The document outlines the purpose and methods of urine examination, highlighting its importance for evaluating health, diagnosing diseases, and monitoring conditions like diabetes. It details various urine specimen types, physical and chemical analyses, and normal urine characteristics like volume, color, and clarity. The document also addresses abnormal urine colors and potential underlying causes, as well as factors influencing urine turbidity and odor.

1. Examination of Urine

2. Purpose
 Urine contains important metabolic information
 Urine is cheap, simple, & readily available
 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)

3. Collection of urine specimens
 The first voided morning urine (most
concentrated) - qualitative
 Random urine (routine)
 24hrs sample- quantitative
 Mid-stream clean catch (MSCC) (for urine
culture)- UTI
 Post prandial sample-D.M
Attention
 Need to be examined within 1 hour

4. 24 hour urine sample
1. For quantitative estimation of proteins
2. For estimation of vanillyl mandelic acid, 5-
hydroxyindole acetic acid, metanephrines
3. For detection of AFB in urine
4. For detection of microalbuminuria

5. 1- Macroscopic Examination
Physical characteristics : color, odor, turbidity,
volume, & specific gravity
− Chemical Analysis (Urine Dipstick) : pH,
glucose, protein, ketones, pus (WBC’s &
bacteria), RBC’s, hemoglobin, bile
2- Microscopic Examination of urine sediment:
crystals, cells, etc.
Types of Analysis

6. Physical examination
 Volume
 Color
 Odour
 Reaction or urinary pH
 Specific gravity

7. Urinary volume
 The average daily urine output 1200 - 1500 mL
(1.2 - 1.5 L)
 The normal daily range of urine output 600 - 2000
mL (0.6 - 2.0 L)
 Polyuria- >2000ml
 Oliguria- <400ml
 Anuria-complete cessation of urine(<200ml)
 Nocturia-excretion of urine by an adult of >500ml
with a specific gravity of <1.018 at night
(characteristic of chronic glomerulonephritis)

8. Causes of polyuria > 2000ml
 Diabetes mellitus
 Diabetes insipidus
 Polycystic kidney
 Chronic renal failure
 Diuretics
 Intravenous saline/glucose

9. Oliguria <400ml
 Dehydration-vomiting, diarrhea, excessive
sweating
 Renal ischemia
 Acute tubular necrosis
 Obstruction to the urinary tract
 Acute renal failure

10. Urine Color and Clarity
 Urine color and clarity can indicate what
substances may be present in urine.
 Confirmation of suspected substances is obtained
during the chemical and microsopic examination.

11. Urine Color
 Normal urine color ranges from pale yellow to deep
amber — the result of a pigment called urochrome
 Most changes in urine color are harmless and
temporary and may be due to:
 Certain foods – beets may turn urine red
 Dyes in foods/drinks
 Supplements – vitamins
 Prescription drugs

12. Abnormal colors of urine & possible causes
 Unusual urine color can indicate an infection or
serious illness .
 Colourless- dilution, diabetes mellitus,
diabetes insipidus, diuretics
1. Milky- genitourinary tract infection
2. Orange-fever, excessive sweating, bilirubin
3. Red-beetroot ingestion,haematuria
4. Brown/ black- alkaptunuria, melanin
 Green - bile, Pseudomonas bacteria

13. Examples of Urine Color

14. Urine Clarity
 Urine clarity refers to how clear the urine is.
 Terms used: clear, transparent, slightly
cloudy, cloudy, or turbid.
 “Normal” urine can be clear or cloudy.
 The clarity of the urine is not as important as
the substance that is causing the urine to be
cloudy.
 Turbidity - “cloudiness” due to
particulate matter
suspended in urine

15. Urine Clarity
 Substances that cause cloudiness but that are not
considered unhealthy include:
 mucous,
 sperm and prostatic fluid,
 cells from the skin,
 normal urine crystals, and
 contaminants (like body lotions and powders).
 Other substances that can make urine cloudy (such
as red blood cells, white blood cells, or bacteria)
indicate a condition that requires attention.

16. Examples of Urine Clarity

17. Odour
 Normal= aromatic due to the volatile fatty
acids
 Standing (“old”) urine takes on an ammonia
odor due to urea-splitting bacterial
 Foul, offensive: Old specimen, pus or
inflammation
− Sweet: Glucose
− Fruity: Ketones