: high fever, lethargy, refusal to eat and drink, vomiting, wet bed. The result is interpreted by the doctor.

A bad test by itself is not a reason to call an ambulance; 103 or 112 — if confusion, drowsiness appear or it is difficult to speak.

The material is for reference: it explains the report but does not replace a doctor's consultation — the final reading of the result remains with the doctor.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer