characteristics of urine

this slide is a simple slide that explain about the characteristics of urine,abnormal characteristics of urine,main terms associated with urine ,also explains casts and crystals...it should be given a general idea about urine characteristics.......its explains its basics
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1. COMPOSITION ( NORMAL&ABNORMAL) AND CHARACTERISTICS OF URINE sasna

2. CONTENTS….. PHYSICAL CHARACTERISTIC OF URINE COLOUR ODOUR TURBIDITY PH VOLUME DENSITY ( Specific Gravity) MAIN TERMS ASSOSIATED WITH URINE COMPOSITION CHEMICAL COMPOSITION OF URINE ABNORMAL CONSTITUENT OF URINE

3. Urine is a liquid product of the body secreted by kidney Through the process is called urination ( micturition ) Excreted through urethra Cellular metabolism generates numerous by product , (rich in nitrogen) that require clearence from the blood stream as urination Urination is the primary method for excreting water soluble chemicals from the body Human urine with human faecus are collectively called human waste URINE

4. ● 95% of volume of normal urine is due to water Organic components: ● urea ● urobilinogen ● uric acid ● creatinine ● amino acids ● metabolites of hormones Inorganic components : ● cations: Na + , K + , Ca 2+ , NH 4 + ● anions: Cl - , SO 4 2- , HCO 3 - , HPO 4 - COMPOSITION OF URINE

5. PHYSICAL CHARACTERISTICS OF URINE Color and transparency Clear, pale to deep yellow (due to urochrome ) Concentrated urine has a deeper yellow/amber color A red or red-brown (abnormal) color could be from a food dye, eating fresh beets, a drug, or the presence of either hemoglobin or myoglobin . If the sample contained many red blood cells, it would be cloudy as well as red. Turbidity or cloudiness may be caused by excessive cellular material or protein in the urine

6. Dark yellow urine is often indicative of hydration Yellow , orange colour is due to the removal of b vitamin Orange urine is also form at certain medication such as rifamine brown urine can be a symptoms of jaundice,rhabdomylosis or gilberts syndrome Pinkish urine can result from the consumption of beet

7. URINE COLOUR CHART

8. Odor Fresh urine is slightly aromatic Standing urine develops an ammonia odor Some drugs and vegetables (asparagus) alter the usual odor Elevated ketones smells fruity or acetone-like Consumption of alchohol,saffron cofee,tunafis and onion can result in teltate scents…

9. PH -5.5 – 6.8 Acidic – meat food, diabetes mellitus , starvation , fever Alkaline – plant food , cystitis , pyelitis

10. Acidic urine contribute to the formation of stones of uric acid ( kidneys,ureter,bladders ) Diet with citrus ,vegetables and dairy product increase urine ph(more basic) Diet with meat,cranberries,druds , will decrease urine ph(more acidic)

11. Volume Average urine production in humanis about 1-2 L per day Volume is depending on the state of hydration,activity level,environmental factor,and health of the individual Density Density of the urine ranges between 1.003-1.035 g cm^-3

12. MAIN TERMS ASSOSIATED WITH URINE COMPOSITION ANURIA : COMPLETE STOPPAGE OF URINE OLIGURIA :REDUCED AMOUNT OF URINE POLYURIA :INCREASED AMOUNT OF URINE NOCTURIA :INCREASED AMOUNT OF URINE @ NIGHT

13. CHEMICAL COMPOSITION OF URINE Urine is 95% water and 5% solutes Nitrogenous wastes include urea, uric acid, and creatinine Other normal solutes include: Sodium, potassium, phosphate, and sulfate ions Calcium, magnesium, and bicarbonate ions Abnormally high concentrations of any urinary constituents may indicate pathology

14. PRINCIPLE CONSTITUENT OF HUMAN URINE A.ORGANIC CONSTITUENTS 1.UREA :THE MOST ABUNDANT ORGANIC CONSTITUENT FORMED BY THE COMBINATION OF NH3 &CO2 2.URIC ACID : PRODUCT OF NUCLEIC ACID CATABOLISM.AND CRYSTALIZE AND CONTRIBUTES TO KIDNEY STONES. 3.HIPPURIC ACID :FORMED FROM THE BENZOIC ACID OF DIETARY FRUITES. 4.CREATININE : DERIVED FROM CREATINE. 5.INDICAN :POTTTASSIUM SALT OF INDOLE. INDOLE IS FORMED IN LARGE INTESTINE BY THE PUTREFACTION OF PROTEIN.IN LIVER ,IT GET TRANSFORMED TO INDICAN. 6.KETONE BODIES:ALSO CALLED ACETONE BODIES.NORMALLY FOUND IN SMALL AMOUNTS.BUT IN DIABETES AND ACUTE STARVATION,THEY APPEAR IN LARGE AMOUNTS. 7.OTHER CONSTITUENTS:FOUND ONLY IN VERY SMALL AMOUNTS.INCLUDE CARBOHYDRATES,PIGMENTS,FATTY ACIDS,MUCIN, ENZYMES,HORMONES,ETC……….

15. B.INORGANIC CONSTITUENTS 1.WATER :THE MOST ABUNDANT OF ALL CONSTITUENT 2.NACL :PRINCIPLE INORGANIC SALT 3.K+,Ca+,Mg+ :OCCURS AS CHLORIDES,SULPHATES,AND PHOSPHATES 4.SO4-- :DERIVED FROM AMINOACIDS 5.PO4--- :OCCURS AS SODIUM COMPOUNDS 6.NH4+ :OCCURS AS AMMONIUM SALTS,DERIVED FROM PROTEIN CATABOLISM AND ALSO FROM GLUTAMINE

16. Urea is synthesized in the liver it is transported by free diffusion through membrane Ammonia is released from Gln buffer function in the urine Creatinine is a product of muscle metabolism it is not reabsorbed by the tubules → creatinine clearance Uric acid is a final product of endogenous and dietary purine degradation Urobilinogen (UBG) is formed from bilirubin in a small intestine - can be oxidized to urobilin in urine . N-containing compounds in urine

17. creatinine Uric acid

18. AMMONIA UROBILINOGEN

19. ABNORMAL COMPOSITION OF URINE URINE AMOUNT URINE COLOUR URINE CINSISTENCY URINE ODOUR URINE STERILITY URINE PH URINE SPECIFIC GRAVITY URINE GLUCOSE URINE KETONE BODIES(acetone) BLOOD IN URINE BACTERIA IN URINE CASTS CRYSTALS

20. Normal :1200-1500 ml Abnormal : Under 1200 ml Decreased fluid intake Kidney failure Abnormal : Over 1500 ml Diabetes Diuretics Increased fluid intake Urine amount

21. Abnormal: Dark amber Insufficient fluid intake resulting in concentrated urine Cloudy Infectious process: Dark orange Drugs (e.g., Pyridium ) Red or dark brown: Disease process causing blood in urine Urine colour

22. Normal : Clear liquid Abnormal : Mucous plugs, viscid, thick eg :Infectious process Urine consistency

23. Normal : Faint aromatic Abnormal : Offensive Infectious process Urine odour Foul smelling odour is a symptom of urinary tract infection

24. Normal : No microorganisms present Abnormal : Microorganisms present eg :Infection of the urinary tract Urine sterility

25. Normal : 4.5 to 8 Abnormal : Over 8 Urinary tract infection, metabolic / respiraory alkalosis, fanconis syndrome Abnormal : Under 4.5 Uncontrolled diabetes, starvation, dehydration, fever, phenyl ketonuria , alkaptonurea , acidosis Urine – ph (4.6 -8.0) Protein diet increase the acidity of urine ,vegetarian diet increases the alkalinity

26. Normal : 1.010 to 1.025 Abnormal : Under 1.010 Eg :Diabetes insipidus , kidney disease , overhydration Abnormal : Over 1.025 Eg :Diabetes mellitus, underhydration , nephritic syndrome. Urine- specific gravity

27. Normal: Not present Abnormal: Present Eg :Diabetes mellitus Urine glucose

28. Normal: Not present Abnormal: Present Eg :Diabetic coma, starvation, prolonged vomiting Urine ketone bodies (acetone)

29. Red blood cell in blood can due to the vigourous exercise or exposure to toxic chemicals High amount of WBC is a symptom of infection Other symptoms of blood in urine due to bacterial infection, parasitic infection(malaria),scurvy, tumours OTHER CELLS ARE ALSO FOUND IN URINE LIKE EPITHELIAL CELLS. BLOOD IN URINE

30. Normal: Not present Abnormal : Occult Eg :Kidney disease Abnormal : Bright red Eg :Hemorrhage Urine -blood

31. Microscopic Examination Pyuria : WBC in Urine Normal: Men: <2 WBCs per hi power field Women: <5 WBC generally indicate the presence of an inflammatory process somewhere along the course of the urinary tract

32. BLOOD IN URINE -HEMATURIA RBC's may appear normally shaped, swollen by dilute urine or crenated by concentrated urine. The presence of dysmorphic (odd shaped) RBC's in urine suggests a glomerular disease such as a glomerulonephritis . CRENATED DYSMORPHIC

33. Too many squamous epithelial cells in urine…. Epithelial cells Sqamous epithelial cells

34. Bacteria are common in urine specimens (from contamination) Therefore, microbial organisms found in all but the most scrupulously collected urines should be interpreted in view of clinical symptoms. BACTERIA IN URINE A:CRENATED RBC B:RBC C: BACTERIA

35. ↑ proteins → proteinuria (glomerulonephrititis, bacterial infection, pregnancy) 150 mg of proteins are excreted daily ● ↑ glucose → glycosuria (diabet es mellitus, emotion stress) renal threshold for Glc is around 10 mmol/L ↑ ketone bodies → ketonuria (starvation, dia betes, pregnancy) other pathological components: bilirubin, blood (ery, Hb),… PATHOLOGICAL COMPONENT OF URINE

36. Urinary sediment = microscopic examination of urine examination of urinary sediment evaluates the presence and number of organ components – cells (ery, leu, epithelial cell, bacteria) and nonorgan components (crystals) crystals are mostly composed of calcium oxalate or calcium phosphate urate stones (from uric acid) - gout, acidic pH of urine OXALATE CRYSTALS URIC ACID CRYSTALS

37. CAST Small fibrous object formed of protein & other material It settle in kidney tubules & collecting ducts Large number of cast in urine is a sign of kidney disease

38. Hyaline casts are composed primarily of a mucoprotein (Tamm- Horsfall protein) secreted by tubule cells. Causes: Low flow rate, high salt concentration, and low pH, all of which favor protein denaturation and precipitation of the Tamm- Horsfall protein. HYALINE CAST Hyaline cast appear transparent

39. Red blood cells may stick together and form red blood cell casts. Indicative of glomerulonephritis , with leakage of RBC's from glomeruli , or severe tubular damage. RED CELL CASTS

40. Usually indicates pyelonephritis (kidney infection) Other causes: Interstitial Nephritis (inflammation of the tubules and the spaces between the tubules and the glomeruli . ) WHITE CELLCASTS

41. NON ORGAN COMPONENTS IN URINE ARE CALLED CRYSTALS

42. Formation is favored in alkaline urine. Urinary tract infection with urease producing bacteria ( eg . Proteus vulgaris ) can promote struvite crystals by raising urine pH and increasing free ammonia. STRUVITE CRYSTAL

43. High uric acid in blood (by-product of purine digestion/high protein diet) Associated with gout (arthritis) URIC ACID CRYSTALS

44. They can occur in urine of any pH. Causes: Dietary asparagus and ethylene glycol (antifreeze) intoxication CALCICM OXALATE CRYSTALS

45. THANK YOU………