URINE ANALYSIS
.Physical examination -1
.Chemical examination -2
.Microscopical examination -3
:Urine sample should be
1- Early morning.
2- Midstream.
3- Fresh.
4- Non-centrifuged.
5- Collected in dry, clean, sterile container
which is free if detergents.
1) PHYSICAL EXAMINATION:-
Volume
Colour
Smell
Aspect
Reaction (PH)
Specific gravity
1) Volume:
Normally: 750 - 2000 ml / 24 hr.
< 500 ml Oliguria (Renal damage)
> 2000 ml Polyuria:
1.Water intake
2. Diuretics
3. D.M.
4. ADH deficiency
N.B: Increased frequency of micturition doesn’t mean
polyuria e.g. cystitis
:Colour )2
Normally: Amber Yellow “ urochrome piment ”
Abnormalities:
1- Red-brown Hb and its derivatives in crush
syndrome.
2- Green-yellow Bile pigments (Jaundice).
3- Brown-black when voided melanin ( malignant
melanome )
4- Black Parenteral iron therapy.
5- Smoky Erythrocytes (glomerular damage or UT
haemorrage)
:Smell (Odour) )3
Normally aromatic ( Urea Ammonia )
Offensive odour Gram –ve infection of urine.
Acetone odour Ketonuria.
:Aspect )4
Normal urine is clear
Turbid urine may be due to:
1- Pus.
2- Alkaline PH ( help formation of
phpsphate and carbonate salts ).
3- Acidic PH ( help formation of urate salts ).
5) Reaction (PH):
Normal urine is acidic ( PH = 5 – 6 ).
Alkaline urine may be due to:
1- Eating fruits and vegetables.
2- Some drugs.
3- Bacterial infection.
6) Specific gravity (Sp.Gr.):
It is an indication about soluble solutes in urine.
Sp.Gr. = Mw of Urine / Mw of water (1000).
Normally: 1015 – 1025.
Factors affecting:
1- volume of urine.
2- Concentration of solutes in urine.
- Oliguria Concentate the solutes Incrase Sp.Gr.
- Polyuria Dilute the solutes decrease Sp.Gr.
- D.M. Polyuria+Glucosuria Incrase Sp.Gr.
:N.B
Fixed Sp.Gr. Means:
Sp.Gr. Of urine = Sp.Gr. Of plasma = 1010 ( Acute tubular
necrosis) Bad prognosis.
1) CHEMICAL EXAMINATION:-
Normal constituents of urine:
1- Organic: 2-Inorganic:
- Urea - Chloride
- Creatinine - Phosphate
-Uric acid - Sulphate
• Abormal constituents of urine:
1) Protein:
Normal urine contains 40 - 150 mg of protein / day.
The glomerular basement membrane prevent
proteinuria.
Alteration of the basement membrane (e.g. acute nephritis
or nephrotic syndrome) proteinuria.
It is detected by heat coagulation test or urine strips.
:Glucose )2
Renal threshold for glucose = 180 mg %
It can be detected by Bendict test or Urine
strips.
:Ketons )3
They are:
1- Acetoacetic acid.
2- β-hydroxybutyric acid.
3- Acetone.
Renal threshold for ketons is 70 mg %.
Normal urine contains: 3 -15 mg / day.
It is present in urine in detectable or high level in
case of:
1- D.M.
2- Starvation.
3- Sever stress or exercise.
It is detected by Rothera’s test or urine strips.
:Bilirubin )4
It appears in urine in some cases of jaundice.
It is detected by Fouchet’s test or urine strips.
3) MICROSCOPICAL EXAMINATION:-
1- CELLS AND CASTS:
-RBCs
-Pus cells
-Casts
2- CRYSTALS:
-Normally, non-pathological.
-Uric acid and calcium oxalate may be found in
acidic urine and phosphates in alkaline urine.
-However, cystine crystals are pathological and are
indicative of cystinuria (an inborn error of metabolism)
