URINE

Module 12
Prepared by:

MK Salazar-Pascua
Urine
▪ The excretory product of the
kidneys.
▪ It passes through the ureters
to the bladder for temporary
storage and is then released
to the exterior through the
urethra.
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Urine
▪ Kidneys make urine by filtering
out unwanted water, waste
products, chemicals, sodium and
potassium ions from the blood.
▫ An exact amount of sodium and
potassium ions and some water is
returned to the bloodstream to
maintain a constant water and salt
balance in the body.
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Normal Fluid Regulation
▪ The hypothalamus regulates the
feeling of thirst and the need to
drink water.
▪ The brain produces vasopressin,
an antidiuretic hormone
▪ When the body needs to retain
water, vasopressin will be
released into the bloodstream. 4
Normal Fluid Regulation
▪ When there is a need to get rid of
water, vasopressin is not released
▪ Urination is triggered when the
urinary bladder fills to 250 ml
▪ Receptors send signal to spinal cord
▪ Motor nerve impulses cause
sphincters to relax and bladder to
contract. 5
Normal Fluid Regulation
▪ In older children and adults, the
brain controls this reflex
▪ Nephrons filter about 180 liters of
water per day, along with
considerable amounts of small
molecules and ions.
▪ Molecules and ions are reabsorbed
both actively and passively. 6
Diuretics
▪ Substances that increase the volume
of urine
▪ Includes drugs that promote the
excretion of salt and water from the
kidneys.
▪ Used to reduce the edema due to salt
and water retention in disorders of
the heart, kidneys, liver or lungs. 7
Physical
Properties
●
●
●
●
Color
Odor
pH
Density
1
● Turbidity
Color
▪ The normal color of urine range from
straw yellow to amber
▫ Urobilin – an orange-brown pigment
- Derived from spontaneous oxidation of urobilinogen

▫ Urochrome – yellow pigment

- Produced continuously during endogenous metabolism
- It is present in plasma and excreted in the urine

▫ Uroerythrin – a pink or red pigment

- Derived from melanin metabolism

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Color

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Abnormal Color: Red/Pink
1. Hematuria (urinary blood)
a. UTI
b. Enlarged prostate
c. Tumors
d. Kidney cysts
e. Kidney or bladder stones
2. Food
Ex: Beets, blackberries, dragon fruit,
and rhubarb
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Abnormal Color: Red/Pink
3. Medications
a. Rifampin
- treatment for tuberculosis
- turn urine reddish orange
b. Phenazopyridine (Pyridium)
- pain reliever for urinary
tract discomfort
c. laxatives containing senna
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Abnormal Color: Orange
1. Medications
a. anti-inflammatory drugs
- sulfasalazine (Azulfidine);
b. phenazopyridine (Pyridium);
c. some laxatives
d. chemotherapy drugs
2. Medical conditions
a. liver or bile duct problems
b. Dehydration
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Abnormal Color: Blue/Green
1. Dyes
2. Medications
a. Amitriptyline - antidepressant
b. Indomethacin - NSAID
c. propofol - anesthetic
3. Medical conditions
a. Familial benign hypercalcemia
b. Urinary tract infections caused
by pseudomonas bacteria.
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Abnormal Color: Brown
1. Food
Ex: Fava beans, rhubarb or aloe
2. Medications
a. antimalarial drugs
- chloroquine and primaquine
b. antibiotics
- metronidazole and nitrofurantoin
c. laxatives (cascara or senna)
d. Methocarbamol — muscle relaxant
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Abnormal Color: Brown
3. Medical conditions.
a. Liver and kidney disorders
b. Urinary tract infections
4. Extreme exercise
a. Muscle injury

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Abnormal Color: Cloudy
1. Urinary tract infections
2. Kidney stones

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Odor
▪ Urinoid
- Normal urine odor
▪ Fruity odor
- Diabetic ketoacidosis
- Uncontrolled diabetes
- Starvation
- Low carb diet
- Presence of acetone.
▪ Pungent odor
- urinary tract infection 18
pH
▪ Normally, freshly voided urine
is acidic.
▪ Some foods (e.g. citrus fruits)
and drugs (e.g. antacids) can
affect urine pH.
▪ Alkaline pH may be noted in
urinary tract infection due to
alkaline fermentation by
bacteria. 19
Specific Gravity
▪ It measures urine density and is
directly proportional to the
amount of solutes present in urine.
▪ The normal urinary specific gravity
ranges from 1.002 to 1.030.
▪ The specific gravity of urine is
measured by a device called
“refractometer” 20
Specific Gravity
▪ Decreased specific gravity occurs
in case of diabetes insipidus and
excessive fluid intake
▪ Increased specific gravity occurs
in diabetes mellitus, severe
vomiting or diarrhea.

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Turbidity
▪ Normal urine is clear.
▪ Turbidity can be caused by “crystals” or “cells”.
▪ Crystals include amorphous urate, triple phosphate
or calcium oxalate, and cells include pus cells or
epithelial cells.

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Normal
Constituents
●
●
●
●
Urea
Creatine
Chlorides
Sulfates
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● Carbonates
Urea
▪ Also known as carbamide
▪ Derived from ammonia and
produced by the deamination of
amino acids.
▫ The amount of urea in urine is
related to the quantity of dietary
protein.
▪ Urea is a waste product that is
excreted by the kidneys
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Creatinine
▪ Creatinine is a waste product
formed by the normal breakdown
of muscle cells.
▪ Healthy kidneys take creatinine
out of the blood and put it into
the urine to leave the body.
▪ High concentrations of creatinine
in urine can indicate diabetes or
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problems with the kidney.
Inorganic Constituents
▪ Chlorides
▫ Depending on the salt intake
▪ Sulfates
▫ Derived from amino acids
▪ Phosphates
▫ Abnormal levels could indicate
▫ Kidney problems
▫ High levels of vitamin D
▫ Overactive parathyroid gland
▫ Tumor 26
Inorganic Constituents
▪ Carbonates
▫ Present in the form of bicarbonates
▪ Ammonia
▫ Very little is present in fresh urine.
▫ secreted by nephron tubules
▫ Urine that is allowed to stand at
room temperature for 24 hours or
longer may give off an odor of
ammonia due to the breakdown of
urea by bacterial action. 27
Abnormal
Constituents
●
●
●
●
Glucose
Ketone bodies
Protein
Bile
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