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Pathological Urine Constituents

Pathological Urine Constituents

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Published by: manni1001 on Jan 16, 2010
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PATHOLOGICAL OR ABNORMAL URINECONSTITUENTS
I- Proteinuria:
- Proteinuria is a condition in which urine contains an abnormal amount of protein.- The majority of proteins found in the urine arise from the blood.- As blood passes through healthy kidneys, they filter the waste products out andleave in the things the body needs, like proteins. Most proteins are too big to passthrough the kidneys' filters into the urine unless the kidneys are damaged. The mainprotein that is most likely to appear in urine is albumin. Proteins from the blood canescape into the urine when the filters of the kidney, called glomeruli, are damaged.Sometimes the term albuminuria is used when a urine test detects albuminspecifically.- Large amounts of protein in the urine may cause it to look foamy. Also, because theprotein has left the body, the blood can no longer soak up enough fluid leading toswelling in the hands, feet, abdomen, or face. These are signs of very large proteinloss.- In a healthy renal and urinary tract system, the urine contains no protein or onlytraces amounts.- Because albumin is filtered more readily than the globulins, it is usually abundant inpathological conditions. Therefore, the term albuminuria is ~~~= proteinuria.
 
- The qualitative tests for proteinuria are most commonly performed using a reagenttest strip. These methods depend on the change in the response of an indicator dye inthe presence of protein. (See the figure)- Quantitative examination of urine protein requires considerable attention tothe volume or time of urine collection because the concentration may vary withtime and volume.- Most assays are performed on urine sample of 12-24h.- Reference Value (RV) for 24-h urine Male = 1-4 mg/dlFemale = 3-10mg/dlChild = 1-10mg/dl-Reference value Qualitative Normal = Negative 
Qualitative Tests for Proteins
-Before performing a test for albumin, the urine should be filtered or centrifuged.
1-Heat Coagulation Test:
 
Fill a test tube one third full of urine and gently heat the upper half of the fluid toboiling, being careful that this fluid does not mix with the lower half which serves asa control. Turbidity indicates proteins or calcium or magnesium phosphate. Acidifythe urine slightly by the addition of 3-5 drops of dilute acetic acid where upon theturbidity if due to phosphate will disappear.
2-Heller's Test:
1-Place 3ml of conc. HNO
3
in test tube. 2-Tie the tube to about a 30 degree angle. Using a pipette allow the urine to flow slowly down the side of the tube. 3-If albumin is present, within a few minutes a white ring will form at the  junction between the two liquids. 
II- Glucosuria:
-Glucosuria is a condition in which urine contains an abnormal amount of glucose.-Glucose is present in glomerular filtrate and is reabsorbed by the proximal tubule.- If the blood glucose level exceeds the reabsorption capacity of the tubules, glucosewill appear in the urine.-Tubular reabsorption of glucose is by active transport in response to the body'sneed to maintain an adequate concentration of glucose.-The blood level at which tubular reabsorption stops is termedrenal thresholdwhich for glucose is between 160-180 mg/ dl.

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