Urine analysis

URINE ANALYSIS

1. DR ABDUL SAMI MPHIL EASTERN MEDICINE The Islamia University of Bahawalpur Pakistan

2. Urine Analysis

3. Contents: Definition Conditions Points to be considered in the Examination of Normal Urine Effect of age and sex on urine

4. Urine Analysis Definition: Urine: “A watery, typically yellowish fluid stored in the bladder and discharged through the urethra. It is one of the body's chief means of eliminating excess water and salt, and also contains nitrogen compounds such as urea and other waste substances removed from the blood by the kidneys.” Urine analysis also called Urinalysis.It is the oldes laboratory procedure .

5. Why Urinalysis? Urine Examintaion Helps in the diagones of Various renal as well as systamic diseases . General evaluation of health . Monitoring of patients with Diabetes . Screening for drug abuse( e.g Sulfonamite or Aminoglycosides .)

6. Composition Of Urine It contain 5 % solids. Its average output is 1-1.5L per day. All substances are found in different concentration. Urine may also contain formed element such as cells,casts,crystals etc.

7. Specimen Collection Improper collection may i nvalidate the result. In some cases 24 hour urine sample is also collected. Container for collection should be wide mouthed, clean and dry. Specimen should analyse with in 2 hours .

8. Macroscopic Examination Of Urine Color Clarity Odor Volume Specific gravity pH

9. Color: Normal urine color has a wide range of variation ranging from pale yellow, straw, yellow, dark yellow ,trace of urobilinogen ( colourless by product of Bilirubin ) appears in urine. The color is affected by: - Concentration of urine. pH. Metabolic activity. Diet intake (Beet). Drugs may change urine color.

10. Colorless or pale yellow: High fluid intake Diabetes Mellitus Diabetes Insipidus Alcohol ingestion Dark yellow(Hot Temperament): Low fluid intake. Excessive sweating Dehydration (burns, fever). Carrots or vitamin (A) orange urine Nitrofurantoin (antibiotic used against E. coli in urinary tract infection ).

11. Clarity (Transparency) Normal urine clear or transparent, any turbidity will indicate. RBCs Epithelial cells Bacteria WBCs (pus). Casts Crystals Lymph Semen .

12. Odour Fresh normal urine has a faint aromatic odour due to the presence of some volatile acids. In some pathological conditions, certain metabolites may be produced to give a specific odor such as: Fruity odor is due to acetone.(Diabetic urine). Ammonia Odour ( urine standing for long time). Offensive odour Bacterial action of pus (UTI). Mousy odour Phenylalanine ( phenylketonurea “ PKU ” ).

13. Volume Children urine volume = 200 – 400ml /24hr (4ml/kg/ hr) . Adult urine volume = 600 – 2500 ml /24hr. 0.5-1ml /kg/hr, Average 1.5 litres . Which depends on : Water intake. External temperature. Mental and physical state. Intake of fluid and diuretics (Drugs, alcohol , tea).

14. Abnormalities Oligouria : Marked decrease in urine flow <400ml. Polyuria : Marked increase in urine flow >2500ml. Anuria :Faliure of the kidneys to produce urine. <100ml/day. Nocturia :Exessive urination during night.

15. Causes of Polyuria Diabetes Insipidus . Diabetes Mellitus. Hypercalcaemia . Hyperthyroidism. Pregnancy. Removal of urinary obstruction.

16. Causes of Oligouria : Dehydration Prolong vomiting Diarrhea Heart Failure Causes of Anuria : Renal defect Loss of Urine Formation Presence of Tumor and Stone

17. PH Maintain normal hydrogen ion concentration in plasma and ECF. Urine PH ranges from 4.5 -8 . Normaly it is slightly acidic lying between 6-6.5. Tested by Litmus paper PH paper Dip sticks

18. Specific Gravity It is meaurement of Urine density which reflects the ability of the kidney to concentrate or dilute the urine relative to the plasma from which it is filtered. Measured by: 1-Urinometer 2-Refractomer 3-Dip-sticks

19. Colour According to Temprament Colour Temprament Dark Yellow Hot Temprament Brown Cold Temprament Very Fair Cold and Moist Temprament Grey Cold and Dry Temprament

20. Effect of Age and Sex On Temprament In Childern : Urine is thick viscid and frothy. In Adults : Pale and watery but at some time it becomes thick. In Infancy : Urine is white because of milk feeding and moist. temprament In Pregnency : Urine is clear but it has faint cloud at top. In Male : on shaking urine becomes turbid at the top. In female : White dull thick and turbid. In Old age people : Pale watery and of low density.