ABNORMAL CONSTITUENTS

2. QUALITATIVE ANALYSIS OF URINE
FOR ABNORMAL CONSTITUENTS

3. Introduction
• Urine is an excretory
product of the body
• It is formed in the
kidney
• Urine examination
helps in the diagnosis
of various renal as well
as systemic diseases
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4. Specimen collection
• For most of the routine
investigations fresh mid
stream specimen of 10-20 ml
urine is collected in a clean
dry vial
• In some cases 24 hour urine
sample is also collected
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5. Composition of normal urine
Composition depends
on Kidney functions
• Glomerular filtration
•Tubular reabsorption
and
•Tubular secretion
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6. Composition of normal urine
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7. Organic constituents of urine
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S.No. Constituent Concentration
1. Urea
(G/day)
25-30
2. Uric acid 0.5-0.8
3. Creatinine 1-1.8
4. Hippuric acid 0.7-0.8

8. Inorganic constituents of urine
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S.No. Constituent Concentration
1 Chlorides
(G/day)
10-15
2 Sodium 3-5
3 Potassium 2-2.5
4 Calcium 0.1-0.3
5 Phosphates 0.8-1.3
6 Sulphates 1.0-1.2
7 Ammonia 0.7-0.8

9. Physical Examination of urine
I) Colour- Freshly excreted urine
is colorless to straw colored
•
• The normal color of urine is
due to the presence of
pigment urochrome
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10. Variations in urinary color
S.No. Color Interpretation
1 Dark • Concentrated
yellow urine- Mild
dehydration
• Vitamin B complex
therapy
2 Orange Drug induced
3 Pinkish Excessive beet root
intake
A) Physiological Variations
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11. Variations in urinary color
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B) Pathological Variations
S.No. Color Interpretation
1 Deep yellow Jaundice
2 Reddish Haematuria
3 Brownish Hemoglobinuria, myoglobinuria and
porphyrias
4 Brown to black Alkaptonuria
5 Cloudy Pus cells and bacteria in infected cells
6 Smoky Red blood cells
7 Black Iron therapy
8 Pinkish brown Presence of urobilin – Hemolytic anemias
9 Milky white Chyluria(Presence of fat globules)

12. Variations in urinary color
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13. Physical Examination of urine
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II) Volume of urine- Normal volume-800-2,500 ml/day
with an average of 1500 ml/day.
Approximately 500 ml/day is the minimum volume of
urine needed in normal health to remove waste products
The volume of urine is affected by-
•Fluid intake
•Fluid loss
•Type of diet
•Cardio-vascular status and
•Renal functions

14. Variations in volume of urine excreted
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A) Polyuria- Polyuria implies an increased volume
of urine excreted per day, generally volume of urine
exceeding 2,500 ml/day is termed as Polyuria.
Conditions causing Polyuria
• Diabetes mellitus
• Diabetes Insipidus
• Late stage of chronic glomerulonephritis
•Drug induced- Diuretics
• Alcohol
• Compulsive polydipsia

15. Variations in volume of urine excreted
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B) Oliguria- Volume of urine less than 500 ml/day is
termed oliguria.
Conditions causing oliguria
• Fever
• Diarrhea (loss of fluid from extra renal sites)
• Severe edema
• Acute nephritis
• Early stage of acute glomerulonephritis
• Cardiac failure and hypertension (reduced
circulatory volume)

16. Variations in volume of urine excreted
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C) Anuria- Complete cessation of urine or volume
of excreted urine less than 100 ml/day.
Conditions causing Anuria
• Acute tubular necrosis
• Blood transfusion reaction
• Surgical shock
• Bilateral renal stones
• Sulphonamide therapy

17. Physical Examination of urine
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IV- Odor of urine
• Normal urine has an aromatic odor
• Variations
• Ammoniacal Odor- On keeping sample for a
long time
• Acetone like Odor- Ketonuria such as Diabetic
ketoacidosis or starvation
• Foul smell due to bacterial infections

18. Physical Examination of urine
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V) pH
Normal urine is acidic, pH ranges between 4.5-8.0 with
a mean of 6.0 in 24 hours
Variations of urinary pH
A)Acidic urine-
Physiologically, It is found after
•
•
A protein rich diet
Heavy exercise
Pathologically , It is found in conditions of acidosis,
such as diabetic ketoacidosis, respiratory acidosis,
and high fever (break down of tissue proteins)

19. Physical Examination of urine
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Variations of urinary pH
B) Alkaline pH
Physiologically it is found after
• Heavy meals
• Diet rich in citrus fruits
•Excessive intake of milk and antacids
Pathologically, it is found in-
• Urinary tract infections
• Conditions of alkalosis

20. Measurement of urinary pH
Urinary pH is measured
by-
• pH papers
• Litmus papers
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21. Tests for abnormal constituents of
urine
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Abnormal urine
Substances which are not present in easily
detectable amounts in urine of normal healthy
individuals but are present in urine under
certain diseased condition are said to be
“Abnormal” or “pathological” constituents of
urine.

22. Abnormal constituents of urine
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• Reducing sugars
• Ketone bodies
• Proteins
• Blood
• Bile salt
• Bile pigments and
• Urobilinogen

23. Tests for abnormal constituents of
urine
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• These constituents are present in normal
health but in very small amount and are not
detected by less sensitive laboratory methods.
• Under certain pathological conditions their
concentration is increased and these are get
detected . The urine is said to be ‘Abnormal ’,
under such conditions.

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Negative
test
Positive
test

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Control for
comparison
Positive
test

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