When The Urinary System Doesn’t Work Right: Urine Tests, Urinary Tract Infections and Kidney Stones.

This is the second post in a two part series. To learn how the healthy urinary system works check out Part 1 (How and Why Does Your Body Create Urine?)

Urinalysis (UA) Test

“Okay, we are going to need a urine sample!” This is always such a fun thing to hear when you visit the doctor’s office, am I right? It really does give your healthcare team a great idea of how your urinary tract is functioning though.

This test is usually performed by having the patient pee into a cup. Most of the time you will be asked to provide what is called a “clean catch” sample of urine. The goal of this method is to prevent germs from outside of your urinary tract from getting into the sample. To do this you will first wash your hands and then you will use the little sterile wipes that they provide you to clean the outside of your body around your urethra. You will then begin to pee into the toilet. Now comes the fun part, after you have peed a bit into the toilet you will now begin to collect urine in the cup they gave you. Once you have an ounce or two in the cup you can finish peeing into the toilet. By cleaning your genitals prior to taking the sample and then letting the first part of your urine go into the toilet you are collecting a “clean” sample of urine to ensure that the germs that are found in the sample are actually from your urinary tract and not what was hanging around just outside of your urethra.

Once your healthcare team gets your sample they have a few options. They can look at it right there in the clinic and it can tell them some valuable information. The appearance of your urine can help determine if your body is healthy. They can also use a tool called a “dipstick.” This has several strips that will change color based on the substances that it comes into contact with. This can help your provider to determine if your urine sample has sugar, protein or signs of inflammation that shouldn’t be in your urine. For further testing they can look at your sample under a microscope or conduct what is called a urine culture. This is an additional test that they can use your original urine sample for. A portion of your urine sample will be allowed to “grow” bacteria in a lab setting so that they can determine more information about your infection and what the best treatment for you will be.

Urinary Tract Infections

The most common type of urinary tract infection or UTI is one that has infected the bladder. These infections happen when bacteria from outside of your body enters through your urethra. The bladder is the first stop in your urinary tract so you will often see symptoms here first. If the UTI is not caught when it is in the bladder it can continue to travel up your urinary tract and cause a kidney infection. While these are not as common, they are more serious than a bladder infection as the infection is now at risk of entering your bloodstream.

I would like to stress that in children and older adults the symptoms of UTI can look a little bit different. This is why staying in communication with your primary healthcare team is so important and can help you to catch things before they become a bigger problem. For instance in an older adult confusion, fatigue and fever may be the first signs you see that clue you into the fact that they actually have a UTI.

kidney stones

We have all heard the term but what is the actual “stone”? Your urine naturally has chemicals in it and a few of these chemicals can be responsible for forming the “stone.” When you end up with too little fluid and too much of a chemical in your urinary tract it can begin to form crystals. Unless these crystals are “flushed” from your urinary tract they will continue to grow as they attract more waste products and chemicals and that is when you start to have problems. As the “stone” becomes larger it will begin to block the flow of urine from wherever it is located, it could be in the kidney or in one of your ureters. This is when you would normally start to feel the uncomfortable symptoms of having a kidney stone.

If you catch the stone while it is still small you may be able to take pain medication and “flush” it out by drinking alot of fluid. If the stone has become too large to pass through your urinary tract your healthcare team will need to help you by “breaking up” the stone. They can do this either by Lithotripsy, which uses shock waves to break up the stone, or by Ureteroscopy, where a tube is inserted into your ureter to help either remove or break up the stone.

kidney disease

Chronic Kidney Disease, also known as Chronic Renal Disease, is a disease that gets worse over time as a person’s kidneys lose more and more of their function. The kidneys play an incredibly important role in removing waste and maintaining healthy fluid and electrolyte levels for your body. If your kidneys are no longer functioning properly you can become very sick. Over time as waste and fluid builds up in your body other systems begin to be affected such as your vascular system (your arteries and veins) and your heart.

There are two main causes of kidney disease. The first is diabetes. When a person has diabetes they have an increased amount of sugar in their blood stream. If this isn’t controlled it can cause “wear and tear” on many of the body’s organs, but especially the kidneys. As the kidneys main job is to filter the blood, the small parts of the kidney are constantly coming into contact with the extra sugar particles in the person’s blood. Over time, these particles can cause wear to the small vessels so that they are no longer able to filter out waste or maintain fluid and electrolyte balances properly. A second main cause of kidney disease is high blood pressure. Like diabetes, the high pressure causes “wear and tear” on a person’s vessels over time. The eventual damage also causes the vessels to no longer be able to filter waste or maintain fluid and electrolyte balances properly.

When kidney disease gets too bad it can turn into kidney failure. Once this happens, a person will need either dialysis or a kidney transplant to survive. When a person’s kidneys are no longer able to filter out waste on their own, they will need the assistance of Dialysis. This is mainly done by a dialysis machine that can help your body by removing excess waste products and fluid from your blood to help keep your body in a functioning state.