UREA ESTIMATION

BY
DR.S.RAJAKUMARI M.D BIOCHEMISTRY
Methods
1.Urease Method
a)Urease Nesselerisation Method
b).Phenol hypochlorite Method.
2. Direct calorimetric :Diacetyl Monoxime Method
3.Autoanalyser Method
 Diacetyl monoxime method
Principle:
Urea reacts with Diacetyl monoxime in hot acid medium in the
presence of ferric chloride and thiosemicarbazide to give pink coloured

complex.The intensity of the colour is directly proportional to

the conentration of urea in the sample.
PROCEDURE-3 large test tube Name as blank, standard, and
test- wait 20min in boiling water bath measure -540 nm (green
filter)
Reagent BLANK (B) STANDARD(S) TEST(T)
DAM/ TSC reagent 3ml 3ml 3ml

Acid mixture 3ml 3ml 3ml

Serum or plasma 2ml

standard 2ml

Distilled water 2ml

 Calculation
• Urea present in 100ml of plasma =
O.D (T)-O.D(B) Concentration of std 100

O.D (S)-O.D(B) Volume of sample

T---B 50
S---B
Result
• Urea present in 100 ml of serum/plasma = mg/dl
Normal values
Normal level of urea in blood is 15-40mg/dl
Normal excreton of urea per day 15-30gms
Clinical interpretation
Increase in blood urea
1. Prerenal cause
a)Dehydration
b) Haemetemesis
c) Shock
d) cardiac failure
2.Renal causes
a.Acute Glomerulonephritis
b. Renal failure
c.Malignant hypertension
d. congenital cystic kidney disease
3.Post Renal causes:
a. Enlarged prostate
b.stones in the urinary tract
c. stricture urethra
d. Tumors of urinary bladder.
4. Decrease in blood urea:
a.Low protein diet
b. severe liver disease
c. overhydration.
• Urea clearance
It is the number of ml of blood which contains the urea excreted in a
minute by the kidneys
urea clearance =mg urea excreted per minute
mg urea per ml blood
UV
B
U=Urea in mg per 100 ml of urine
V=volume of urine excreted per minute
B= mg urea per 100 ml of blood
• Normal Range:
Maximum clearance :60 - 95ml / min
standard clearance: 40-65ml/min
Increase in urea clearance in early stage of nephrotic syndome.
Decrease in urea clearance in severe renal failure.
Measuerment of clearance is a test of glomerular filtration rate.
• 22 year old female is admitted in hospital with H/O passing loose stools - 6
times and vomiting 4 times for two days. Her urine output is reduced.

O/E pt conscious, dehydration ++

PR: 112/min BP: 90/70 mm Hg

1.What is your provisional diagnosis? 5marks

2.Mention the relevant Blood and Urine investigations.

3.Mention the normal reference range of the relevant parameters .

4. Write the principle and procedure of estimation of Urea in Blood

(5 marks )

5.Estimate the amount of Urea in the given sample.

(5 marks)

Discussion. (10 marks)

• 1. ACUTE GASTRO ENTERITIS WITH PRE RENAL UREMIA
BLOOD INVESTIGATIONS:
Blood Urea
Serum Creatinine
Plasma Glucose (Random)
Serum Chloride
Serum Bicarbonate

URINARY INVESTIGATIONS:
Urine specific gravity
• . NORMAL REFERENCE RANGE:

Blood Urea - 15 - 40 mg /dl

Serum Creatinine - 0.6 -1.2 mg /dl
Plasma Glucose (R) – 80 - 120 mg / dl
Serum Electrolytes
Serum Sodium - 136 -145 mEq /L
Serum Potassium -3.5 - 5.5 mEq /L
Serum Chloride – 96 - 106 mEq /L
Serum Bicarbonate - 22 to 26 mEq /L