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Transcript
Urine
What is urine?
Urine is a liquid waste product of the
body secreted by the kidneys by a
process of filtration from blood and
excreted through the urethra.
Composition
• Urine is a transparent solution that can range
from colorless to amber but is usually a pale
yellow. It is normally odorless but can acquire
strong odors due to bacterial action.
• Urine is an aqueous solution of metabolic wastes
such as urea, dissolved salts, and organic
compounds.
• Most noticeably, ammonia is produced by
breakdown of urea, a major component of urine.
Hazards
• Urea is toxic and can be irritating to skin and
eyes. High concentrations in the blood can
cause damage to organs of the body. Low
concentrations of urea such as in urine are not
dangerous.
Characteristics
• The typical bright yellow colour of urine is
caused by the pigment urochrome as well as
the degradation products of bilirubin and
urobilin.
Unusual coloration
• Yellowing/light Orange may be caused by removal of
excess vitamin B
from the bloodstream.
• Bloody urine is termed hematuria, potentially a sign of
a bladder infection.
• Dark orange to brown urine can be a symptom of
jaundice or Gilbert's syndrome.
• Black or dark-colored urine is referred to as melanuria
and may be caused by a melanoma.
• Reddish or brown urine may be caused by porphyria.
• Dark yellow urine is usually indicative of dehydration.
Turbidity
• Turbid urine may be a symptom of a bacterial
infection.
• and can also be due to crystallization of salts
such as calcium phosphate.
PH
•
• The pH of urine can normally vary between
4.5 and 8.
• Strongly acidic or alkaline urine may be
symptomatic of disease.
Volume
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The amount of urine produced depends on numerous
factors including :
state of hydration,
activities,
environmental factors,
size, and health.
In adult humans the average production is about 1 - 2 L per
day.
Polyuria is a condition of excessive production of urine (>
2.5 L/day), in contrast to oliguria where < 400 mL are
produced per day, or anuria with a production of < 100 mL
per day.
Density or specific gravity
• Normal urine density or specific gravity values
vary between 1.003-1.035 (g.cm-3) , and any
deviations may or may not be associated with
urinary disorders.
Substances found in normal urine
• Urine is aprox. 95% water.
• The other components of normal urine are the
solutes that are dissolved in the water
component of the urine.
Organic molecules
• These are electrically neutral and can be
relatively large (compared with the 'simpler'
ions - below).These include:
• Urea
• Creatinine
• Others
Urea
• Urea is an organic (i.e. carbon-based)
compound whose chemical formula is:
CON2H4 or (NH2)2CO. It is also known as
carbamide.
• Urea is derived from ammonia and produced
by the deamination of amino acids. The
amount of urea in urine is related to quantity
of dietary protein
Creatinine
• Creatinine is a normal (healthy) constituent of
blood.
• It is produced mainly as a result of the
breakdown of creatine phosphate in muscle
tissue.
• It is usually produced by the body at a fairly
constant rate (which depends on the muscle
mass of the body).
Uric acid
• Uric acid is an organic (i.e. carbon-based)
compound whose chemical formula is:
C5H4N4O3.
Due to its insolubility, uric acid has a tendency
to crystallize, and is a common part of kidney
stones.
Other substances/molecules
• Example of other substances that may be found
in small amounts in normal urine include :
• carbohydrates,
• enzymes,
• fatty acids,
• hormones,
• pigments, and mucins (a group of large, heavily
glycosylated proteins found in the body).
Ions
• Are atoms or groups of atoms that have either,
lost some outer electrons, hence have a
positive electric charge,
• or have gained some outer electrons (to the
atom or group of atoms), and hence have a
negative electric charge.
• These include:
These include:
• Sodium (Na+) : Amount in urine varies with diet and the amount of
aldosterone (a steroid hormone) in the body.
• Potassium (K+) : Amount in urine varies with diet and the amount of
aldosterone (a steroid hormone) in the body.
• Chloride (Cl-) : Amount in urine varies with dietart intake (chloride is
a part of common salt, NaCl).
• Magnesium (Mg2+) : Amount in urine varies with diet and the
amount of parathyroid hormone in the body. (Parathyroid hormone
increases the reabsorption of magnesium by the body, which
therefore decreases the quantity of magnesium in urine.)
• Calcium (Ca2+) : Amount in urine varies with diet and the amount of
parathyroid hormone in the body. (Parathyroid hormone increases
the reabsorption of calcium by the body, which therefore decreases
the quantity of calcium in urine.)
Small groups formed from a few different
elements:
• Ammonium (NH4+) : The amount of ammonia
produced by the kidneys may vary according to
the pH of the blood and tissues in the body.
• Sulphates (SO42-) : Sulphates are derived from
amino acids. The quantity of sulphates excreted
in urine varies according to the quantity and type
of protein in the person's diet.
• Phosphates (H2PO4-, HPO42-, PO43-) : Amount in
urine varies with the amount of parathyroid
hormone in the body - parathyroid hormone
increases the quantity of phosphates in urine.
What are the abnormal
constituents of urine?
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•
•
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Abnormal urine can have:
Carbohydrates
Proteins
ketone bodies
Blood
Bile salts
Bile pigments
Fats
CARBOHYDRATES
• Physiologically in pregnancy and lactation,
lactose is excreted in pregnant women.
• Pathologically: if lactose is excreted in the
urine, then this is due to lactose intolerance.
• Glucose could be excreted in the urine in
Diabetes mellitus, renal glycosuria
• Fructose in essential fructosuria
• Galactose in galactosemia
PROTEINS:
Secretion of proteins in urine is due to:
1- Increase in the permeability of the glomerular
capillaries as in nephrotic syndrome
2- Damage to the capillaries membranes as in
glomerulonephritis
• The following proteins can be excreted in
abnormal urine:
• Albumin
• Globulin
• Hemoglobin (protein of RBC)
• Myoglobin
• Bence Jones Proteins
Albumin and globulin are found in the urine in
the condition called proteinuria, also in
nephrotic syndrome and glomerular nephritis.
Hemoglobin is excreted in urinay tract
infections.
Myoglobin is excreted due to muscular atrophy.
Bence jones proteins are not usually
synthesised in the body. They are produced in
the condition called multiple myeloma, by
plasma cells.
KETONE BODIES
They are basically three chemicals :
• acetone
• acetoacetic acid
• beta hydroxy butaric acid
• All the three are the intermediates in lipid
metabolism.
• Defect in metabolism can lead to the presence
of ketone bodies in urine
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•
•
•
Increased catabolism of fats is due to :
starvation
increased fat intake in diet
decreased carbohydrates in the diet
diabetes ketoacidosis
RBC/ HEMOGLOBIN
In certain disease state such as:
• hemolytic anemia
• Urinary tract infections
• Renal trauma
BILE SALTS:
In Jaundice
BILE PIGMENTS:
in obstructive jaundice