characteristics of urine
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CONTENTS…..PHYSICAL CHARACTERISTIC OF URINE COLOUR
ODOUR
TURBIDITY
PH
VOLUME
DENSITY ( Specific Gravity)
MAIN TERMS ASSOSIATED WITH URINE COMPOSITION
CHEMICAL COMPOSITION OF URINE
ABNORMAL CONSTITUENT OF URINE
•Urine is a liquid product of the body secreted by kidney Through the process is called urination ( micturition) Excreted through urethra
•Cellular metabolism generates numerous by product , (rich in nitrogen) that require clearence from the blood stream as urination
•Urination is the primary method for excreting water soluble chemicals from the body
•Human urine with human faecus are collectively called human waste
URINE
● 95% of volume of normal urine is due to waterOrganic components:● urea● urobilinogen● uric acid● creatinine● amino acids● metabolites of hormonesInorganic components:● cations: Na+, K+, Ca2+, NH4
+
● anions: Cl-, SO4 2-, HCO3
-, HPO4-
COMPOSITION OF URINE
PHYSICAL CHARACTERISTICS OF URINE
Color and transparencyClear, pale to deep yellow (due to urochrome)Concentrated urine has a deeper
yellow/amber colorA red or red-brown (abnormal) color could be
from a food dye, eating fresh beets, a drug, or the presence of either hemoglobin or myoglobin.
If the sample contained many red blood cells, it would be cloudy as well as red.
Turbidity or cloudiness may be caused by excessive cellular material or protein in the urine
Dark yellow urine is often indicative of hydration
Yellow ,orange colour is due to the removal of b vitamin
Orange urine is also form at certain medication such as rifamine
brown urine can be a symptoms of jaundice,rhabdomylosis or gilberts syndrome
Pinkish urine can result from the consumption of beet
Odor Fresh urine is slightly aromatic
Standing urine develops an ammonia odor
Some drugs and vegetables (asparagus) alter the usual odor
Elevated ketones smells fruity or acetone-like
Consumption of alchohol,saffron cofee,tunafis and onion can result in teltate scents…
PH -5.5 – 6.8
Acidic – meat food, diabetes mellitus, starvation, fever
Alkaline – plant food, cystitis, pyelitis
•Acidic urine contribute to the formation of stones of uric acid (kidneys,ureter,bladders)
•Diet with citrus ,vegetables and dairy product increase urine ph(more basic)
•Diet with meat,cranberries,druds, will decrease urine ph(more acidic)
Volume
•Average urine production in humanis about 1-2 L per day•Volume is depending on the state of hydration,activity level,environmental factor,and health of the individual
Density
• Density of the urine ranges between 1.003-1.035 g cm^-3
MAIN TERMS ASSOSIATED WITH URINE COMPOSITION
ANURIA : COMPLETE STOPPAGE OF URINE
OLIGURIA :REDUCED AMOUNT OF URINE
POLYURIA :INCREASED AMOUNT OF URINE
NOCTURIA :INCREASED AMOUNT OF URINE @ NIGHT
CHEMICAL COMPOSITION OF URINE
• Urine is 95% water and 5% solutes• Nitrogenous wastes include urea, uric
acid, and creatinine• Other normal solutes include:• Sodium, potassium, phosphate, and
sulfate ions• Calcium, magnesium, and
bicarbonate ions • Abnormally high concentrations of any
urinary constituents may indicate pathology
PRINCIPLE CONSTITUENT OF HUMAN URINEA.ORGANIC CONSTITUENTS
1.UREA :THE MOST ABUNDANT ORGANIC CONSTITUENT FORMED BY THE COMBINATION OF NH3 &CO22.URIC ACID : PRODUCT OF NUCLEIC ACID CATABOLISM.AND CRYSTALIZE AND CONTRIBUTES TO KIDNEY STONES.3.HIPPURIC ACID :FORMED FROM THE BENZOIC ACID OF DIETARY FRUITES.4.CREATININE : DERIVED FROM CREATINE.5.INDICAN :POTTTASSIUM SALT OF INDOLE. INDOLE IS FORMED IN LARGE INTESTINE BY THE PUTREFACTION OF PROTEIN.IN LIVER ,IT GET TRANSFORMED TO INDICAN.6.KETONE BODIES:ALSO CALLED ACETONE BODIES.NORMALLY FOUND IN SMALL AMOUNTS.BUT IN DIABETES AND ACUTE STARVATION,THEY APPEAR IN LARGE AMOUNTS.7.OTHER CONSTITUENTS:FOUND ONLY IN VERY SMALL AMOUNTS.INCLUDE CARBOHYDRATES,PIGMENTS,FATTY ACIDS,MUCIN, ENZYMES,HORMONES,ETC……….
B.INORGANIC CONSTITUENTS
1.WATER :THE MOST ABUNDANT OF ALL CONSTITUENT
2.NACL :PRINCIPLE INORGANIC SALT
3.K+,Ca+,Mg+ :OCCURS AS CHLORIDES,SULPHATES,AND PHOSPHATES
4.SO4-- :DERIVED FROM AMINOACIDS
5.PO4--- :OCCURS AS SODIUM COMPOUNDS
6.NH4+ :OCCURS AS AMMONIUM SALTS,DERIVED FROM PROTEIN CATABOLISM AND ALSO FROM GLUTAMINE
Urea is synthesized in the liver - it is transported by free diffusion through membrane
Ammonia is released from Gln - buffer function in the urine
Creatinine is a product of muscle metabolism-it is not reabsorbed by the tubules → creatinine clearance
Uric acid is a final product of endogenous and dietary purine degradation
Urobilinogen (UBG) is formed from bilirubin in a small intestine- can be oxidized to urobilin in urine.
N-containing compounds in urine
ABNORMAL COMPOSITION OF URINE
URINE AMOUNT URINE COLOUR URINE CINSISTENCY URINE ODOUR URINE STERILITY URINE PH URINE SPECIFIC GRAVITY URINE GLUCOSE URINE KETONE BODIES(acetone) BLOOD IN URINE BACTERIA IN URINECASTS CRYSTALS
Normal :1200-1500 mlAbnormal: Under 1200 ml Decreased fluid intake
Kidney failureAbnormal: Over 1500 ml
Diabetes Diuretics Increased fluid intake
URINE AMOUNT
Abnormal: • Dark amber
Insufficient fluid intake resulting in concentrated urine• CloudyInfectious process:
• Dark orangeDrugs (e.g., Pyridium)
• Red or dark brown:Disease process causing blood in urine
URINE COLOUR
Normal: Faint aromaticAbnormal: Offensive
Infectious process
URINE ODOUR•Foul smelling odour is a symptom of urinary tract infection
Normal: No microorganisms presentAbnormal: Microorganisms present
eg :Infection of the urinary tract
URINE STERILITY
Normal: 4.5 to 8Abnormal: Over 8
Urinary tract infection, metabolic / respiraory alkalosis, fanconis syndrome
Abnormal: Under 4.5Uncontrolled diabetes, starvation, dehydration, fever, phenyl ketonuria, alkaptonurea , acidosis
URINE – PH (4.6 -8.0)•Protein diet increase the acidity of urine ,vegetarian diet increases the alkalinity
Normal: 1.010 to 1.025Abnormal: Under 1.010
Eg :Diabetes insipidus, kidney disease, overhydration
Abnormal: Over 1.025Eg :Diabetes mellitus, underhydration, nephritic syndrome.
URINE-SPECIFIC GRAVITY
Normal: Not presentAbnormal: Present
Eg :Diabetic coma, starvation, prolonged vomiting
URINE KETONE BODIES (ACETONE)
• Red blood cell in blood can due to the vigourous exercise or exposure to toxic chemicals• High amount of WBC is a symptom of infection• Other symptoms of blood in urine due to bacterial infection, parasitic infection(malaria),scurvy, tumours•OTHER CELLS ARE ALSO FOUND IN URINE LIKE EPITHELIAL CELLS.
BLOOD IN URINE
Normal: Not presentAbnormal: Occult
Eg :Kidney diseaseAbnormal: Bright red
Eg :Hemorrhage
URINE -BLOOD
Microscopic Examination Pyuria: WBC in Urine
Normal:Men: <2 WBCs per hi power field
Women: <5
•WBC generally indicate the presence of an inflammatory process somewhere along the course of the urinary tract
BLOOD IN URINE -HEMATURIA
RBC's may appear normally shaped, swollen by dilute urine or crenated by concentrated urine.
The presence of dysmorphic (odd shaped) RBC's in urine suggests a glomerular disease such as a glomerulonephritis.
CRENATED
DYSMORPHIC
•Bacteria are common in urine specimens (from contamination)•Therefore, microbial organisms found in all but the most scrupulously collected urines should be interpreted in view of clinical symptoms.
BACTERIA IN URINE
A:CRENATED RBC B:RBCC:BACTERIA
• ↑ proteins → proteinuria (glomerulonephrititis, bacterial infection, pregnancy)
• 150 mg of proteins are excreted daily
● ↑ glucose → glycosuria (diabetes mellitus, emotion stress)
• renal threshold for Glc is around 10 mmol/L
• ↑ ketone bodies → ketonuria (starvation, diabetes, pregnancy)
• other pathological components: bilirubin, blood (ery, Hb),…
PATHOLOGICAL COMPONENT OF URINE
Urinary sediment = microscopic examination of urine
• examination of urinary sediment evaluates the presence and number of organ components – cells (ery, leu, epithelial cell, bacteria) and nonorgan components (crystals)
• crystals are mostly composed of calcium oxalate or calcium phosphate
• urate stones (from uric acid) - gout, acidic pH of urine
OXALATE CRYSTALS URIC ACID CRYSTALS
CAST
• Small fibrous object formed of protein & other material
•It settle in kidney tubules & collecting ducts
•Large number of cast in urine is a sign of kidney disease
Hyaline casts are composed primarily of a mucoprotein (Tamm-Horsfall protein) secreted by tubule cells.
Causes: Low flow rate, high salt concentration, and low pH, all of which favor protein denaturation and precipitation of the Tamm-Horsfall protein.
HYALINE CAST
Hyaline cast appear transparent
Red blood cells may stick together and form red blood cell casts. Indicative of glomerulonephritis, with leakage of RBC's from glomeruli, or severe tubular damage.
RED CELL CASTS
Usually indicates pyelonephritis (kidney infection)Other causes: Interstitial Nephritis (inflammation of the tubules and the spaces between the tubules and the glomeruli. )
WHITE CELLCASTS
oFormation is favored in alkaline urine.
oUrinary tract infection with urease producing bacteria (eg. Proteus vulgaris) can promote struvite crystals by raising urine pH and increasing free ammonia.
STRUVITE CRYSTAL
High uric acid in blood (by-product of purine digestion/high protein diet)Associated with gout (arthritis)
URIC ACID CRYSTALS
They can occur in urine of any pH. Causes: Dietary asparagus and ethylene glycol (antifreeze) intoxication
CALCICM OXALATE CRYSTALS
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