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Urine analysis
Urine analysis involves collecting a urine sample and using reagent strips or microscopic examination to test for various substances. Reagent strips can detect glucose, bilirubin, ketones, protein, blood, and other parameters. Microscopic examination looks for cells, casts, crystals, and other features. Normal urine composition includes urea, uric acid, creatinine, chloride, and phosphate. Abnormal results may indicate diseases like infections, kidney problems, or other disorders. Care must be taken to collect samples properly for accurate analysis and diagnosis.
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Urine analysis
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- 2. Urine dipstick • Screeningfor disease • Fresh urine is collected into clean dry container • Reagent strip immersed in the urine specimen, ensure all the reagent blocks are covered. • Errors in results
- 4. • Three urinesamples are shown. The one at the left shows a red, cloudy appearance. The one in the center is red but clear. The one on the right is yellow, but cloudy.
- 5. Parameters in urinedipstick test • Glucose • Bilirubin • Urobilinogen • Ketones • Specific gravity • pH • Protein • Blood • Nitrite • Leucocytes
- 6. Physical examination ofurine • Volume a) physiological factor -increase intake of water -temperature -physical activity -others due to diuretic drugs, coffee and alcohol -normal adult urine volume : 600-1200ml/hour -difference in urine volume due to: polyuria, oliguria, anuria and nocturia
- 7. • Colour - normal : pale yellowish- urochrom pigment - abnormal : due to food intake and drugs Red : beets, rhubarb (alkaline urine) Orange-yellowish : carrot, antibiotic Green, blue-green : drugs eg: amitrypline Dark brown : drugs eg: methyldopa, metronidazole - abnormal : due to pathological Red/maroon : rbc, hemoglobin, myoglobin ‘wine-red’ : porphyrin Dark brown : melanin, homogentisic acid Yellowish-brown or greenish-brown : bilirubin, bile pigment
- 8. • Odour normal:aromatic odour - Food and drugs causes characteristic odour e.g: methyl salicylic, asparagus - Ketosis : fruity/sweet - Congenital metabolism disorder : e.g: phenylketonuria ‘mousy’
- 9. • Appearance/ transparency Normal: -Slightturbidity: mucus (in women), squamous epithelial cell -Turbidity: calcium oxalate, uric acid, amorphous phosphate, amorphous urates Abnormal: -turbid-red : rbc -turbid : bacterial or yeast infection -milky: lipid
- 10. Normal urine composition • Urea - End product of protein metabolism - 50% from urine composition - 25-30 g/24hr • Uric acid - End product of purine metabolism - 0.5-1 g/24hr • Creatinine - Skeletal muscle tissue
- 11. • Creatine - Canbe found in muscle tissues in form of phosphocreatin • Sulphur - Protein intake • Indican - Triptophan katabolism in intestine • Ammonia - Final product of protein metabolism
- 12. • Chloride - Second largest composition found in urine - Excreted in form of NaCl : 10-15g/24hr urine • Phosphate - Protein intake - 1.1g/24hr urine
- 13. Pathological urine composition • Glucose • Protein • Ketones • Pus cells • Red blood cells • Lipid • Amino acid • Bile pigment • Calculi
- 14. Microscopic sediment ofurine • Cells -rbc, wbc, squamous epithelial cells, urethral epithelial cells • Casts - Represent a collection of protein and cellular debris in a kidney tubule - Eg: hyaline : occasionally found in normal urine but their number is increased in renal diseases. - Cellular cast: one or more type of cells are trapped during their formation. Eg; pus cell casts, red cell casts, epithelial casts, and mixed cellular casts. - Granular casts : fine granules appear in glomerular and tubular renal disease.
- 15. Cyrstals • Uric asid • Amorphous urates • Amourphous phosphate • Calcium oxalate • Triple phosphate • Calcium carbonate • Tyrosine • Leucine • Cystine • Cholesterol
- 16. • Red bloodcells in urine appear as refractile disks. With hypertonicity of the urine, the RBC's begin to have a crenated appearance
- 17. • These whiteblood cells in urine have lobed nuclei and refractile cytoplasmic granules.
- 18. • Large polygonalsquamous epithelial cells with small nuclei are seen here.
- 19. • Oval fatbodies consist of degenerated tubular cells containing abundant lipid, which appears refractile.
- 20. broad (Figure 3). Urinarycasts. (A) Hyaline cast (200 X); (B) erythrocyte cast (100 X); (C) leukocyte cast (100 X); (D) granular cast (100 X).
- 21. Urinary crystals. (A)Calcium oxalate crystals (arrows; 100 X); (B) uric acid crystals (100 X); (C) triple phosphate crystals with amorphous phosphates (400 X); (D) cystine crystals (100 X).
- 22. Type of UrineSample & Collection Sample Sampling Purpose Morning sample First urine in the Pregnancy test, morning microscopic test Random sample No specific time Routine screening, chemical & FEME Postprandial 2 hours after meal Determine glucose in diabetic monitoring Midstream/clean Discard first few ml, Culture match collect the rest 2 hours Within 2 hours period Determine urobilinogen 24 hours Within 24 hours period Determine renal function