Urine

Urine formation Video

 What is urine?
Urine is a liquid waste product
of the body secreted by the
kidneys by a process of blood
filtration and excretion through
the urethra.
 Composition
O 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.
O Urine is an aqueous solution of metabolic
wastes such as urea, dissolved salts, and
organic compounds.
O Most noticeably, ammonia is produced by
breakdown of urea, a major component of
urine.
 Hazards
O 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

O The typical bright yellow color of urine is

caused by the pigment urochrome as well as
the degradation products of billirubin and
urobillin.
 Unusual coloration

O Yellowing/light Orange may be caused by removal of

excess vitamin B from the bloodstream.
O Bloody urine is termed hematuria, potentially a sign of
a bladder infection.
O Dark orange to brown urine can be a symptom of
jaundice or Gilbert's syndrome.
O Black or dark-colored urine is referred to as melanuria
and may be caused by a melanoma.
O Reddish or brown urine may be caused by porphyria.
O Dark yellow urine is usually indicative of dehydration.
 Turbidity
O Turbid urine may be a symptom of a bacterial
infection.
O and can also be due to crystallization of salts
such as calcium phosphate.
 PH

OThe pH of urine can normally vary between 4.5

and 8. (average around 6).

OStrongly acidic or alkaline urine may be

symptomatic of disease.
 Volume

The amount of urine produced depends on numerous

factors including :
O state of hydration,
O activities,
O environmental factors,
O age, and health.
O In adult human, the average production is about 1 - 2 L
per day.
O 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

O It is the ratio of the weight of a volume of

urine to the weight of the same volume of
distilled water at a constant temperature.

O 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
O Urine is aprox. 95% water.
O The other components of normal urine are the
solutes that are dissolved in the water
component of the urine.
 Organic molecules
O These are electrically neutral and can be
relatively large (compared with the 'simpler'
ions).These include:
O Urea
O Creatinine
O Others
 Urea
O Urea is an organic (i.e. carbon-based)
compound whose chemical formula is:
CON2H4 or (NH2)2CO. It is also known as
carbamide.
O 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
O Creatinine is a normal (healthy) constituent of
blood.
O It is produced mainly as a result of the
breakdown of creatine phosphate in muscle
tissue.
O It is usually produced by the body at a fairly
constant rate (which depends on the muscle
mass of the body).
 Uric acid
O 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
O Example of other substances that may be found in
small amounts in normal urine include :
O carbohydrates,
O enzymes,
O fatty acids,
O hormones,
O pigments, and mucins (a group of large, heavily
glycosylated proteins found in the body).
 Ions
O Sodium (Na+) : Amount in urine varies with
diet and the amount of aldosterone (a steroid
hormone) in the body.
O Potassium (K+) : Amount in urine varies with
diet and the amount of aldosterone (a steroid
hormone) in the body.
O Chloride (Cl-) : Amount in urine varies with
dietary intake (chloride is a part of common
salt, NaCl).
O 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.)

O 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.)

O Phosphates (H2PO4-, HPO42-, PO43-) amount in

urine varies with diet and the amount of parathyroid
hormone in the body - parathyroid hormone decreases
the quantity of phosphates in urine.
Small groups formed from a few
different elements:
O Ammonium (NH4+) : The amount of ammonia
produced by the kidneys may vary according
to the pH of the blood and tissues in the body.
O 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.
 What are the abnormal
constituents of urine?
Abnormal urine can have:
O Carbohydrates
O Proteins
O ketone bodies
O Blood
O Bile salts
Fats
 CARBOHYDRATES

O Physiologically in pregnancy and lactation,

lactose is excreted in pregnant women.
O Pathologically: if lactose is excreted in the
urine, then this is due to lactose intolerance.
O Glucose could be excreted in the urine in
Diabetes mellitus, renal glycosuria
O Fructose in essential fructosuria
O Galactose in galactosemia
O-The presence of significant amount of glucose in
urine is called glycosuria (e.g diabetes mellitus, renal
glycosuria)

O-The quantity of glucose that appears in the

urine is dependent upon
O - the blood glucose level
O - The rate of glomerular filtration
O - and the degree of tubular reabsorption

O- (Usually glucose will not be present in the urine

until the blood level exceeds 160 – 180 mg/dl, which
is the normal renal threshold for glucose )
 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
abnormally in urine:
OAlbumin
OGlobulin
OHemoglobin (protein of RBC)
OMyoglobin
OBence 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 synthesized in

the body. They are produced in the condition called
multiple myeloma, by plasma cells.
 KETONE BODIES
Are formed during the catabolism of fatty acids
They are basically three chemicals :
O acetone
O acetoacetic acid
O Beta-hydroxy butaric acid
All the three are the intermediates in lipid
metabolism.
Defect in metabolism can lead to presence of
ketone bodies in urine
 Increased catabolism of fats is due to :
O starvation
O increased fat intake
O decreased carbohydrates in take
O diabetes ketoacidosis
 RBC/ HEMOGLOBIN

In certain disease state such as:

O hemolytic anemia
O Urinary tract infections
O Renal trauma
BILE SALTS:
In Jaundice

BILE PIGMENTS:
in obstructive jaundice

Q:
The main bile pigments are bilirubin and biliverdin and these are
the catabolism of hemoglobin.
Ultimately these leave the body in feces and small amount in
the urine
** Presence of bile pigments in the urine helps to diagnose
increased production of bilirubin which is an indication of liver
dysfunction