Urinalysis
Encyclopedia
A urinalysis also known as Routine and Microscopy (R&M), is an array of tests performed on urine
, and one of the most common methods of medical diagnosis
. The word is a portmanteau of the words urine and analysis.
The target parameters that can be measured or quantified in urinalysis include many substances and cells, as well as other properties such as specific gravity
.
A part of a urinalysis can be performed by using urine test strips, in which the test results can be read as color changes. Another method is light microscopy of urine samples.
A sodium-related parameter is fractional sodium excretion
, which is the percentage of the sodium filtered by the kidney which is excreted in the urine. It is a useful parameter in acute renal failure
and oliguria
, with a value below 1% indicating a prerenal disease and a value above 3% indicating acute tubular necrosis
or other kidney damage.
can quantify parameters such as:
The numbers and types of cell
s and/or material such as urinary casts
can yield a great detail of information and may suggest a specific diagnosis.
Urine
Urine is a typically sterile liquid by-product of the body that is secreted by the kidneys through a process called urination and excreted through the urethra. Cellular metabolism generates numerous by-products, many rich in nitrogen, that require elimination from the bloodstream...
, and one of the most common methods of medical diagnosis
Medical diagnosis
Medical diagnosis refers both to the process of attempting to determine or identify a possible disease or disorder , and to the opinion reached by this process...
. The word is a portmanteau of the words urine and analysis.
The target parameters that can be measured or quantified in urinalysis include many substances and cells, as well as other properties such as specific gravity
Specific gravity
Specific gravity is the ratio of the density of a substance to the density of a reference substance. Apparent specific gravity is the ratio of the weight of a volume of the substance to the weight of an equal volume of the reference substance. The reference substance is nearly always water for...
.
A part of a urinalysis can be performed by using urine test strips, in which the test results can be read as color changes. Another method is light microscopy of urine samples.
Target parameters
In addition to the substances mentioned in tables below, other tests include:- a description of color and appearance.
Ions and trace metals
| Target | Lower limit | Upper limit | Unit | Comments |
|---|---|---|---|---|
| Nitrite Nitrite test A nitrite test is a chemical test used to determine the presence of nitrite ion in solution.-Chemical method:A common nitrite test can be performed by adding 4 M sulfuric acid to the sample until acidic, and then adding 0.1 M iron sulfate to the solution... |
n/a | 0 / negative | The presence of nitrites in urine is termed Nitrituria, and indicates the presence of coliform bacteria. |
|
| Sodium Sodium Sodium is a chemical element with the symbol Na and atomic number 11. It is a soft, silvery-white, highly reactive metal and is a member of the alkali metals; its only stable isotope is 23Na. It is an abundant element that exists in numerous minerals, most commonly as sodium chloride... (Na) - per day |
150 | 300 | mmol / 24hours | The sodium levels are frequently ordered during the workup of acute renal failure. The fractional excretion of sodium, abbreviated as FeNa is an important marker in distinguishing pre-renal from post-renal failure. |
| Potassium Potassium Potassium is the chemical element with the symbol K and atomic number 19. Elemental potassium is a soft silvery-white alkali metal that oxidizes rapidly in air and is very reactive with water, generating sufficient heat to ignite the hydrogen emitted in the reaction.Potassium and sodium are... (K) - per day |
40 | 90 | mmol / 24hours | Urine potassium may be ordered in the workup of hypokalemia. In case of GI loss of potassium, the urine potassium will be low. In case of renal loss of potassium, the urine potassium levels will be high. Decreased levels of urine potassium are also seen in hypoaldosteronism and adrenal insufficiency. |
| Urinary calcium Urinary calcium Urinary calcium is calcium in the urine. It is termed -calcuria or -calciuria as a suffix.-Normal amount:In a urinalysis, the normal amount of urinary calcium can be measured in amount per time... (Ca) - per day |
15 | 20 | mmol / 24hours | An abnormally high level is called hypercalciuria Hypercalciuria Hypercalciuria or hypercalcinuria is the condition of elevated calcium in the urine. Chronic hypercalcinuria may lead to impairment of renal function, nephrocalcinosis, and renal insufficiency.... and an abnormally low rate is called hypocalciuria Hypocalciuria Hypocalciuria is a low level of calcium in the urine. It is a significant risk factor for predicting eclampsia in pregnancy. It is also common in patients with Gitelman syndrome. It is also found in Familial hypocalciuric hypercalcemia.... . |
| 100 | 250 | mg / 24 hours | ||
| Phosphate Phosphate A phosphate, an inorganic chemical, is a salt of phosphoric acid. In organic chemistry, a phosphate, or organophosphate, is an ester of phosphoric acid. Organic phosphates are important in biochemistry and biogeochemistry or ecology. Inorganic phosphates are mined to obtain phosphorus for use in... (P) - per day |
n/a | 38 | mmol / 24hours | is the hyperexcretion of phosphate Phosphate A phosphate, an inorganic chemical, is a salt of phosphoric acid. In organic chemistry, a phosphate, or organophosphate, is an ester of phosphoric acid. Organic phosphates are important in biochemistry and biogeochemistry or ecology. Inorganic phosphates are mined to obtain phosphorus for use in... in the urine Urine Urine is a typically sterile liquid by-product of the body that is secreted by the kidneys through a process called urination and excreted through the urethra. Cellular metabolism generates numerous by-products, many rich in nitrogen, that require elimination from the bloodstream... . This condition is divided into primary and secondary types. Primary hypophosphatemia is characterized by direct excess excretion of phosphate by the kidneys, as from primary renal dysfunction, and also the direct action of many classes of diuretic Diuretic A diuretic provides a means of forced diuresis which elevates the rate of urination. There are several categories of diuretics. All diuretics increase the excretion of water from bodies, although each class does so in a distinct way.- Medical uses :... s on the kidneys. Additionally, secondary causes, including both types of hyperparathyroidism Hyperparathyroidism Hyperparathyroidism is overactivity of the parathyroid glands resulting in excess production of parathyroid hormone . The parathyroid hormone regulates calcium and phosphate levels and helps to maintain these levels... cause hyperexcretion of phosphate in the urine. |
A sodium-related parameter is fractional sodium excretion
Fractional sodium excretion
The fractional excretion of sodium is the percentage of the sodium filtered by the kidney which is excreted in the urine. It is measured in terms of plasma and urine sodium, rather than by the interpretation of urinary sodium concentration alone, as urinary sodium concentrations can vary with...
, which is the percentage of the sodium filtered by the kidney which is excreted in the urine. It is a useful parameter in acute renal failure
Acute renal failure
Acute kidney injury , previously called acute renal failure , is a rapid loss of kidney function. Its causes are numerous and include low blood volume from any cause, exposure to substances harmful to the kidney, and obstruction of the urinary tract...
and oliguria
Oliguria
Oliguria is the low output of urine, It is clinically classified as an output below 300-500ml/day. The decreased output of urine may be a sign of dehydration, renal failure, hypovolemic shock, HHNS Hyperosmolar Hyperglycemic Nonketotic Syndrome, multiple organ dysfunction syndrome, urinary...
, with a value below 1% indicating a prerenal disease and a value above 3% indicating acute tubular necrosis
Acute tubular necrosis
Acute tubular necrosis or is a medical condition involving the death of tubular cells that form the tubule that transports urine to the ureters while reabsorbing 99% of the water . Tubular cells continually replace themselves and if the cause of ATN is removed then recovery is likely...
or other kidney damage.
Proteins and enzymes
| Target | Lower limit | Upper limit | Unit | Comments |
|---|---|---|---|---|
| Protein | 0 | trace amounts / 20 |
mg/dL | Proteins may be measured with the Albustix Test. Since proteins are very large molecules (macromolecules), they are not normally present in measurable amounts in the glomerular filtrate or in the urine. The detection of protein in urine, called proteinuria Proteinuria Proteinuria means the presence of anexcess of serum proteins in the urine. The protein in the urine often causes the urine to become foamy, although foamy urine may also be caused by bilirubin in the urine , retrograde ejaculation, pneumaturia due to a fistula, or drugs such as pyridium.- Causes... may indicate that the permeability Vascular permeability Vascular permeability, often in the form of capillary permeability, characterizes the capacity of a blood vessel wall to allow for the flow of small molecules or even whole cells in and out of the vessel. Blood vessel walls are lined by a single layer of endothelial cells... of the glomerulus is abnormally increased. This may be caused by renal infections or it may be caused by other diseases that have secondarily affected the kidneys such as diabetes mellitus Diabetes mellitus Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced... , jaundice Jaundice Jaundice is a yellowish pigmentation of the skin, the conjunctival membranes over the sclerae , and other mucous membranes caused by hyperbilirubinemia . This hyperbilirubinemia subsequently causes increased levels of bilirubin in the extracellular fluid... , or hyperthyroidism Hyperthyroidism Hyperthyroidism is the term for overactive tissue within the thyroid gland causing an overproduction of thyroid hormones . Hyperthyroidism is thus a cause of thyrotoxicosis, the clinical condition of increased thyroid hormones in the blood. Hyperthyroidism and thyrotoxicosis are not synonymous... . |
| hCG Human chorionic gonadotropin Human chorionic gonadotropin or human chorionic gonadotrophin is a glycoprotein hormone produced during pregnancy that is made by the developing embryo after conception and later by the syncytiotrophoblast .. Some tumors make this hormone; measured elevated levels when the patient is not... In non-pregnant adults |
- | 50 | U/L | This hormone appears in the urine of pregnant Pregnancy Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets... women Woman A woman , pl: women is a female human. The term woman is usually reserved for an adult, with the term girl being the usual term for a female child or adolescent... . Home pregnancy test Pregnancy test A pregnancy test attempts to determine whether or not a woman is pregnant.These markers are found in urine and blood, and pregnancy tests require sampling one of these substances. The first of these markers to be discovered, human chorionic gonadotropin , was discovered in 1930 to be produced by... s commonly detect this substance. |
Blood cells
| Target | Lower limit | Upper limit | Unit | Comments |
|---|---|---|---|---|
| Red blood cell Red blood cell Red blood cells are the most common type of blood cell and the vertebrate organism's principal means of delivering oxygen to the body tissues via the blood flow through the circulatory system... s (RBCs) / erythrocytes |
0 | 2 - 3 | per High Power Field High Power Field High Power Field when used in relation to microscopy references the area visible under the maximum magnification power of the objective being used. Often, this represents a 400x magnification level when referenced in scientific papers.... (HPF) |
|
| RBC casts | n/a | 0 / negative | ||
| White blood cell White blood cell White blood cells, or leukocytes , are cells of the immune system involved in defending the body against both infectious disease and foreign materials. Five different and diverse types of leukocytes exist, but they are all produced and derived from a multipotent cell in the bone marrow known as a... s (WBCs) / leukocytes |
0 | 2 / negative | ||
| - | 10 | per µl or mm3 |
"Significant pyuria Pyuria In medicine, Pyuria refers to urine which contains pus. Defined as the presence of 4 or more neutrophils per high power field of unspun, voided mid-stream urine. It can be sign of a bacterial urinary tract infection... " at greater than or equal to 10 leucocytes per microlitre (µl) or cubic millimeter (mm3) |
|
| Blood Blood Blood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells.... |
n/a | 0 / negative | May be present as intact RBC which indicates bleeding or discoloration. Note that a very small amount of blood is enough to give the entire urine sample or the foley bag a red/pink hue, and it is difficult to judge the amount of bleeding from a gross examination. The urine color may also be red due to excretion of pigment such as myoglobin and hemoglobin, in which case the urine dipstick shows presence of blood but there are no RBC seen on microscopic examination. Always check INR/PT/PTT and send a fresh urine sample for urinalysis when blood is detected. A case can also be made for urine cytology Urine cytology Urine typically contains epithelial cells shed from the urinary tract. Urine cytology evaluates this urinary sediment for the presence of cancerous cells from the lining of the urinary tract, and it is a convenient noninvasive technique for follow-up analysis of patients treated for urinary tract... , especially for elderly patients. |
|
Other molecules
| Target | Lower limit | Upper limit | Unit | Comments |
|---|---|---|---|---|
| Glucose Glucose Glucose is a simple sugar and an important carbohydrate in biology. Cells use it as the primary source of energy and a metabolic intermediate... |
n/a | 0 / negative | Glucose can be measured with Benedict's Test. Although glucose is easily filtered in the glomerulus, it is not present in the urine because all of the glucose that is filtered is normally reabsorbed from the renal tubules back into the blood. Presence of glucose in the urine is called glucosuria. |
|
| Ketone bodies Ketone bodies Ketone bodies are three water-soluble compounds that are produced as by-products when fatty acids are broken down for energy in the liver and kidney. They are used as a source of energy in the heart and brain. In the brain, they are a vital source of energy during fasting... |
n/a | 0 / negative | When there is carbohydrate Carbohydrate A carbohydrate is an organic compound with the empirical formula ; that is, consists only of carbon, hydrogen, and oxygen, with a hydrogen:oxygen atom ratio of 2:1 . However, there are exceptions to this. One common example would be deoxyribose, a component of DNA, which has the empirical... deprivation, such as starvation or high protein diets, the body relies increasingly on the metabolism Metabolism Metabolism is the set of chemical reactions that happen in the cells of living organisms to sustain life. These processes allow organisms to grow and reproduce, maintain their structures, and respond to their environments. Metabolism is usually divided into two categories... of fats for energy. This pattern is also seen in people with the disease diabetes mellitus, when a lack of the hormone insulin Insulin Insulin is a hormone central to regulating carbohydrate and fat metabolism in the body. Insulin causes cells in the liver, muscle, and fat tissue to take up glucose from the blood, storing it as glycogen in the liver and muscle.... prevents the body cells from utilizing the large amounts of glucose Glucose Glucose is a simple sugar and an important carbohydrate in biology. Cells use it as the primary source of energy and a metabolic intermediate... available in the blood. This happens because insulin is necessary for the transport of glucose from the blood into the body cells. The metabolism of fat proceeds in a series of steps. First, triglycerides are hydrolyzed to fatty acids and glycerol Glycerol Glycerol is a simple polyol compound. It is a colorless, odorless, viscous liquid that is widely used in pharmaceutical formulations. Glycerol has three hydroxyl groups that are responsible for its solubility in water and its hygroscopic nature. The glycerol backbone is central to all lipids... . Second the fatty acids are hydrolyzed into smaller intermediate compounds (acetoacetic acid, betahydroxybutyric acid, and acetone). Thirdly, the intermediate products are utilized in aerobic cellular respiration Cellular respiration Cellular respiration is the set of the metabolic reactions and processes that take place in the cells of organisms to convert biochemical energy from nutrients into adenosine triphosphate , and then release waste products. The reactions involved in respiration are catabolic reactions that involve... . When the production of the intermediate products of fatty acid metabolism (collectively known as ketone bodies) exceeds the ability of the body to metabolize these compounds they accumulate in the blood and some end up in the urine (ketonuria Ketonuria Ketonuria is a medical condition in which ketone bodies are present in the urine.It is seen in conditions in which the body produces excess ketones as an alternative source of energy. It is seen during starvation or more commonly in type I diabetes mellitus... ). |
|
| Bilirubin Bilirubin Bilirubin is the yellow breakdown product of normal heme catabolism. Heme is found in hemoglobin, a principal component of red blood cells. Bilirubin is excreted in bile and urine, and elevated levels may indicate certain diseases... |
n/a | 0 / negative | The fixed phagocytic cells of the spleen and bone marrow destroy old red blood cells and convert the heme groups of hemoglobin to the pigment bilirubin. The bilirubin is secreted into the blood and carried to the liver where it is bonded to (conjugated with) glucuronic acid, a derivative of glucose. Some of the conjugated bilirubin is secreted into the blood and the rest is excreted in the bile as bile pigment that passes into the small intestine. The blood normally contains a small amount of free and conjugated bilirubin. An abnormally high level of blood bilirubin may result from: an increased rate of red blood cell destruction, liver damage, as in hepatitis and cirrhosis, and obstruction of the common bile duct as with gallstones. An increase in blood bilirubin results in jaundice, a condition characterized by a brownish yellow pigmentation of the skin and of the sclera Sclera The sclera , also known as the white or white of the eye, is the opaque , fibrous, protective, outer layer of the eye containing collagen and elastic fiber. In the development of the embryo, the sclera is derived from the neural crest... of the eye. |
|
| Urobilinogen Urobilinogen Urobilinogen is a colourless product of bilirubin reduction. It is formed in the intestines by bacterial action. Some urobilinogen is reabsorbed, taken up into the circulation and excreted by the kidney. This constitutes the normal "enterohepatic urobilinogen cycle".Increased amounts of bilirubin... |
0.2 | 1.0 | Ehrlich units or mg/dL |
|
| Creatinine Creatinine Creatinine is a break-down product of creatine phosphate in muscle, and is usually produced at a fairly constant rate by the body... - per day |
4.8 | 19 | mmol / 24hours | |
| Free catecholamine Catecholamine Catecholamines are molecules that have a catechol nucleus consisting of benzene with two hydroxyl side groups and a side-chain amine. They include dopamine, as well as the "fight-or-flight" hormones adrenaline and noradrenaline released by the adrenal medulla of the adrenal glands in response to... s, dopamine Dopamine Dopamine is a catecholamine neurotransmitter present in a wide variety of animals, including both vertebrates and invertebrates. In the brain, this substituted phenethylamine functions as a neurotransmitter, activating the five known types of dopamine receptors—D1, D2, D3, D4, and D5—and their... - per day |
90 | 420 | μg / 24hours | |
| Free cortisol Cortisol Cortisol is a steroid hormone, more specifically a glucocorticoid, produced by the adrenal gland. It is released in response to stress and a low level of blood glucocorticoids. Its primary functions are to increase blood sugar through gluconeogenesis; suppress the immune system; and aid in fat,... |
28 or 30 | 280 or 490 | nmol/24h | Values below threshold indicate Addison's disease Addison's disease Addison’s disease is a rare, chronic endocrine disorder in which the adrenal glands do not produce sufficient steroid hormones... , while values above indicate Cushing's syndrome Cushing's syndrome Cushing's syndrome is a hormone disorder caused by high levels of cortisol in the blood. This can be caused by taking glucocorticoid drugs, or by tumors that produce cortisol or adrenocorticotropic hormone or CRH... . A value smaller than 200 nmol/24h (72 µg/24h) strongly indicates absence of Cushing's syndrome. |
| 10 or 11 | 100 or 176 | µg Microgram In the metric system, a microgram is a unit of mass equal to one millionth of a gram , or 1/1000 of a milligram. It is one of the smallest units of mass commonly used... /24h Hours Hours may refer to:* The plural of the unit of time, hour* an expression of time using the 24-hour clock system * Horae , Greek deities* Hours, Pyrénées-Atlantiques, a commune in France... |
||
| Phenylalanine Phenylalanine Phenylalanine is an α-amino acid with the formula C6H5CH2CHCOOH. This essential amino acid is classified as nonpolar because of the hydrophobic nature of the benzyl side chain. L-Phenylalanine is an electrically neutral amino acid, one of the twenty common amino acids used to biochemically form... |
30.0 | mg/L | In neonatal screening, a value above upper limit defines phenylketonuria. | |
Other urine parameters
| Test | Lower limit | Upper limit | Unit | Comments | |
|---|---|---|---|---|---|
| Urine specific gravity Urine Specific Gravity Urine specific gravity is a laboratory test that measures the concentration of particles in the urine. Normal values are between 1.020 to 1.028 Osmolality is normally used for more detailed analysis but USG remains popular for its convenience.... |
1.003 | 1.030 | no unit | This test detects the ion concentration of urine. Small amounts of protein or ketoacidosis Ketoacidosis Ketoacidosis is a metabolic state associated with high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids. The two common ketones produced in humans are acetoacetic acid and β-hydroxybutyrate.... tend to elevate the urine's specific gravity Specific gravity Specific gravity is the ratio of the density of a substance to the density of a reference substance. Apparent specific gravity is the ratio of the weight of a volume of the substance to the weight of an equal volume of the reference substance. The reference substance is nearly always water for... (SG). This value is measured using a urinometer Urinometer A Urineometer is a simple piece of equipment for determining urine specific gravity.A typical urinometer is composed of a float, a weight, and a stem. The float is an air-filled glass tube, ending in the weight on the left and the stem on the right. The weight is a bulb filled with ball bearings... and indicates whether you are hydrated or dehydrated. If the SG of your urine is under 1.010 you are hydrated. If your urine SG is above 1.020, you are dehydrated. |
|
| Osmolality | 400 | n/a | mOsm Osmole (unit) Osmolarity is the measure of solute concentration, defined as the number of osmoles of solute per litre of solution . The osmolarity of a solution is usually expressed as Osm/L , in the same way that the molarity of a solution is expressed as "M"... /kg |
||
| pH PH In chemistry, pH is a measure of the acidity or basicity of an aqueous solution. Pure water is said to be neutral, with a pH close to 7.0 at . Solutions with a pH less than 7 are said to be acidic and solutions with a pH greater than 7 are basic or alkaline... |
5 | 7 | (unitless) | ||
| Bacterial cultures | by urination Urination Urination, also known as micturition, voiding, peeing, weeing, pissing, and more rarely, emiction, is the ejection of urine from the urinary bladder through the urethra to the outside of the body. In healthy humans the process of urination is under voluntary control... |
- | 100,000 | colony forming units per millilitre (CFU/mL) | Bacteriuria Bacteriuria In medicine, bacteriuria denotes the presence of bacteria in urine not due to contamination from urine sample collection.Urine is normally a sterile bodily fluid when inside the bladder, but can pick up commensals and pathogens when exiting through the urethra... can be confirmed if a single bacterial species is isolated in a concentration greater than 100,000 colony forming units per millilitre of urine in clean-catch midstream urine specimens (one for men, two consecutive specimens with the same bacterium for women). |
| by bladder catheterisation | - | 100 | For urine collected via bladder catheterisation, the threshold is 100 colony forming units of a single species per millilitre. |
||
Methods
When a doctor orders a urinalysis they will request either a routine urinalysis or a R&M urinalysis. The difference being a routine urinalysis is everything but the microscopy or culture, whereas the R&M is Routine and Microscopy urinalysis.Urine test strip
A urine test stripUrine test strip
A urine test strip or dipstick is a basic diagnostic instrument used to determine pathological changes in the urine in standard urinalysis. A standard urine test strip may comprise up to 10 different chemical pads or reagents which react when immersed in, and then removed from, a urine sample....
can quantify parameters such as:
- LeukocytesWhite blood cellWhite blood cells, or leukocytes , are cells of the immune system involved in defending the body against both infectious disease and foreign materials. Five different and diverse types of leukocytes exist, but they are all produced and derived from a multipotent cell in the bone marrow known as a...
- with presence in urine known as leukocyturia - NitriteNitriteThe nitrite ion has the chemical formula NO2−. The anion is symmetric with equal N-O bond lengths and a O-N-O bond angle of ca. 120°. On protonation the unstable weak acid nitrous acid is produced. Nitrite can be oxidised or reduced, with product somewhat dependent on the oxidizing/reducing agent...
- with presence in urine known as Nitrituria - ProteinProteinProteins are biochemical compounds consisting of one or more polypeptides typically folded into a globular or fibrous form, facilitating a biological function. A polypeptide is a single linear polymer chain of amino acids bonded together by peptide bonds between the carboxyl and amino groups of...
- with presence in urine known as ProteinuriaProteinuriaProteinuria means the presence of anexcess of serum proteins in the urine. The protein in the urine often causes the urine to become foamy, although foamy urine may also be caused by bilirubin in the urine , retrograde ejaculation, pneumaturia due to a fistula, or drugs such as pyridium.- Causes...
also see AlbuminuriaAlbuminuriaAlbuminuria is a pathological condition wherein albumin is present in the urine. It is a type of proteinuria.Measurement=The amount of protein being lost in the urine can be quantified by collecting the urine for 24 hours, measuring a sample of the pooled urine, and extrapolating to the volume...
and MicroalbuminuriaMicroalbuminuriaMicroalbuminuria occurs when the kidney leaks small amounts of albumin into the urine, in other words, when there is an abnormally high permeability for albumin in the renal glomerulus.-Diagnosis:... - BloodRed blood cellRed blood cells are the most common type of blood cell and the vertebrate organism's principal means of delivering oxygen to the body tissues via the blood flow through the circulatory system...
- with presence in urine known as HematuriaHematuriaIn medicine, hematuria, or haematuria, is the presence of red blood cells in the urine. It may be idiopathic and/or benign, or it can be a sign that there is a kidney stone or a tumor in the urinary tract , ranging from trivial to lethal... - specific gravitySpecific gravity (kidney)Specific gravity, in the context of clinical pathology, is a urinalysis parameter commonly used in the evaluation of kidney function and can aid in the diagnosis of various renal diseases.-Background:...
- pHPHIn chemistry, pH is a measure of the acidity or basicity of an aqueous solution. Pure water is said to be neutral, with a pH close to 7.0 at . Solutions with a pH less than 7 are said to be acidic and solutions with a pH greater than 7 are basic or alkaline...
Microscopic examination
Cell (biology)
The cell is the basic structural and functional unit of all known living organisms. It is the smallest unit of life that is classified as a living thing, and is often called the building block of life. The Alberts text discusses how the "cellular building blocks" move to shape developing embryos....
s and/or material such as urinary casts
Urinary casts
Urinary casts are cylindrical structures produced by the kidney and present in the urine in certain disease states. They form in the distal convoluted tubule and collecting ducts of nephrons, then dislodge and pass into the urine, where they can be detected by microscopy.They form via precipitation...
can yield a great detail of information and may suggest a specific diagnosis.
- HematuriaHematuriaIn medicine, hematuria, or haematuria, is the presence of red blood cells in the urine. It may be idiopathic and/or benign, or it can be a sign that there is a kidney stone or a tumor in the urinary tract , ranging from trivial to lethal...
- associated with kidney stoneKidney stoneA kidney stone, also known as a renal calculus is a solid concretion or crystal aggregation formed in the kidneys from dietary minerals in the urine...
s, infectionInfectionAn infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
s, tumorTumorA tumor or tumour is commonly used as a synonym for a neoplasm that appears enlarged in size. Tumor is not synonymous with cancer...
s and other conditions - PyuriaPyuriaIn medicine, Pyuria refers to urine which contains pus. Defined as the presence of 4 or more neutrophils per high power field of unspun, voided mid-stream urine. It can be sign of a bacterial urinary tract infection...
- associated with urinary infectionsUrinary tract infectionA urinary tract infection is a bacterial infection that affects any part of the urinary tract. Symptoms include frequent feeling and/or need to urinate, pain during urination, and cloudy urine. The main causal agent is Escherichia coli... - eosinophiluriaEosinophiluriaEosinophiluria is the abnormal presence of eosinophils in the urine.It can be measured by detecting levels of eosinophil cationic protein.-Associated conditions:It can be associated with a wide variety of conditions, including:* urinary tract infection...
- associated with allergic interstitial nephritis, atheroembolic diseaseCholesterol embolismCholesterol embolism occurs when cholesterol is released, usually from an atherosclerotic plaque, and travels along with the bloodsteam to other places in the body, where it obstructs blood vessels... - Red blood cell casts - associated with glomerulonephritisGlomerulonephritisGlomerulonephritis, also known as glomerular nephritis, abbreviated GN, is a renal disease characterized by inflammation of the glomeruli, or small blood vessels in the kidneys...
, vasculitisVasculitisVasculitis refers to a heterogeneous group of disorders that are characterized by inflammatory destruction of blood vessels. Both arteries and veins are affected. Lymphangitis is sometimes considered a type of vasculitis...
, malignant hypertensionMalignant hypertensionMalignant hypertension or hypertensive emergency is severe hypertension with acute impairment of an organ system and the possibility of irreversible organ-damage... - White blood cell casts - associated with acute interstitial nephritis, exudative glomerulonephritisGlomerulonephritisGlomerulonephritis, also known as glomerular nephritis, abbreviated GN, is a renal disease characterized by inflammation of the glomeruli, or small blood vessels in the kidneys...
, severe pyelonephritisPyelonephritisPyelonephritis is an ascending urinary tract infection that has reached the pyelum or pelvis of the kidney. It is a form of nephritis that is also referred to as pyelitis... - (heme) granular casts - associated with acute tubular necrosisAcute tubular necrosisAcute tubular necrosis or is a medical condition involving the death of tubular cells that form the tubule that transports urine to the ureters while reabsorbing 99% of the water . Tubular cells continually replace themselves and if the cause of ATN is removed then recovery is likely...
- crystalluriaCrystalluriaCrystalluria refers to crystals found in the urine when performing a urine test. Crystalluria is considered as one of the side effects of sulphonamides.-Clinical significance:It can be an indication of urolithiasis.It can be associated with cysteinuria....
-- associated with acute urate nephropathy (or "Acute uric acid nephropathy", AUAN) - calcium oxalatinCalcium oxalateCalcium oxalate is a chemical compound that forms needle-shaped crystals, known in plants as raphides. A major constituent of human kidney stones, the chemical is also found in beerstone, a scale that forms on containers used in breweries...
- associated with ethylene glycolEthylene glycolEthylene glycol is an organic compound widely used as an automotive antifreeze and a precursor to polymers. In its pure form, it is an odorless, colorless, syrupy, sweet-tasting liquid...
toxicity
Other methods of urinalysis
- Urine culture - a microbiological cultureMicrobiological cultureA microbiological culture, or microbial culture, is a method of multiplying microbial organisms by letting them reproduce in predetermined culture media under controlled laboratory conditions. Microbial cultures are used to determine the type of organism, its abundance in the sample being tested,...
of urine samples, detecting bacteriuriaBacteriuriaIn medicine, bacteriuria denotes the presence of bacteria in urine not due to contamination from urine sample collection.Urine is normally a sterile bodily fluid when inside the bladder, but can pick up commensals and pathogens when exiting through the urethra...
. It is indicated when a urinary tract infectionUrinary tract infectionA urinary tract infection is a bacterial infection that affects any part of the urinary tract. Symptoms include frequent feeling and/or need to urinate, pain during urination, and cloudy urine. The main causal agent is Escherichia coli...
is suspected. - Icotest - The test used to detect the destruction of old Red Blood Cells (RBC) in the urine.
- HemoglobinHemoglobinHemoglobin is the iron-containing oxygen-transport metalloprotein in the red blood cells of all vertebrates, with the exception of the fish family Channichthyidae, as well as the tissues of some invertebrates...
Test - HemolysisHemolysisHemolysis —from the Greek meaning "blood" and meaning a "loosing", "setting free" or "releasing"—is the rupturing of erythrocytes and the release of their contents into surrounding fluid...
in the blood vessels, a rupture in the capillaries of the glomerulusGlomerulusA glomerulus is a capillary tuft that is involved in the first step of filtering blood to form urine.A glomerulus is surrounded by Bowman's capsule, the beginning component of nephrons in the vertebrate kidney. A glomerulus receives its blood supply from an afferent arteriole of the renal...
, or hemorrhage in the urinary system may cause hemoglobinHemoglobinHemoglobin is the iron-containing oxygen-transport metalloprotein in the red blood cells of all vertebrates, with the exception of the fish family Channichthyidae, as well as the tissues of some invertebrates...
to appear in the urine.
See also
- UroscopyUroscopyUroscopy is the historic medical practice of visually examining a patient's urine for pus, blood, or other symptoms of disease. It dates back to ancient Egypt, Babylon, and India. It was particularly emphasized in Byzantine medicine....
, the ancient form of this analysis - Medical technologistMedical technologistA Medical Laboratory Scientist is a healthcare professional who performs chemical, hematological, immunologic, microscopic, and bacteriological diagnostic analyses on body fluids such as blood, urine, sputum, stool, cerebrospinal fluid , peritoneal fluid, pericardial fluid, and synovial...
- Urinary castsUrinary castsUrinary casts are cylindrical structures produced by the kidney and present in the urine in certain disease states. They form in the distal convoluted tubule and collecting ducts of nephrons, then dislodge and pass into the urine, where they can be detected by microscopy.They form via precipitation...
- ProteinuriaProteinuriaProteinuria means the presence of anexcess of serum proteins in the urine. The protein in the urine often causes the urine to become foamy, although foamy urine may also be caused by bilirubin in the urine , retrograde ejaculation, pneumaturia due to a fistula, or drugs such as pyridium.- Causes...
- Urine test stripUrine test stripA urine test strip or dipstick is a basic diagnostic instrument used to determine pathological changes in the urine in standard urinalysis. A standard urine test strip may comprise up to 10 different chemical pads or reagents which react when immersed in, and then removed from, a urine sample....
- Urine collection deviceUrine collection deviceA urine collection device or UCD is a device that allows the collection of urine for analysis or for purposes of simple elimination...
- Drug testDrug testA drug test is a technical analysis of a biological specimen – for example urine, hair, blood, sweat, or oral fluid / saliva – to determine the presence or absence of specified parent drugs or their metabolites...