Pathology of Urine

Pathology of Urine

Urine is the chief excretory fluid eliminated through kidney. Most of the waste products are eliminated through urine. Urine shows
the presence of large number of organic & in-organic substances.

Normal Constituents of Urine

1. Urea: – It is main end product of protein metabolism. About 25-30gm of urea is excreted per 24 hrs.

Clinical Significance:  

In liver disease urea levels are increased  

In fever  

In Diabetes high urea levels observed.  

Test for Urea:

1. 3ml of urine sample + few drops of alkaline sodium hypobromate Solution  (NaOBr). –> Effervescence of Nitrogen –> Urea is present

2. 5ml of urine+ 4 drops of phenoptaline + Pinch full of ureas powder & mix –> Solution becomes Pink –> Urea is present. 

2. Uric acid: – It is the end product of purine metabolism. About 0.7gm of acid excreted through urine per 24 hrs.

Clinical Significance: 

 In gout kidney doses the power of eliminating uric acid properly. This leads to the deposition of uric acid in the joint.   Excretion of uric acid is increased in leukemia.  

Test for Uric Acid:  

a) Schiff’s test: Moister a strip of filter paper with AgNO3 solution and add drops of urine. –> Black or Yellow brown stain formed –>Uric acid is present

b) Benedict’s Test:-  5ml. of urine + 5 drops of Benedict’s uric acid reagent + 3gms  of anhydrous sodium carbonate (Na2CO3) &Mix by shaking. –> A deep blue color develops. –> Uric acid is present.

3. Creatinine:-

It is the product of the breakdown of creatine. About 1.7gm of Creatinine is excreted through urine per 24 hrs.

Clinical Significance:  

It increases in fasting & after high water ingestion.  

Increased amounts are found in malnutrition—the disintegration of muscular tissue & in carcinoma of the liver.  Decreased level of Creatinine is found in anemia, paralysis, leukemia.  

Test for Creatinine;-  

a) Jaffe’s Test: 5ml. of urine + 1ml. of saturated solution of picric acid +  3gm. Of anhydrous Na2CO3 mix well by shaking. –> A deep orange color is formed –> Creatinine is present

b) Weyl’s Test:-  5ml. of urine+ 5 drops of sodium nitropruside+2ml. of 10%  NaOH –> Ruby red color is formed &  soon changes To yellow –> Creatinine is present.

Abnormal Constituents of Urine:

Substances that are not present in easily detectable amounts in normal healthy individuals’ urine but present in urine under certain diseased conditions are said to be Abnormal or pathological Constituents of urine.

The Abnormal Constituents are:-

1. Reducing sugars like glucose, fructose, lactose, and pentose.

2. Proteins like albumin, globulin.

3. Ketone bodies like Acetone, Acetoacetic acid, Beta-hydroxyl butyric acid.

4. Bile salts like sodium glycolate, sodium taracolate.

5. Bile pigments like bilurubin, biliverdin.

6. Blood

7. Pus

FAQs

1. What is urinalysis? Urinalysis is the examination of urine to assess its physical, chemical, and microscopic properties, providing valuable diagnostic information about kidney function and overall health.
2. What are some common causes of abnormal urine color? Abnormal urine color may result from various factors, including dehydration, medications, dietary intake, and underlying medical conditions such as liver disease or urinary tract infections.
3. How is urinary tract infection diagnosed? Urinary tract infections are diagnosed based on urinalysis findings, urine culture, and clinical symptoms such as dysuria, urinary frequency, and fever. Treatment typically involves antibiotics targeted at the causative pathogen.
4. What are the risk factors for developing kidney stones? Risk factors for kidney stones include dehydration, diet high in sodium or oxalate-rich foods, family history of kidney stones, certain medical conditions, and metabolic disorders.
5. Can urinary incontinence be treated? Yes, urinary incontinence can be managed through lifestyle modifications, pelvic floor exercises, medications, and surgical interventions, depending on the underlying cause and severity of symptoms.

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