The waste product of the body is urine. Its composition, as well as the quantity, physical and chemical properties, even in a he althy person, are changeable and depend on many harmless causes that are not dangerous and do not cause any ailments. But there are a number of indicators determined by the laboratory when taking tests that indicate various diseases. The assumption that not everything is in order in the body can be done independently, just pay attention to some characteristics of your urine.
How urine is made
The formation and composition of urine in a he althy person depend primarily on the work of the kidneys and the loads (nervous, nutritional, physical and others) that the body receives. Every day, the kidneys pass through themselves up to 1500 liters of blood. Where does so much come from, because on average a person has only 5 liters of it? The fact is that this liquid tissue or liquid organ (as blood is also called) passes through the kidneys about 300 times a day.
With each such passage through the capillaries of the renalbodies, it is cleaned from waste products, proteins and other things that are unnecessary to the body. How does it work? The aforementioned capillaries have very thin walls. The cells that form them work as a kind of living filter. They trap large particles and let water, some s alts, amino acids through, which seep into a special capsule. This fluid is called primary urine. Blood enters the tubules of the kidneys, where some filtered substances return from the capsules, and the rest are excreted through the ureters and urethra to the outside. This is the familiar secondary urine to all of us. The composition (physico-chemical and biological, as well as pH) is determined in the laboratory, but some preliminary outlines can be done at home. To do this, you should carefully examine some of the characteristics of your urine.
Measurements
Of the one and a half thousand liters of blood passed through themselves, the kidneys reject about 180. With repeated filtration, this volume decreases to 1.5-2 liters, which is an indicator of the norm, in the amount of which a he althy person should excrete urine per day. Its composition and volume may vary, depending on:
- season and weather (in summer and in the heat the norm is less);
- exercise;
- age;
- the amount of liquid you drink per day (on average, the volume of urine is 80% of the liquids that have entered the body);
- some products.
Deviation of the quantitative norm in one direction or another can be a symptomthe following diseases:
- polyuria (more than 2 liters of urine per day) can be a sign of nervous disorders, diabetes, edema, exudates, that is, the release of fluid into the organs;
- oliguria (0.5 liters of urine or less) occurs with heart and kidney failure, other kidney diseases, dyspepsia, nephrosclerosis;
- anuria (0.2 liters or less) - a symptom of nephritis, meningitis, acute renal failure, tumors, urolithiasis, spasms in the urinary tract.
In this case, urination may be too rare or, conversely, frequent, painful, increase at night. With all these deviations, you need to see a doctor.
Color
The composition of human urine is directly related to its color. The latter is determined by special substances, urochromes, secreted by bile pigments. The more of them, the yellower and more saturated (higher in density) urine. It is generally accepted that the color from straw to yellow is considered the norm. Some products (beets, carrots) and medicines (Amidopyrin, Aspirin, Furadonin and others) change the color of urine to pink or orange, which is also the norm. Pictured is a urine color test.
Present diseases determine the following color changes:
- red, sometimes in the form of meat slops (glomerulonephritis, porphyria, hemolytic crisis);
- darkening of the collected urine in the air up to black (alkaptonuria);
- dark brown (hepatitis, jaundice);
- gray-white (pyuria, that is, the presence of pus);
- greenish, bluish (rotting inintestine).
Smell
This parameter can also indicate the changed composition of human urine. So, the presence of diseases can be assumed if the following smells dominate:
- acetone (symptom of ketonuria);
- faeces (E. coli infection);
- ammonia (means cystitis);
- very unpleasant, fetid (in the urinary tract there is a fistula in the purulent cavity);
- cabbage, hops (presence of methionine malabsorption);
- sweat (glutaric or isovaleric acidemia);
- decaying fish (trimethylaminuria disease);
- "mouse" (phenylketonuria).
Urine normally has no strong odor and is clear. Also at home, you can examine the urine for foaminess. To do this, it must be collected in a container and shaken. The appearance of abundant, long-lasting foam means the presence of protein in it. Further, more detailed, analyzes should be carried out by specialists.
Turbidity, Density, Acidity
Urine is tested for color and smell in the laboratory. Attention is also drawn to its transparency. If the patient has cloudy urine, the composition may include bacteria, s alts, mucus, fats, cellular elements, red blood cells.
The density of human urine should be in the range of 1010-1024 g/liter. If it is higher, this indicates dehydration, if lower, it indicates acute renal failure.
Acidity (pH) should be in the range of 5 to 7. This indicator can fluctuate depending on the food and medicine taken by a person. If thesecauses are excluded, pH below 5 (acid urine) may mean that the patient has ketoacidosis, hypokalemia, diarrhea, lactic acidosis. At a pH above 7, a patient may have pyelonephritis, cystitis, hyperkalemia, chronic renal failure, hyperthyroidism, and some other diseases.
Protein in urine
The most undesirable substance that affects the composition and properties of urine is protein. Normally, it should be in an adult up to 0.033 g / liter, that is, 33 mg per liter. In infants, this figure can be 30-50 mg / l. In pregnant women, protein in the urine almost always means some complications. It was previously thought that the presence of this component in the range from 30 to 300 mg means microalbuminuria, and above 300 mg - macroalbuminuria (kidney damage). Now they determine the presence of protein in daily urine, and not in single urine, and its amount up to 300 mg in pregnant women is not considered a pathology.
Protein in human urine can temporarily (one-time) increase for the following reasons:
- postural (body position in space);
- exercise;
- febrile (fever and other febrile conditions);
- for unexplained reasons in he althy people.
Protein in the urine is called proteinuria when repeated. She happens:
- mild (protein from 150 to 500 mg / day) - these are symptoms that occur with nephritis, obstructive uropathy, acute post-streptococcal and chronic glomerulonephritis, tubulopathy;
- moderatelysevere (from 500 to 2000 mg / day protein in the urine) - these are symptoms of acute post-streptococcal glomerulonephritis; hereditary nephritis and chronic glomerulonephritis;
- sharply pronounced (more than 2000 mg/day of protein in the urine), which indicates the presence of amyloidosis, nephrotic syndrome in the patient.
Erythrocytes and leukocytes
The composition of secondary urine may include the so-called organized (organic) sediment. It includes the presence of erythrocytes, leukocytes, particles of squamous, cylindrical or cubic epithelium of cells. Each of them has its own rules.
1. Erythrocytes. Normally, men do not have them, and women contain 1-3 in the sample. A small excess is called microhematuria, and a significant excess is called macrohematuria. This is a symptom:
- kidney disease;
- bladder pathology;
- discharge of blood into the genitourinary system.
2. Leukocytes. The norm for women is up to 10, for men - up to 7 in the sample. Exceeding the amount is called leukoceturia. It always indicates the current inflammatory process (disease of any organ). Moreover, if there are 60 or more leukocytes in the sample, the urine acquires a yellow-green color, a putrid odor and becomes cloudy. Having found leukocytes, the laboratory assistant determines their nature. If it is bacterial, then the patient has an infectious disease, and if not bacterial, the cause of leukoceturia is problems with the kidney tissue.
3. Squamous epithelial cells. Normally, men and women either do not have them, orthere are 1-3 in the sample. An excess indicates cystitis, drug-induced or dysmetabolic nephropathy.
4. Epithelial particles are cylindrical or cubic. Normally absent. Excess indicates inflammatory diseases (cystitis, urethritis and others).
S alts
In addition to the organized, the composition of the urine test also determines the unorganized (inorganic) sediment. It is left by various s alts, which normally should not be. At pH less than 5 s alts can be as follows.
- Urates (reasons - malnutrition, gout). They look like a thick brick-pink sediment.
- Oxalates (products with oxalic acid or diseases - diabetes, pyelonephritis, colitis, inflammation in the peritoneum). These s alts are uncolored and look like octagons.
- Uric acid. This indicator is considered normal at values from 3 to 9 mmol / l. Excess indicates kidney failure and problems with the gastrointestinal tract. It can also be exceeded during stress. Uric acid crystals vary in shape. In the sediment, they acquire the color of golden sand.
- Sulfate of lime. Rare white precipitate.
At pH above 7 s alts are:
- phosphates (the cause is foods containing a lot of calcium, phosphorus, vitamin D, or diseases - cystitis, hyperparathyroidism, fever, vomiting, Fanconi's syndrome); the precipitate of these s alts in the urine is white;
- triple phosphates (same causes as phosphate);
- uric acid ammonium.
The presence of a large amount of s alt leads to the formation in the kidneysstones.
Cylinders
Changes in the composition of urine are significantly affected by diseases associated with the kidneys. Then cylindrical bodies are observed in the collected samples. They are formed by coagulated protein, epithelial cells from the renal tubules, blood cells and others. This phenomenon is called celindruria. The following cylinders are distinguished.
- Hyaline (coagulated protein molecules or Tamm-Horsfall mucoproteins). Normally 1-2 per sample. Excess occurs with great physical activity, feverish conditions, nephrotic syndrome, kidney problems.
- Granular (glued together destroyed cells from the walls of the renal tubules). The reason is severe damage to these renal structures.
- Waxy (coagulated protein). Appear with nephrotic syndrome and with the destruction of the epithelium in the tubules.
- Epithelial. Their presence in the urine indicates pathological changes in the tubules of the kidneys.
- Erythrocytes (these are red blood cells stuck around hyaline cylinders). Appear with hematuria.
- Leukocytes (these are stratified or stuck together leukocytes). Often found together with pus and fibrin protein.
Sugar
The chemical composition of urine shows the presence of sugar (glucose). Normally it is not. To obtain correct data, only daily fees are examined, starting from the second deurination (urination). Detection of sugar up to 2, 8-3 mmol / day. not considered a pathology. Excess can be caused by:
- diabetes;
- diseasesendocrinological nature;
- pancreas and liver problems;
- kidney disease.
During pregnancy, the rate of sugar in the urine is slightly higher and equal to 6 mmol / day. When glucose is detected in the urine, a blood test for sugar is also required.
Bilirubin and urobilinogen
Bilirubin is not part of normal urine. Rather, it is not found due to scanty quantities. Detection indicates such diseases:
- hepatitis;
- jaundice;
- cirrhosis of the liver;
- gallbladder problems.
Urine with bilirubin has an intense color, from dark yellow to brown, and when shaken, it produces a yellowish foam.
Urobilinogen, which is a derivative of conjugated bilirubin, is always present in urine as urobilin (yellow pigment). The norm in the urine of men is 0.3-2.1 units. Erlich, and women 0.1 - 1.1 units. Ehrlich (Ehrlich unit is 1 mg of urobilinogen per 1 deciliter of urine sample). An amount below normal is a sign of jaundice or is caused by a side effect of certain medications. Exceeding the norm means liver problems or hemolytic anemia.
