2. INTRODUCTION
•
•
Normal urine is pale yellow or straw in colour .
Normal urine is acidic in nature. Normal urine
has aromatic odour.
• Normal urine contains organic constituents
like urea, uric acid and creatinine.
• Normal urine contains inorganic constituents
like chloride, sulphate, phosphate and
calcium.
3. •
•
Urine is the excretory waste product
formed by kidneys
It reflects the overall metabolic and kidney
functions of the body .
4. URINE ANALYSIS
•
•
•
A complete analysis of urine includes the
following
Bacteriological analysis
it is done by microbiologists to identify
the infecting organism by culture.
Microscopic analysis
it is done to detect the presence of pus
cells,rbc casts etc
5. • BIOCHEMICAL ANALYSIS
(a) Routine qualitative examination for
detecting pathological variations in
physical properties and presence of
abnormal constituents .
(b) Quantitative estimation of many
biochemical constituents like proteins ,
creatinine ,calcium etc.
6. URINE SAMPLE
•
•
Mid stream morning sample
TO collect the sample the patient is advised to
discard the initial part of the first voided urine
in the morning after getting up and then to
collect 15 – 20 ml of mid stream of urine flow
in container
It should be immediately analysed or within a
few hours of collection and should be
refrigerated in the meantime .
7. •
•
•
24-hour Urinary sample
The sample is collected for 24 hours
from the time after discarding the first
morning sample
A preservative is added while collecting
the sample .
Commonly such a sample is used for
quantitative estimation of different
constituents e.g. creatinine , proteins ,
calcium etc
8. •
•
•
Random urine sample
This sample is collected on the spot at
any time of the day .
It has limited utility and generally used for
detection of glucose , ketone bodies and
proteins.
9. URINARY PRESERVATIVES
•
•
•
Concentrated HCL
10 ml concentrated HCL is adequate for
a 24-hour specimen
It is suitable for urea ammonia,protein,
nitrogen and calcium estimations
No preservative is needed for immediate
analysis of spot urine sample.
10. • Thymol
5ml of 100g/L solution is isopropanal is
suitable for estimation of sodium ,
potassium , chloride , bicarbonate ,
calcium , phosphorus ,urea ,amino acids
creatinine ,protein , etc
11. TYPES OF URINE ANALYSIS
•
•
Normal constituents of urine
Abnormal constituents of urine
14. VOLUME
Average urine output is 800mL to 2.5L
per day,depending upon the water intake.
Changes in volume of urine are called-
Polyuria 2.5L/day
Oliguria 300mL/ day
Anuria - No urine output in 24 hours.
15. • COLOUR
Normal urine is light yellow or straw
coloured.
APPEARANCE
Normal urine is clear transparent without
any turbidity or sediment.
SPECIFIC GRAVITY
It is normaly between 1.010 to 1.025
16. • pH–Normal urine is acidic
Normal pH is between 4.7 to 8.0
Average 6.0 .
ODOUR
Normal urine has a slight ammonia like odour
Commonly seen variations are –
FRUITY in ketoacidosis due to acetone.
FOUL smell in infection by bacteria.
MOUSY smell in phenylketonuria .
17. CHEMICAL COMPOSITION
•Normal urine contains both organic
inorganic constituents.
•Inorganic constituent includes
sodium
potassium
Calcium
magnesium
19. TESTS FOR ORGANIC
CONSTITUENTS
•
•
•
A. TEST FOR UREA (Sodium hypobromite
test)
B. Test for uric acid (phosphotungstic test)
C. Test for Creatinine(picric acid test /
Jaffe’s Test )
20. UREA
•
•
•
•
•
Main product of protein metabolis.
Soluble in water.
Produced in liver.
Normally 20-30mg/day of urea is excreted
from the body .
Increased urinary urea is seen in the high
protein diet ,excessive tissue breakdown ,
high fever severe wasting diseases.
21. • Decrease urinary urea is seen in the renal
failure ,low protein diet ,severe hepatic
insufficiency.
22. Sodium Hypobromite Test
TEST OBSERVATION INFRENCE
S
To 2 ml of urea solution in a
test tube,
Add 5 drops of sodium
hypobromite.
Brisk effervescence of
Nitrogen gas is observed
Urea is Confirmed.
Normal Urine Contains Urea
23. URIC ACID
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•
•
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End product of purine metabolism.
Uric acid is a reducing agent in alkaline
condition. it reduces phosphotungstic
acid to tungsten blue.
Normal uric acid
FEMALE 2.4-6.0 mg/dL .
MALE 3.4-7.0 mg/dl
24. PHOSOHOTUNGSTIC TEST
TEST
OBSERVATI
ON
INFRENCE
To 2 ml of uric acid solution,
add few drops of
phosphotungstic acid and
few drop of 20% sodium
carbonate
Blue colour is obtained Uric acid is confirmed.
Normal urine contains uric
acid
25. CREATININE
•
•
•
It is the waste product produced by
muscle metabolism
NORMAL RANGE 0.12 TO 1.8gm/day
ABNORMAL EXCRETION
Kidney disease
Kidney infection
Kidney failure
urinary tract obstruction
27. Jaffe’s Test
TEST OBSERVATION INFRENCES
Take 5 ml of urine sample
add 2 ml of saturatetd picric
acid solution and a few drop
of 10% NaoH
Orange colour is obtained Creatinine is Confirmed.
Normal Urine Contains
Creatinine.
29. CHLORIDE
•
•
Normal excretion 10 to 15gm/day
Decrease excretion
Diarrhoea
vomiting
edema
cirrhosis of liver addison disease
Increase excrition
addision disease
30. Test for chloride
•
•
•Reagent Required: - concentrated HNO3 (nitric acid)
5% AgNo3(silver nitrate) solution.
•Reaction: -Chloride present in urine react with
silver nitrate to form white ppt of silver chloride.
31. TEST OBSERVATION INFRENCES
Take 2 ml of Urine sample
and add few drops of conc.
Nitric acid.
And then 2ml of silver
nitrate solution
Mix it well and observe.
White precipitate is
obtained.
Normal urine contains
chloride.
32. Test for Sulphates
•
•
•
Sources of urinary sulphate are sulphur containing
amino acids,vitamins and lipids
Normal excretion 1 to 1.2gm/day
Decreased condition
various renal diseases
Increased condition
intake of high protein diet
excesive tissue break down
jaundice
cyanide poisoning
33. •
•
Reagent Required: - Barium chloride
concentrated HCL.
•Reaction: - Sulphate present in urine
reacts with barium chloride solution to
form white precipitate of barium sulphate.
34. TEST OBSERVATI
ON
INFERENCES
3 ml Urine sample
+ 2/3drops of
concentrated Hcl
+ 2-3 ml of
Barium Chloride .
Mix it well and
observe.
White precipitate
is
obtained.
Nor
mal urine contains
sulphate.
35. Test for Phosphate
The sources of urinary phosphate are breakdown of
phospholipids, nucleoprotein and phosphoprotein
Normal excretion
0.8 to 1.3 gm/day
Decreased excretion
Hypoparathyroidism , diarrhoea vomiting
nephritis and infection
Increased condition
Rickets osteomalacia Hyperparathyroidism
acidosis
36. TEST OBSERVATIO
N
INFERENCE
S
3conc ml Urine
sample + 5 drops.
HNO3.
Add 3 ml of
ammonium
molybdate and
heat it.
Yellow colour of
ppt is seen.
Phosphate is
confirmed.
Therefore normal
urine contains
phosphate
37. TEST FOR AMMONIA
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•
Normal excrition 0.7 to 0.8 gm/day
Decreased condition
Alkolosis Nephritis
Increased condition
Diabetes and Ketoacidosis
38. TEST OBSERVATIO
N
INFRENCES
To 5 ml of the
urine sample, add
2 ml sodium
carbonate till the
solution is
alkaline to litmus .
Boil the solution
place of
moistered red
Note the change
in colour to blue .
Ammonia is
present.
Therefore
normal urine
contains
Ammonia.
39. TEST FOR CALCIUM
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•
Normal excretion 0.1 to 0.3 gm/day
Decreased condition
Hypoparathyrodisum hypovitaminnosis
D and alkalosis
Increased condition
Hyperparathyrodisum Hypervitaminosis D ,
renal failure and acidosis
40. TEST OBSERVATIO
N
INFRENCES
Take 5ml Urine +
5 drops of 1%
acetic acid + 5 ml
of potassium
oxalate
Trace amount of
White precipitate
of calcium
oxalate is
obtained.
Calcium is
present.
Therefore
normal urine
contains
Calcium.
42. TURBIDITY
•
1.
2.
3.
Turbidity could be due to presence of
Pus cells like in infections
Fat globules like chyluria or nephrotic
syndrome
Phosphates precipitation
43. SPECIFIC GRAVITY
•
•
Normal specific gravity is between 1.010
to 1.025 But In diabetes insipidus ,it is low
and fixed usually below 1.010.
ISOTHENURIA
Watery urine with specific gravity less
than 1.010 is called isothenuria . It is seen
in chronic renal failure and Diabetes
insipidus.
44. •
1.
2.
3.
Common causes of increase of specific
gravity
Diabetes mellitus due to glucosuria
Nephrotic syndrome due to albuminuria
Dehydration leading to oliguria
45. ABNORMALITIES
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•
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•
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Changes in urine colour and their
significance.
Dark yellow colour Jaundice
Reddish brown _ Haemoglobinuria
commonly seen after hemolysis
Bright red due to blood (haematuria)
Stones anywhere in urinary tract
Injury e.g. urethral rupture
Cancers of urinary system
Dark amber colour _ Vitamin B complex therapy
46. Common causes of oliguria and
anuria
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OLIGURIA (Urine volume 300mL/day)is
more common than anuria .Volume
depletion leading to decreased renal blood
flow causes oliguria which is seen in
following condition
Shock
After excessive blood loss like in accident
victim
After excessive vomiting like in intestinal
obstruction
After excessive diarrhoea like in chlorea
47. •
•
-
-
-
After excessive sweating
ANAURIA Complete absence of urine
output is uncommon . Sever oliguria
(100mL/day) is commonly seen in
Acute renal failure due to tubular necrosis
Shock
Post blood tranfusion,etc
48. • GLYCOSURIA
Presence of reducing sugar in urine is
called glycosuria
Pregnancy and lactation are characterised
by Lactosuria.
These are common physiological causes.
