The kidneys and bladder work together to make urine and remove it from our body.
The kidneys filter waste products and water from the blood to form urine.
The urine moves from the kidneys through tubes called ureters to the bladder, which stores the urine until it is full.
From the bladder, urine leaves the body through another thin tube, the urethra.
After the bladder starts to empty, it normally empties all of the urine.
Tests on urine provide information and clues to many diseases, and can also be indications of the condition of a patient's health.
A routine urine-screening test may be done to help find the cause for a number of different symptoms.
The kidneys remove waste material, minerals, fluids, and other substances from the blood for elimination through urine.
Therefore, urine can contain hundreds of different bodily waste products.
Many factors (such as diet, fluid intake, exercise, and kidney function) affect the constituents of urine.
WHY IT IS DONE???
A urine test may be done:
To check for a disease or infection of the urinary tract. Symptoms of a urine infection may include colored or bad-smelling urine, pain when urinating, hard to urinate, flank pain, blood in the urine (hematuria), or fever.
To check the treatment of conditions such as diabetes, kidney stones, a urinary tract infection (UTI), or some kidney or liver diseases.
As part of a regular physical examination.
STANDARD OPERATION PROCEDURE FOR URINE FEME
SAMPLE: Fresh Urine
MATERIAL REQUIRED: Urine Strip (10 parameters), 10mL sample tube, pasteur pipette, microscope slide, cover slip, microscope and urine analyzer (Urisys 1100 or Urisys 1800).
1) Put 10mL urine in urine tube
2) Dip 1 urine strip in urine
3) Wipe and put it in the reader and press start
4) Analyzer will read the strip and result will be printed out
5) Record result and proceed to spin urine at 1500rpm for 5 minutes.
1) Discard 9mL of urine and mix the remaining 1mL
2) Put 1 drop of urine on a microscope slide using a pasteur pipette and put a cover slip on it.
3) Examine urine slide with microscope at 40x magnification and report the observation per high power field.
URINE FULL EXAMINATION
A regular urinalysis often includes the following tests.
Many factors affect the color of urine, including fluid balance, diet, medications and disease.
Normal color – pale to dark yellow
The intensity of the color generally indicates the concentration of the urine; pale or colorless urine indicates that the urine is dilute, and deep yellow urine indicates that it is concentrated.
Vitamin B supplements can turn urine bright yellow. Reddish brown urine is usually caused by certain medications, eating blackberries or beets or by the presence of blood in urine.
Also called opacity or turbidity - determines the cloudiness of the urine.
Urine is normally clear, but bacteria, blood, sperm, crystals, or mucus can make urine appear cloudy.
Normal odor : Slightly "nutty" odor.
Some diseases cause a change in the normal odor of urine.
For example, an infection with E. coli bacteria can cause a foul odor while diabetes or starvation can cause a sweet, fruity odor.
Measures the amount of substances dissolved in the urine.
It also indicates how well the kidneys are able to adjust the amount of water in urine.
The higher the specific gravity, the more the solid material dissolved in the urine.
Normal SG : 1.005 – 1.025
When a person drinks a lot of liquids, the kidneys generally produce greater than normal amounts of dilute urine.
When a person drinks very little liquid, the kidneys generally make only small amounts of concentrated urine.
To measure of how acidic or alkaline the urine is.
Normal pH: 4.6 – 8.0
A high (alkaline) pH can be caused by severe vomiting, a kidney
disease, some UTIs, and asthma. A low (acidic)
pH may be caused by severe lung disease (emphysema),
uncontrolled diabetes, aspirin overdose, severe diarrhea,
dehydration, starvation or drinking too much alcohol.
Normally there is no protein in the urine (negative).
Sometimes a small amount of protein is released into the urine when a person stands up (this condition is called postural proteinuria).
Fever, strenuous exercise, normal pregnancy, and some diseases (especially kidney disease) may also cause protein in the urine.
Glucose is the type of sugar usually found in blood.
Normally there is very little or no glucose in urine.
However, when the blood sugar level is very high, as in uncontrolled diabetes, it spills over into the urine.
Glucose can also be present in urine when the kidneys are damaged or diseased, adrenal gland problem, liver damage, brain injury or certain types of poisoning.
Normal : no ketones (negative).
When fat is broken down for energy, the body produces by-products called ketones (or ketone bodies) and releases them into the urine.
Large amounts of ketones in the urine may signal a dangerous condition known as Diabetic Ketoacidosis.
A diet low in sugars and starches (carbohydrates), starvation, or prolonged vomiting may also cause ketones in the urine.
Normal : Negative
Substance formed by the breakdown of RBCs.
It is passed from the body in stool and should not found in urine.
If it is present, it often means the liver is damaged or that the flow of bile from the gallbladder is blocked.
Normal : Negative
Substance formed by the breakdown of bilirubin.
It is also passed from the body in stool and only small amounts of urobilinogen are found in urine.
Urobilinogen in urine can be a sign of liver disease (cirrhosis, hepatitis) that the flow of bile from the gallbladder is blocked.
Normal : Negative
Bacteria that cause a urinary tract infection (UTI) make an enzyme that changes urinary nitrates to nitrites.
Nitrites in urine show a UTI is present.
Leukocyte esterase (WBC esterase)
Normal : Negative
Leukocyte esterase shows leukocytes (WBCs) in the urine. WBCs in the urine may mean a UTI is present.
URINE MICROSCOPIC EXAMINATION
It will typically be done when there are abnormal findings on the physical or chemical examination and also to verify the results produced from the urine analyzers.
It is performed on urine sediment – urine that has been centrifuged to concentrate the substances in it at the bottom of a tube.
The fluid at the top of the tube is then discarded and the drops of fluid remaining are examined under a microscope.
In healthy people, the urine contains small numbers of cells and other formed elements from the entire urinary tract, and epithelial cells from the kidney, ureter , bladder, and urethra.
A microscopic examination of urine sediment detects the presence and amounts of red blood cells, white bloods cells, crystals, casts and bacteria or yeast.
Red Blood Cells (RBCs) Normally, a few RBCs are present in urine sediment (0-5 per hpf).
Inflammation, injury, or disease in the kidneys or elsewhere in the urinary tract can cause RBCs to leak out of the blood vessels into the urine.
RBCs can also be a contaminant due to an improper sample collection and blood from hemorrhoids or menstruation.
RBCs may appear normally shaped, swollen by dilute urine or crenated by concentrated urine.
Hematuria is the presence of abnormal numbers of red cells in urine due to: .... glomerular damage .... tumors which erode the urinary tract .... kidney trauma, .... urinary tract stones, .... upper and lower urinary tract infections, .... nephrotoxins, and physical stress
White Blood Cells (WBCs) The number of WBCs in urine sediment is normally low (0-5 per hpf).
When the number is high, it indicates an infection or inflammation somewhere in the urinary tract.
WBCs can also be a contaminant, such as those from vaginal secretions.
Epithelial Cells Normally, a few epithelial cells from the bladder (transitional epithelial cells) or from the external urethra (squamous epithelial cells) can be found in the urine sediment.
Cells from the kidney (kidney cells) are less common.
In urinary tract conditions such as infections, inflammation, and malignancies, more epithelial cells are present.