Routine Examination of Urine Analysis, Composition of Urine, Collection of Urine sample, Preservatives, Physical examination of urine.

 

Urine Analysis:-

The physical, chemical and microscopic examination is known as urine analysis.  Routine examination of urine is known as routine urine analysis. Urine analysis is an important part of the initial examination of patient Urine:-

Urine is the fluid containing water soluble waste products excreted from the blood via kidney. 

Composition of Urine :-

Urine is composed of 95% water and 5% of urea, uric acid, calcium, sodium, potassium phosphates etc. The composition of urine affected by three factors :-

1.       Nutrition status of the individual. 

2.       Functions of kidneys.

3.       State of metabolic processes. 

Urine examination.

 Click here to watch  :- Haemoglobin Estimation

Click here to watch     :-   Blood urea, Estimation of urea Berthelot method.

Click here to watch     :-   Blood and its composition.

Collection of Urine sample:-

 

Morning Urine sample is good for analysis. First  sample should be discard and mid stream sample should be collected. Urine sample should be collected in sterile, dry and fresh container.  Urine sample must be examined after 30 minutes of collection.

 

Preservatives:-

If there is any delay in processing,  preservative should be added to preserve sample some preservative are-

·        Concentrated hydrochloric acid.

·        Thymol

·        Chloroform

·        Toluene

·        Formalin

 

Routine examination for Urine Analysis:-

Urine analysis in three steps-

          Physical examination of urine

2.         Chemical examination of urine

3.          Microscopic examination of urine

 

1.     Physical examination of urine:-

(i)                Volume

(ii)              Colour

(iii)            Odour

(iv)            Transparency

 

2.     Chemical examination(test strips used)  of urine:-

(i)                Specific gravity

(ii)              Protein

(iii)            Glucose

(iv)            Ketones

(v)              Bilirubin

(vi)            Urobilinogen

(vii)          Ph

 

3.     Microscopic examination of urine:-

 

(i.)                          White blood cells (leucocytes)

(ii.)                        Red blood cells ( Rbc ’s)

(iii.)                      Epithelial cells

(iv.)                      Casts

(v.)                        Crystals

(vi.)                      Bacteria

(vii.)                    Others component.

 

 

Routine Urine Examination.

     Physical examination of urine:-

 

Physical examination of urine is called as macroscopic examination.

 

1.     Volume:- 

 Volume of urine depend on the intake the volume of water  of a person.  When the large volume of water intake, the kidney will eliminate a large volume of urine output. When the less volume of water intake the kidney will eliminate a small volume of urine output. In some cases urine output is very les or very large amount. These conditions called the abnormal conditions. Some conditions are-

(a) Polyuria:-

The elimination of large volume(more than 2000ml) of urine consistently  in 24 hours. This condition called the polyuria.

     Causes-  

Diabetes mellitus, Chronic renal failure, Neurotic polydipsia (abnormal thirst)

(b) Diuresis:-

    The elimination of urine volume increases, even if the increase volume of urine is   temporary. This condition called the diuresis.

 Causes-

Diuretic drugs, excessive fluid intake.

  (c) Oliguria:-

The elimination of an abnormally small amount of urine (<200ml) in 24 hours.

Causes-

Excessive sweating, Dehydration, Obstruction of urine flow, Acute renal tubular necrosis, Diarrhoea.

 

(d) Anuria:-

       In this condition complete absence of urine.

       Causes-

       Dehydration, Acute renal tubular necrosis, acute glomerulonephritis and

         Renal ischemia.

 

(e) Nocturia:-

  The excretion of urine of an adult,  more than 500ml at night is called Nocturia.

 Causes-

Chronic glomerulonephritis.

 

 

2.     Colour:-

 

The normal colour of urine is straw and yellow.  This colour due to present of urochrome in the urine. Urochrome is the yellow pigment present bin large concentration of urine.

Some time the urine colour changes, called the abnormal colour of urine.

 

(a)   Dark yellow:-

 This colour indicates very concentrated constituents in a comparatively low volume .this condition  is associated with febrile condition.

 

(b) Yellow brown/green brown:-

 This colour of urine due to the presence of bilirubin. That is related to clinical condition like jaundice.  On standing Bilirubin oxidized to biliverdin, a green colour pigment and gives  the green colour to the urine.

 

  (c) Orange red/ orange brown:-

 This colour of urine due to the presence of urobilin. On standing urobilinogen oxidized to urobilin, gives this colour to the urine. This colour may be seen when some drugs taken such as aminopyrines.

 

 (d)  Clear red:-

 A clear red colour present of urine indicates the presence of haemoglobin ( haemoglobinuria) , the colour pigment of the red blood cells. This condition is due to presence of increase red blood cells destruction in the body. Red blood cells seen in urine in some conditions like. blood transfusion, certain drugs intake, autoimmune haemolytic anaemia, glucose-6- phosphate dehydrogenase.

 (e) cloudy red:-

 This colour is due to the  presence of intact red blood cells. This condition called the haematuria. This condition is different from haemoglobinuria.

 

(f) Dark brown/black:-

 This colour is due to presence of melanin or homogentisic acid. When the urine voided it is colourless, but on standing it becomes black.

Melanin is associated with melanoma, a type of tumour. Black colour of urine is also due to presence of phenol poisoning.

 

(g) Milky white:-

 The urine may appear milky white in a condition known as chyluria.

 

(h) Other colours:-

            Some others colour like pink, blue, green etc. are present dur to the          

           indigestion of food such as vegetables, fruits etc.  there is no clinical

            significance.

 

3.     Odour :-

 

Normal fresh urine contains aromatic odour due to the presence of acids.

 Bacterial action occurs when the is allowed to stand it produces the ammoniacal colour.

 

4.     Transparency:-

 

The transparency of urine specimen is expressed as clear, cloudy or turbid. Normally, the colour is clear, but after some time on standing it becomes cloudy. This cloudiness is become due to precipitation of chemical substances (crystals, amorphous material, urates etc.)

 

 Click here to watch:- Forms of haemoglobin

Click here to watch :- degradation and complexes of haemoglobin