Urinalysis Diagnostic Tests:

1. Appearance:

• • Should be straw-colored(light yellow).
  • Dark urine indicates dehydration.
  • Clear urine:  Indicates proper hydration, but if very clear, could suggest overhydration.
  • Cloudy urine:  Possible presence of:
    • protein (proteinuria, albuminuria),
    • blood (hematuria), bacteria (bacteriuria), or
    • pus (pyuria)—signs of infection or damage to glomeruli.

2. Odour:

• • Generally mild. Strong odour suggests infection or other issues.
• Specific gravity and Osmotic Concentration:
  • Measures solutes concentration. Normal range indicates proper hydration and kidney function.
  • Specific gravity:  Slightly above 1.000 (i.e. 1.010-1.025) —reflects some solutes in water.
  • Higher specific gravity: concentrated urine, possibly due to:
    • dehydration, or
    • high solute load.
  • Lower specific gravity: dilute urine, possibly due to:
    • overhydration,
    • nephron damage (inability to concentrate urine – common in renal tubular damage and Diabetes Insipidus= a disease characterized by low ADH release by pituitary gland).

3. Blood & Microorganisms in Urine:

• Hematuria:  Blood in urine—can indicate glomerular damage or kidney trauma.
• White blood cells in Urine:
  • Excess indicates infection (pyuria).
  • Bacteria seen under microscopy suggest urinary tract infection (UTI).
• Pus:  Collection of dead cells and bacteria, indicating infection.
• Proteinuria: Sign of glomerular damage or inflammation.

4. Waste Products in Urine:

• Urea, creatinine, ammonia, uric acid, bilirubin:
  • Urea:  Main nitrogenous waste from protein
  • Creatinine:  From muscle
  • Ammonia:  Toxic, formed from amino acid deamination during protein break-down; converted to urea.
  • Uric acid:  From DNA
  • Bilirubin:  From hemoglobin breakdown; hyperbilirubinemia (high levels of bilirubin in the blood) indicates liver or hemolytic issues.
• Elevated levels indicate kidney dysfunction or liver problems.

5. pH:

• Urine pH varies but is usually slightly acidic(~4.5–8).

6. Safety & Cultural Notes:

• Urine should be sterile.
• Bright color or unusual odor may suggest infection or contamination.
• Cultural curiosity:
  • Drinking urine is not recommended due to potential toxins and bacteria.
  • Saltwater rinses can reduce toxin release from jellyfish stings; fresh water may worsen symptoms.

7. Microscopic Analysis:

• Urinary casts:
  • Cylindrical structures formed from cell debris, proteins, or blood within the tubules.
  • Clumped cells or fibers: Sign of glomerular damage or tubular injury.
  • Not normal, can occur if bacteria or protein are present.

8. Glucose and Ketones:

• Glucose:
  • Usually reabsorbed in the nephron; presence in urine indicates nephron overload or damage.
  • Risk Factor: High blood glucose (hyperglycemia) typical in diabetes mellitus.
• Ketones:
  • Products of fatty acid breakdown.
  • Elevated in diabetic ketoacidosis when glucose utilization is impaired and lipids are used as fuel molecule.
  • Excessive breakdown of fats leads to ketonemia (ketones in blood) and then ketonuria(ketones in urine).

9. Blood and Waste Products:

• Elevated urea, creatinine, ammonia, uric acid, or bilirubin suggest organ dysfunction (kidney or liver).
• High urea can also be due to increased protein intake, or dehydration, or GI bleeding (due to plasma protein breakdown in GI)

Summary:

Urinalysis provides crucial information on kidney function, hydration, infection, and metabolic status. Detection of glucose, ketones, blood, or bacteria indicates underlying pathology such as diabetes or infection. Microscopic examination reveals evidence of tissue damage, renal injury, or disease progression, supporting diagnosis and treatment planning.