Foam:
High Protein:
High Bilirubin:
Pink/ Red/ Red Brown Hazy Few particulates, print easily seen through
most common abnormal color Cloudy Many particulates, print blurred through urine
unstable hemoglobin Turbid Print cannot be seen through urine
- Dipyrrole or bilifuscin (negative for blood, negative Milky May precipitate or be clotted.
for bilirubin)
For genetically susceptible person…
- Beets ingestion - red in alkaline urine
- Blackberries ingestion - red in acidic urine
medication, menstrual contamination(non-pathologic)
SMOKEY CLEAR
- Hematuria (presence of - Hemoglobinuria
intact RBC’s) - Myoglobinuria
- Porphyrinuria (port wine
color)
Blue/ Green
PATHOLOGIC
Green in the case of:
- Bacterial infections (Pseudomonas aeruginosa)
- Severe obstructive jaundice (dark green color)
Blue in the case of: Bacterial Growth
- Increased urinary indican- INDICANURIA (Hartnup’s uniform opalscence
Syndrome/ “Blue Diaper Syndrome”) - Not removed by acidification/ titration
NON-PATHOLOGIC uses double beam turbidimeter
Green in the case of: - Useful for urine infection screening
- Clorets ingestion (breath deodorizer)
Blue in the case of: Chyluria
- Methocarbamol (Robaxin) urine contains lymph fluids
- Amitriptyline (Elavil) clots may usually form
- Methylene blue caused by the obstruction of lymph flow or rupture of
- Phenol lymph vessels to renal pelvis
Brown/ Black
PATHOLOGIC Pseudochyluria
Melanuria (brown-black) use of paraffin based vaginal cream
- over production of melanin
SPECIFIC GRAVITY
- seen in cases if malignant melanoma
Density of a solution compared with the density of a
Alkaptonuria
similar volume of distilled water at same temperature.
- inborn error of metabolism
Ratio of the weight of a substance to the weight of an
- deficiency in homogentisic acid oxidase
equal volume of a reference substance.
-
NON-PATHOLOGIC
Specific Gravity= weight of object/weight of equal volume of
Intake of the following medications: reference substance
- Metronidazole (Flagyl)- treatment for amoebiasis = density of substance
- Levodopa/ Methydopa (antihypertension)
Density of water is 1.0 g/mL at 40 C.
Cola-colored urine Sp. gr. of solids or liquids are expressed in g/cm3 or g/mL
Rhabdomyolysis - high hemiglobin Reference substance:
L-dopa intake 1. For solid and liquids: WATER
2. For gases: AIR
CLARITY
General term that refers to transparency/ turbidity of URINE SPECIFIC GRAVITY
urine specimen. Measure of
- concentration of solutes
Manner of Reporting in the Laboratory - concentrating and diluting power of the kidney
Clarity Term
Specific gravity of glomerular filtrate: 1.007
Clear No visible particulates, TRANSPARENT Fixed urinary specific gravity of 1.007
- Poor tubular reabsorption Read the specific gravity at the lower meniscus of the
High specific gravity urinometer.
- Dehydration
- Presence of abnormal solutes such as Diodrast,
protein, and glucose How to get corrected specific gravity?
Get the specific gravity of the urine and specimen.
GENERAL USE OF SPECIFIC GRAVITY: Get the temperature of the urinometer for which it was
detection of diabetes insipidus standardized and the room temperature. (Always change
to measure the hydration and dehydration state of a temperatures to centigrade; C=F-32 X 5/9 or .555)
person Subtract the lower temperature from the higher
to detect loss of the concentrating ability of the renal temperature or get the differences between the two
tubules temperatures, (Rule: In every 3 degrees centigrade rise
Screening for unsuitable specimen due to low from the standard temperature; add .001 and for every 3
concentration. degrees centigrade fall from the standard temperature,
subtract .001)
GENERAL TERMS Divide the difference by 3 (to find out how many 3s are
there in the difference).
Hypersthenuria Add or subtract the product to or from the last two digits
urine specific gravity is increased of the urinometer’s actual specific gravity reading of the
above 1.010 specimen.
Seen in cases of: DISADVANTAGE:
- Diabetes mellitus 1. Large volume required (10-15mL)
- Fever 2. Must be calibrated daily
- Acute nephritis 3. Temperature corrections are needed for specimens with
temperature difference greater than 3°C from the
Hyposthenuria calibrated temp.
urine specific gravity is decreased. 4. Corrections are required when glucose or protein is
present.
less than 1.007
Seen in cases of:
Speegrav Method
- Chronic nephritis
Temperature – compensated instrument
- Diabetes insipidus
Operates on the principles of a float controlling a gate that
exposes a photocell to light
Isosthenuria
Specific gravity is determined photoelectrically
Urine specific gravity is normal
Far superior to the hydrometer method
Fixed at about 1.010
Refractometer/ Total Solid Meter/ TS meter
Normal values:
Random urine sample: 1.015 - 1.025
PRINCIPLE: Refractive Index (comparison of the velocity of light in
First morning specimen: 1.020
air with the velocity of light in a solution)
Timed specimen: 1.010 - 1.030
Reading is generally 0.002 lower than urinometer.
URINOMETER: A.K.A “HYDROMETER”
temperature compensated at 60-100 F
uses large drop of sample
PRINCIPLE: Density
Subject to errors due to:
less accurate than the other method for urine specific
- Presence of CHO and CHON
gravity determination.
Must be calibrated daily with:
not recommended by CLSI.
- Distilled water: 1.000
requires large amount of urine sample
- 3% Sodium Chloride: 1.015 ± 0.001
calibrated with distilled water at a specific temperature.
- 5% Sodium Chloride: 1.022 ± 0.001
needs correction for the following instances:
- 9% Sucrose: 1.034 ± 0.001
- 3C increase or decrease in temperature
Three factors that affect the refractive index of a solution:
- Presence of protein and sugar in the specimen
1. Wavelength of light used.
2. Temperature of solution
Procedure:
3. Concentration of solution.
Fill the cylinder with urine about ¾ full.
Float the urinometer into it (rotate the urinometer to
Harmonic Oscillation Densitometry: (HOD)
avoid touching the sides of the cylinder).
PRINCIPLE: Density
Reagent Strip
PRINCIPLE: pKa changes of a polyelectrolyte pad.
Reagents:
Bromthymol blue
Polymethyl vinyl ether
ODOR CAUSE
Aromatic Normal
Ammonia-like “old” urine—improperly stored
Pungent, fetid UTI
Fruity, sweet Ketones (DM, Starvation, Vomiting,
diarrhea, dieting, malnutrition,
exercises)
Maple syrup Maple Syrup Urine Disease
Mousy/ Barny Phenylketonuria
Rancid Tyrosinemia
Sweaty Feet Isovaleric Acidemia
Cabbage, hops Methionine malabsorption
Bleach Contamination
Rotten Fish Odor Trimethyl Aminoaciduria
Sulfur Odor/ Burnt Gun Cysteinuria, homocysteinuria,
Powder cysteinosis
Rotting/ old fish trimethylaminuria
Menthol-like Phenol-containing medications
Bleach Adulteration of the specimen or
container contaminant.