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QUALITATIVE ANALYSIS OF URINE
FOR ABNORMAL CONSTITUENTS
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
08/16/14 Biochemistry 3
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
08/16/14 Biochemistry 4
Composition of normal urine
Composition depends
on Kidney functions
• Glomerular filtration
•Tubular reabsorption
and
•Tubular secretion
08/16/14 Biochemistry 5
Composition of normal urine
08/16/14 Biochemistry 6
Organic constituents of urine
08/16/14 Biochemistry for medics- Lecture Notes 7
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
Inorganic constituents of urine
08/16/14 Biochemistry for medics- Lecture Notes 8
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
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
08/16/14 Biochemistry for medics- Lecture Notes 9
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
08/16/14 Biochemistry for medics- Lecture Notes 10
Variations in urinary color
08/16/14 Biochemistry for medics- Lecture Notes 11
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)
Variations in urinary color
08/16/14 Biochemistry for medics- Lecture Notes 12
Physical Examination of urine
08/16/14 Biochemistry for medics- Lecture Notes 13
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
Variations in volume of urine excreted
08/16/14 Biochemistry for medics- Lecture Notes 14
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
Variations in volume of urine excreted
08/16/14 Biochemistry for medics- Lecture Notes 15
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)
Variations in volume of urine excreted
08/16/14 Biochemistry for medics- Lecture Notes 16
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
Physical Examination of urine
08/16/14 Biochemistry for medics- Lecture Notes 17
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
Physical Examination of urine
08/16/14 Biochemistry for medics- Lecture Notes 18
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)
Physical Examination of urine
08/16/14 Biochemistry for medics- Lecture Notes 19
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
Measurement of urinary pH
Urinary pH is measured
by-
• pH papers
• Litmus papers
08/16/14 Biochemistry for medics- Lecture Notes 20
Tests for abnormal constituents of
urine
08/16/14 Biochemistry for medics- Lecture Notes 21
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.
Abnormal constituents of urine
08/16/14 Biochemistry for medics- Lecture Notes 22
• Reducing sugars
• Ketone bodies
• Proteins
• Blood
• Bile salt
• Bile pigments and
• Urobilinogen
Tests for abnormal constituents of
urine
08/16/14 Biochemistry for medics- Lecture Notes 23
• 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.
7/14/2021 24
7/14/2021 25
Negative
test
Positive
test
7/14/2021 26
7/14/2021 27
Control for
comparison
Positive
test
7/14/2021 28

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Urine analysis practical

  • 1.
  • 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 08/16/14 Biochemistry 3
  • 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 08/16/14 Biochemistry 4
  • 5. Composition of normal urine Composition depends on Kidney functions • Glomerular filtration •Tubular reabsorption and •Tubular secretion 08/16/14 Biochemistry 5
  • 6. Composition of normal urine 08/16/14 Biochemistry 6
  • 7. Organic constituents of urine 08/16/14 Biochemistry for medics- Lecture Notes 7 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 08/16/14 Biochemistry for medics- Lecture Notes 8 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 08/16/14 Biochemistry for medics- Lecture Notes 9
  • 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 08/16/14 Biochemistry for medics- Lecture Notes 10
  • 11. Variations in urinary color 08/16/14 Biochemistry for medics- Lecture Notes 11 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 08/16/14 Biochemistry for medics- Lecture Notes 12
  • 13. Physical Examination of urine 08/16/14 Biochemistry for medics- Lecture Notes 13 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 08/16/14 Biochemistry for medics- Lecture Notes 14 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 08/16/14 Biochemistry for medics- Lecture Notes 15 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 08/16/14 Biochemistry for medics- Lecture Notes 16 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 08/16/14 Biochemistry for medics- Lecture Notes 17 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 08/16/14 Biochemistry for medics- Lecture Notes 18 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 08/16/14 Biochemistry for medics- Lecture Notes 19 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 08/16/14 Biochemistry for medics- Lecture Notes 20
  • 21. Tests for abnormal constituents of urine 08/16/14 Biochemistry for medics- Lecture Notes 21 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 08/16/14 Biochemistry for medics- Lecture Notes 22 • Reducing sugars • Ketone bodies • Proteins • Blood • Bile salt • Bile pigments and • Urobilinogen
  • 23. Tests for abnormal constituents of urine 08/16/14 Biochemistry for medics- Lecture Notes 23 • 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.