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Physical properties of urine
Urine formation depends on air temperature, rest, sleep. The mechanism for reducing diuresis during sleep resembles that which occurs under the influence of the antidiuretic hormone of the posterior pituitary gland. Muscle exercises lead to a decrease in plasma renal output, which causes a decrease in sodium excretion. Heat reduces glomerular filtration, causing oliguria and also lowers sodium excretion. The amount of urine excreted during the day depends on age. The amount of urine excreted per day by a healthy adult varies from 1200 to 1500 ml. The amount of urine excreted during the day in children can be calculated by the formula:
600 + 100 (x - 1) = ml in 24 hours,
where x is the number of years the child is from 1 year to 10 years.
Morning portion of urine is approximately 100-200 ml and does not give an idea of daily diuresis. The measurement of this amount is appropriate for the interpretation of its relative density. The amount of urine in a laboratory is measured in beakers or graduated cylinders.
Polyuria - an increase in daily urine output. Polyuria is observed when taking large amounts of fluid, eating foods that increase the excretion of urine (watermelon, melon), with the convergence of edema, with diabetes and diabetes insipidus.
Oliguria - a pronounced decrease in daily diuresis. Oliguria is observed with limited intake of fluid, increased sweating, vomiting, diarrhea, with an increase in edema.
Anuria - the cessation of the flow of urine into the bladder. Anuria occurs with severe trauma, with severe blood loss, acute cardiovascular failure; renal anuria is associated with pathological processes in the kidneys, subrenal anuria is associated with complete blockage of the kidneys with stones or compression of their tumors.
Ishuria - urinary retention in the bladder due to the inability to self-urinate.
Causes of Ishuria:
1) adenoma or prostate cancer;
2) inflammatory diseases of the prostate;
3) urethral stricture;
4) compression of the tumor or blockage with a stone exit from the bladder;
5) disorders of the neuromuscular apparatus of the bladder.
The color of normal fresh urine - from straw to amber yellow - is due to the content of pigment in it - urochrome. During storage, the urine darkens, which is associated with the oxidation of bilirubinoids. The color of urine can vary with various pathological processes (table. 21).
Some food products (beets, blueberries, carrots) also affect the color of urine.
Table 21. Urine discoloration depending on various causes.
bgcolor = white> Urine color
| Causes of urine discoloration |
| Colorless || Dilution, diabetes; taking diuretics or alcohol |
| Milky white || Purulent diseases of the genitourinary tract, chyluria |
| Orange || Fever, sweating, concentrated urine |
| Reddish || Macrohematuria, hemoglobinuria |
| Dark yellow, sometimes with a greenish brown tint || Excretion in the urine of bile pigments with parenchymal or obstructive jaundice |
| Greenish yellow || High pus content |
| Off blue or green || Rotting urine with typhoid or cholera; methyl blue |
| Dark brown, brown red or yellow || Super concentrated urine, acute febrile conditions, bilirubinuria |
| Brown, brown black or black || Bleeding in the urinary tract (with acidic urine); hemoglobinuria; porphyria; methemoglobinuria |
Freshly collected urine in a healthy person is completely transparent, since all its constituent components are in dissolved form. If the excreted urine is cloudy, then this is due to the presence in it of a large number of blood cells, urinary tract epithelial cells, salts, fat and microorganisms.
Tentatively, the cause of turbidity can be established as follows (table. 22):
| Table 22. Change in color of urine when taking drugs |
| Urine color || Medicinal products |
| Red || Taking antipyrine, amidopyrine, santonin (with an alkaline urine reaction) |
| Pink || High-dose acetylsalicylic acid |
| Brown || Phenol, Cresol, Lysol, Bear’s Eye, Activated Carbon |
| Dark brown || Sanol, naphthol |
1) if by heating 4-5 ml of urine in a test tube it becomes transparent, then the turbidity was caused by uric acid salts (urates);
2) if the turbidity of the urine does not change during heating, then 10-15 drops of concentrated acetic acid are added to it - the complete or partial disappearance of the turbidity indicates that it was caused by salts of phosphoric acid (phosphates);
3) the turbidity that disappears with the addition of hydrochloric acid is caused by calcium oxalate;
4) if the turbidity disappears when the urine is agitated with a mixture of ether and ethyl alcohol, then it was caused by an admixture of fat;
5) if, after carrying out all of the above samples, the urine remains turbid, then, in all probability, this is caused by microorganisms, the presence of which is detected by microscopic examination.
Fresh urine does not have an unpleasant odor.
The ammonia smell of urine is observed with cystitis, putrefactive - with gangrenous processes in the urinary tract, fecal - with a vesicorectal fistula, fruit - with diabetes, the urine acquires a sharp fetid odor when eating large quantities of garlic, horseradish, asparagus.
The urine reaction is normal with mixed foods, acidic or neutral (pH 5.5-7.0). It is determined in freshly released urine, since when standing, carbon dioxide is released and the pH shifts to the alkaline side. The reaction of urine can vary depending on the diet: eating meat causes a pH shift in the acidic direction, plant products - in the alkaline.
In addition to the nature of the food, various metabolic processes occurring in the body and the functional state of the renal tubules affect the pH of the urine, so the reaction has limited clinical value. Its information content increases in conjunction with the results of other laboratory and clinical indicators, as well as when comparing the pH values of urine and blood (table. 23).
Table 23. The ratio of pH of urine and blood for pathology
| Urine reaction || Blood reaction || Pathology |
| Sour || Sour || Diabetes (ancestor, coma), fever, starvation, renal failure, tuberculosis of the kidneys, leukemia |
| Alkaline || Alkaline || Cystitis, pyelntis, hematuria, after vomiting and diarrhea, with the absorption of exudates, transudates, with soda and mineral water |
| Alkaline || Sour || Hyperchloremic acidosis, renal tubular acidosis, chronic infections of the urinary tract (bacterial decomposition of nitrogen-containing substances of urine to ammonia) |
| Sour || Alkaline || Hypokalemic state (paradoxical aciduria) |
To determine the pH, litmus paper, other indicators of a wide range (pH 1.0-12.0), narrow-range pH-indicator papers, bromthymol blue indicator or ionometry method can be used.
Relative Density (Opl)
In healthy people, under normal conditions, the relative density of urine ranges from 1.010 to 1.025 and depends on the concentration of substances dissolved in it (protein, glucose, urea, salts, etc.). Urine density is determined using a hydrometer (urometer) with a scale range from 1.001 to 1.050.
The relative density of morning urine in excess of 1.018 indicates the preservation of the concentration ability of the kidneys and eliminates the need for its special study. A single determination of the relative density is not critical diagnostic value.
High relative density of urine can be caused by:
1) low fluid intake;
2) a large loss of fluid during vomiting, with sweat, with diarrhea;
3) reduced diuresis in cardiovascular failure, kidney disease without impairing their concentration function;
Low relative density may be due to:
1) polyuria due to heavy drinking;
2) polyuria caused by the use of diuretics; resorption of large exudates and transudates;
3) prolonged fasting while following a protein-free diet;
4) renal failure (chronic glomerulonephritis, pyelonephritis, nephrosclerosis, amyloid-wrinkled kidney);
5) diabetes insipidus.
Chemical properties of urine
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Physical properties of urine
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