2. Objectives:
• Spot the purpose of urine analysis.
• Recognize proper specimen collection, types of urine
samples.
• Identify the items of physical analysis (volume, color,
odor, aspect, PH, and specific gravity).
• Identify the items of chemical analysis by using urine
testing strips.
• Interpretation of the physical and chemical urine
analysis results.
• Characterize the following terms: proteinuria,
glycosuria, and ketonuria.
3. Why urine analysis?
• General evaluation of health
• Diagnosis of disease or disorders of the
kidneys or urinary tract
• Diagnosis of other systemic disease that
affect kidney function
• Monitoring of patients with diabetes
• Screening for drug abuse (eg.
Sulfonamide or aminoglycosides)
4. Collection of urine specimens
• Improper collection---- may
invalidate the results
• Containers for collection of urine should
be wide mouthed, clean, dry, tightly
covered, and sterile.
5. Types of urine sample
Sample type Sampling Purpose
Random specimen No specific time
most common, taken
anytime of day
Routine screening.
Morning sample First urine in the morning,
most concentrated
Pregnancy test, microscopic
examination
Clean catch midstream Discard first few ml, collect
the rest
Culture
24 hours All the urine passed during
the day and night and next
day Ist sample iscollected.
used for quantitative and
qualitative analysis of
substances
Postprandial 2 hours after meal Determine glucose in
diabetic monitoring
Supra-pubic aspired Needle aspiration Obtaining sterile urine
6. Urine analysis ;What to look for?
• It consists of the following
measurements:
1- Physical examination.
2- Chemical examination.
7. Physical examination of urine
Examination of physical
characteristics:
• Volume
• Color
• Aspect
• Odor
• pH
• Specific gravity
a reagent strip is used to measure pH and
specific gravity
8. Physical examination continued…
Normal: 750-2000 ml/day.
N.B: In random voided sample, volume can not
be assessed.
Oliguria: Urine Output < 500 ml/day
Seen in
Physiological: restricted fluid intake.
Pathological: dehydration.
Anuria: Urine output < 100ml/day.
Polyuria: Urine Output > 2000 ml/day
Seen in
– Increased water ingestion
– Diabetes mellitus.
V
olume
9. Physical examination continued…
Normal: Amber yellow in color due to pigments
urochrome pigment and urobilin.
The color of urine depends upon it’s
constituents:
• Pale, colorless: diluted urine.
• Deep Yellow: concentrated urine.
Color
11. Aspect - Normal urine is clear
- Turbid urine may be due to:
1- Pus (Urinary tract infection).
2- Excessive cellular material.
3- Protein.
4- Precipitation of non pathological salts.
12. Physical examination continued…
Odour• Normal - aromatic due to the volatile fatty
acids
• On long standing – ammonical
(decomposition of urea forming ammonia
which gives a strong ammonical smell)
• Offensive: pus (urinary tract infection).
• Fruity – Ketonuria (acetone).
13. Physical examination continued…
• Normally, urine is slightly acidic lying
between 5 – 6.
• Alkaline urine may be due to:
1- Eating fruits and vegetables.
2- Some drugs.
3- Bacterial infection.
pH
14. Physical examination continued…
reflects the ability of the kidney to
concentrate or dilute the urine.
Normal :1.015- 1.025.
Sp.Gr. = MW of Urine / MW of water
(1000).
Factors affecting:
1- Volume of urine.
2- Concentration of solutes in urine.
•It is measurement of urine density which
Specific
gravity
15. Chemical analysis of urine
• The chemical analysis of urine us
undertaken to evaluate the levels of the
following components:
– Protein
– Glucose
– Ketones
16. Principle of dipsticks:
• The presence of normal and
abnormal chemical elements in
the urine are detected using
dry reagent strips called
dipsticks.
• Strip consists of bands of many
reagants which change in color
in the presence of certain
substance.
17. • Abormal constituents of urine:
1) Protein:
Normal urine contains <150 mg/d of total protein.
Proteinuria may occur due to:-
• Physiological causes: often temporary proteinuria
due to stress, exercise, fever, aspirin therapy.
• Pathological causes: renal diseases.
18. 2) Glucose:
• Glucose is normally not present in urine.
• When glucose is present, the condition is called
glucosuria.
• Renal threshold for glucose = 180 mg %
19. 3) Ketones:
They are:
1- Acetoacetic acid.
2- β-hydroxybutyric acid.
3- Acetone.
Normal urine contains: 3 -15 mg / day.
It is present in urine in detectable or high level
in case of:
1- Diabetic ketoacidosis.
2- Sever stress or exercise.
