Urinalysis

600 to 2500 mL

The normal volume of urine per day

• Amount of water intake.

• External temperature.

• Individual mental and physical state.

• Diet.

Factors of affecting Urine Volume

Water intake

An increase in the amount of _ also increases the volume of urine

External temperature

The higher is the _, the lower is the urine produced.

Mental excitement

_ increases volume of urine.

Strenuous exercise

Decreases volume of urine due to excessive perspiration.

Diuretics

• Nitrogenous end products are _

• substances that stimulate the kidney causing an increase in the volume of urine excreted.

Diuresis

is the condition where there is an increased amount of urine excretion.

High protein

_ diet causes the increase in the production of urea is diuretic

Polyuria

A condition in which the volume of urine is above normal

Polyuria

• Pancreatic diabetes (diabetes mellitus)

• Diabetes insipidus.

• Certain nervous system disease

• During convalescence from acute diseases

• Upon ingestion of diuretics

Pancreatic diabetes (diabetes mellitus)

The increases amount of glucose in blood exerts a diuretic effect

Diabetes insipidus

The absence of anti-diuretic hormone vasopressin diminishes reabsorption in the tubules

Anuria

A condition where there is no urine secreted at all. The condition is observed with people suffering from acute glumerulonephitis, and poisoning by mercuric chloride.

Oliguria

The urine quantity is less than the normal. Most often, the condition results from the dehydration, cardiac insufficiency and fever.

Oliguria

• Acute nephritis

• Heart disease

• Vomiting

• Fever

• Diarrhea

Nocturia

• This is the tendency of an individual to void at night. This may not be due to pathologic condition.

• Passage of more than 500mL of urine with specific gravity below 1.018 during 12-hour period at night.

• May be encountered during early stage of diabetes mellitus

1.008 to 1.030

Specific gravity normal value

Specific gravity

• varies according to the concentration of solutes in urine

• This value can be used to estimate the amount of total dissolved solids in urine.

2.661

Long’s coefficient

Volume

Normally, the specific gravity is inversely proportional to _

High specific gravity

The _ in pancreatic diabetes is due to the high concentration of glucose present in urine.

• The amount of fluid intake

• Time of the day

• Pathologic condition (like diabetes mellitus)

Factors which may influence the specific gravity of urine.

Uriometer

A _ is a special type of hydrometer used to determine the specific gravity of urine

4.7 to 8.0

The pH of urine ranged from _ with an average of 6.0.

250 mL of 0.1 N acid

The titratable acidity of urine is equal to _ (meq of H+ ion)

Phosphates and sulfates

Protein foods like phosphoprotein, nucleoproteins, and phosphoglycerides increases the acidity due to the excess _ produces in its catabolism.

β-hydroxybutyric acid and acetoacetic acid

Acidity in high in diabetes mellitus as a result of large quantities of acetone bodies namely _

Alkaline

urine is due to the removal of HCl from blood which becomes _ during gastric digestion

Alkaline tide

• It is a temporary increase in alkalinity

• It is responsible for the feeling of well-being after a hearty meal.

Alkaline ash

Citrus fruits produces alkaline urine because of its _. Milk also produces alkaline

Oxidation

Vegetable food usually increases alkalinity because of the alkaline ash they give on _

Urea to ammonia and carbon dioxide

Urine becomes alkaline on standing due to conversion of _

Pale yellow to amber

The normal color of urine

Color

The lesser is the volume the more intense is the _.

• Urochrome

• Uroerythin

• Urophorphyrins

• Hematophorphyrin

• Riboflavin

The color is due to the presence of the these pigments

Yellow orange

Santonin

Reddish brown

Senna, rhubarb, cascara

Green

Methylene blue

Black

Carbolic Acid poisoning

• Green (Bile Pigments)

• Deep Yellow

• Brown

Liver Disease

Fever

Dark yellow/Brownish

Reddish

Internal Hemorrhage

On standing

• Develop a could or nebucula composed of mucoid or nucleoprotein, together with some epithelial cells from the lining of the genitourinary tract

• May become alkaline due to the decomposition of urea to ammonia and carbon dioxide which allows the calcium phosphate and ammonium magnesium phosphate to precipitate

Acidic urine

allows the precipitation of uric acid salts like urates, and oxalates which are pink in color.

Pathologic urine

The presence of fat globules or pus cells which is an indication of infection in the urinary tract is observed

• Volatile organic acids

• Urinod (Substance of unknown structure)

Freshly voided urine has an aromatic odor due to the presence of

Putrefaction

When it is strongly ammoniacal or putrid, it is indicative of some _ that has taken place.

Fruity odor

In pathological condition, the presence of acetone bodies gives characteristics _, which is of diagnostic value in acidosis

Asparagus

Unpleasant odor of methylmercaptan (CH3SH) is eliminated in the urine after ingestion of _

Oil wintergreen

Methylsalicylate rub gives the odor of _

NaCl

Normally, urine has a salty taste because of the presence of _

Glucose

In diabetes, the urine is sweet due to the presence of _

Urea

• It is the most important nitrogenous constituent of urine.

• Eighty percent (80%) to ninety (90%) percent of nitrogen in urine is in this form.

• It is the principal end product of protein metabolism.

• It is a direct function of the total nitrogen intake.

12-36g

The amount of urea in urine is in the range of _ per day for 70kg adult.

Protein

Excretion of urea is directly related to _ excretion. Urea is said to be diuretic. As the _ ingestion increases, urea concentration increases, the volume of urine also increases

Protein metabolism

The amount of urea increases when the rate of _ increase due to fever, diabetes, or excess adrenocortical activity.

Acidosis

The amount of urea decreases during _, where the nitrogen is utilized on the formation of ammonia that will neutralize the acidity

0.5 to 0.6g

The amount of uric acid in urine rarely decreases below _, even in purine free diet.

Nucleoproteins

The amount can reach up to 1g/day with a diet rich in _ such as glandular meats.

0.7g/day

For a usual American diet, uric acid excretion is about - on the average

Uric Acid

This is the most important end product of oxidation of purine in the body. IT could be derived from the breakdown of dietary cellular nucleoprotein.

Uric Acid

• slightly soluble in water, but form soluble salts with alkali

• Precipitates readily from acid urine on standing (as red uric acid salts or urates).

• They may also crystallize in the kidney to form stones.

• not diuretics

• Certain drugs

• Disintegration of nuclear materials

• Hepatitis

• Polycythemia

Uric Acid excretion may increase in

Gout

Uric acid excretion may decrease in

ALLANTOIN

It is derived from partial oxidation of uric acid. It is present in human urine at a very low concentration but high in subprimate animals where it is the principal end product of purine metabolism.

HIPPURIC ACID

It is a combination of glycine and benzoic acid. It results from benzoic acid ingested as such or arising from compounds in the food containing aromatic nuclei