Abnormal constituents of urine Proteinuria (protein in urine); Small mwt proteins (such as peptide hormones,Insulin glucagon, growth hormone) can appear in the GF, these filtered proteins are largely reabsorbed by the proximal tubules, via pinocytosis. Thus normally only trace amounts of proteins are present in the urine that are not readily detected. Albumin is the major protein present in proteinuria. Causes of proteinuria ; a)Physiological proteinuria (0.5% of protein present); Examples of such cases include severe excercise, standing for a long time (due to temporary impairment of renal circulation), pregnancy. b)Pathological proteinuria : 1-Pre-renal, when the primary causes are factors operating before the kidney,such as a heart problem causing an impaired renal circulation, multiple myeloma …) 2-Renal ; when the lesion is in the kidney as in glomerularnephritis. 3-post-renal, as in inflammation of the lower urinary tract.

Abnormal constituents of urine Glycosuria; It is a term used to refer to the presence of an unusual amount of reducing sugar in urine, once the specific sugar is identified it is given a more specific description glucosuria, fructosuria. Glucosuria ; This term is used to indicate an abnormal detection of glucose in urine.Normally not more than 10 – 20mg/dl, unusual amounts of glucose can be found in urine after anesthesia, or emotional stress. -It can be found in cases of uncontrolled diabetis mellitus (most common cause of glucosuria). -It can also be found in cases of hyperthyroidism. -Renal glucosuria which is caused by a disorder of the renal tubular function. Keton bodies (ketonuria); It refers to the presence of unusual amounts of ketone bodies in urine. Normally only 3-15mg are excreted per day. Ketonuria can occur in cases such as ketosis and in starvation, excess fat metabolism. Bilirubin; It is not present normally in significant amounts since it is mainly excreted through bile, unusual amounts of bilirubin is detected in urine in cases of obstructive jaundice, and unusual amounts of uribilinogen seen in cases of hemolytic jaundice.

Abnormal constituents of urine Blood (hematuria); Blood occurs in urine in cases such as nephritis or lesion of the kidney or urinary tract, such as the presence of stones.

Urine Analysis Urinalysis can reveal diseases that have gone unnoticed because they do not produce striking signs or symptoms. Examples include diabetes mellitus, various forms of glomerulonephritis, and chronic urinary tract infections. 1-Macroscopic analysis; It involves the first part of a urinalysis which is direct visual observation. Normal, fresh urine is pale to dark yellow or amber in color and clear. 2-URINE DIPSTICK CHEMICAL ANALYSIS;The most cost-effective device used to screen urine is a paper or plastic dipstick. This microchemistry system allows qualitative and semi-quantitative analysis within one minute by simple but careful observation. The color change occurring on each segment of the strip is compared to a color chart to obtain results. Which can detect the presence of unusual amounts of certain metabolites such as, proteins, glucose, ketone bodies, bilirubin, nitrite, it can also measure pH and specific gravity of urine. 3-MICROSCOPIC URINALYSIS; A sample of well-mixed urine (usually ml) is centrifuged in a test tube at relatively low speed (about 2-3,000 rpm) for 5-10 minutes until a moderately cohesive button is produced at the bottom of the tube. The supernate is decanted and a volume of 0.2 to 0.5 ml is left inside the tube. The sediment is resuspended in the remaining supernate by flicking the bottom of the tube several times. A drop of resuspended sediment is poured onto a glass slide and coverslipped and examined under the microscope.

Urine Analysis The urine is investigated to detect the presence of red blood cells, white blood cells epithelial cells, crystals. Methods of urine collection ;- Clean-catch, midstream urine specimen should be collected after cleansing the external urethral meatus. -Catherization of the bladder through the urethra for urine collection is carried out only in special circumstances. -Suprapubic transabdominal needle aspiration of the bladder. this provides the purest sampling of bladder urine. This is a good method for infants and small children. Examples of some of the urine dipstick chemical analysis, -Dipsticks employing the glucose oxidase reaction for screening are specific for glucose but can miss other reducing sugars such as galactose and fructose. For this reason, most newborn and infant urines are routinely screened for reducing sugars by methods other than glucose oxidase (such as the Clinitest, a modified Benedict's copper reduction test). -Dipsticks detect protein by production of color with an indicator dye, Bromphenol blue, which is most sensitive to albumin but detects globulins and Bence-Jones protein poorly. Precipitation by heat is a better semiquantitative method, but overall, it is not a highly sensitive test. The sulfosalicylic acid test is a more sensitive precipitation test. It can detect albumin, globulins, and Bence-Jones protein at low concentrations.-

Renal Calculi kidney stones are solid concretions or calculi (crystal aggregations) formed in the kidneys from dissolved urinary minerals.calculicrystal kidneysurinaryminerals Chemical nature of the stones :The most common of them are oxalate stones in about 80% of cases, calcium phosphate such as in cases of hyperparathyroidism, uric acid stones (5-10%) which is common in gout,and others such as cystine stones such as in cystinuria. Causes; Kidney stones do not have single, well-defined cause, but are usually the result of a combination of factors, which include ; -A high urinary concentration of the constituents of the calculi either due to oliguria or a high rate of excretion of a relevant substance. -A change in pH which favors the precipitation of calculi. -Many of the stones are idiopathic. -It can be diagnosed by x-rays, ultrasound tests,microscopic investigation of the urine.

Renal Calculi