1. بسم الله الرحمن الرحيم

2. Urine Analysis

3. Urinanalysis Urinanalysis is performed to:
To detect a metabolic disease
To detect a kidney disease.
It’s composed of:
Physical exam.
Chemical exam
Microscopic exam.

4. Urinanalysis Physical examination Volume: 1-2 L\day.
Polyuria → DM & D. insipidis.
Oliguria → hypotension, glomerulonephritis.
2. Odor: Aromatic then ammoniacal.
Fruity odor → DM (ketosis)
Bad odor → Pus

5. Urinanalysis 3. Appearance: Clear and yellow.
 UTI → cloudy (Pus & Bacteria)
Urinary schistosomiasis → red, cloudy
Fever → brown, cloudy (hemoglobin)
Jaundice → Green-brown due to bile pigments
Hepatitis → Chocolate brown

6. Urinanalysis 4. pH : Slightly acidic (6.8)
alkalosis → Vomiting and alkaline diet
Acidosis → High protein diet or DM
5. Specific gravity: – 1.025
Decreased → renal failure.
Increased → Urine contains glucose, protein, or heavy particles.

7. Urinanalysis B. Chemical examination
Protein: Size and charge barriers keep protein molecules from entering the urine.
Proteinuria due to:
Renal factors:
Increased glomerular permeability → ↑ albumin
Diminished tubular reabosrption → ↑ low molecular weight proteins

8. Urinanalysis B) Pre-renal load:
Multiple myleoma (increased monoclonal Ab synthesis).
Muscle dystroph (increased liberation of Mb).
Increased hemolysis of RBC (increased liberation of Hb).

9. Urinanalysis Classification of proteinuria: Minimal:
<1 gram of protein per day (e.g. Mild glomerular disease).
Moderate:
grams of protein per day (e.g. overflow proteinuria from multiple myeloma).
Severe:
>4 grams of protein per day (e.g. Nephrotic syndrome).

10. Urinanalysis 2. Glucose: Glucosuria occurs in case of:
High blood glucose conc. → in untreated DM and glucose infusion.
A reduced rate of glucose reabsorption, e.g. tubular damage.
An increase in the rate of glomerular filtration during pregnancy.

11. Urinanalysis 3. Ketone bodies:
3 types of ketone bodies: Acetone, Acetoacetic acid, 3-hydroxybutyrate.
Ketonuria → Diabetic ketoacidosis and severe starvation.
Why? Both cases are characterized by increase in lipid utilization.

12. Urinanalysis 4. Blood:  Hematouria occurs due to:
Infections as Schistosomiasis
Renal, e.g. glomerulonephritis, renal tract stones and kidney tumors.
Toxins or Drugs as Phenols, cyclophosphamide and sulphas.

13. Urinanalysis 5. Bilirubin:
 Bilirubinuria → due to hepatocellular and obstructive jaundice, viral hepatits.
6. Urobilinogen
7. Nitrite → nitrate reducing-bacteria

14. Urinalysis Reagent strips
Urinanalysis
Urinalysis Reagent strips

15. Urinanalysis C. Microscopic examination
Detect RBCs, Kidney cells, or Crystals.
Oxalate Crystals Triple Phosphate

16. Thanks for Your Attention