Microscopy Solutions for Urinalysis

Microscopy Solutions for Urinalysis

Observing Urine, Detecting Abnormalities

As clinical laboratory professional, you understand the critical role microscopic examination plays in analyzing urine samples for abnormalities. Microscopes can provide invaluable insights into the physical and chemical composition of urine, enabling you to come up with accurate diagnosis and treatment plans. Utilizing brightfield, phase and polarization contrast techniques, you examine urine sediment to detect cells, crystals, and other substances. This thorough examination allows to identify indications of various conditions, including diabetes mellitus, glomerulonephritis, and chronic urinary tract infections.

Urine is a key indicator for many diseases such as urinary tract infections, kidney disease and
diabetes. And, normally it’s easy to obtain. That’s why, the examination of urine is part of each clinical laboratory routine to analyze whether there are abnormalities.

After a visual analysis of color, smell and appearance of a fresh urine sample, usually a chemical analysis is performed using so called dipsticks. In case of abnormal findings on the visual or chemical analysis, a microscopic analysis is typically performed on urine sediment to visualize solid components such as blood cells, epithelial cells, microorganisms and pathogens.

Urine sediment is normally examined with a transmitted light microscope with brightfield or phase contrast. To visualize crystals, polarization contrast can be helpful, too. The sediment is first examined with low magnification to identify most crystals, casts, squamous cells, and other large objects. Next, examination is carried out at high magnification to identify crystals, cells, and bacteria.

Microscopy Solutions for Urinalysis

Microscope Requirements

Urine is traditionally examined with upright light microscopes. In general, brightfield microscopes are the instrument of choice. However, urinalysis guidelines also recommend the use of microscopes equipped with phase contrast and polarized light filters to identify urine particles like dysmorphic erythrocytes and casts (phase contrast) as well as lipids and crystals (polarized light). LED illumination increases the quality of sample visualization. Standard objectives for routine urinary sediment are a 10x for casts and a 40x for cells and other smaller structures, resulting in a 100x or 400x magnification (when used with 10x eyepieces). 400x is also fine to visualize bacteria. In order to get a more detailed observation of bacterial morphology, such as shape, size, and cellular structures, 1000x magnification can be helpful. However, at a higher magnification, it can be increasingly difficult to keep them in focus as they move.


Application Examples

Courtesy of J. Poloni
Crystals in urine, polarization contrast, Courtesy of J. Poloni
Courtesy of A. Michelsen
Erythrocyte, red blood cells showing thorn apple shape due to non-physiological pH-value of urine in brightfield
Courtesy of A. Michelsen
Fungus mycelium in brightfield
Phase contrast image of urine sediment

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