URINE COMPOSITION

Chemical Composition of
Urine
Urine is 95% water and 5% solutes
Nitrogenous wastes include urea, uric
acid, and creatinine
:Other normal solutes include
Sodium, potassium, phosphate, and sulfate
ions
Calcium, magnesium, and bicarbonate ions

Abnormally high concentrations of any

urinary constituents may indicate
pathology

Composition of urine
Urine contains organic and inorganic
solids:

Chief organic solids:

Non protein nitrogen (NPN) compounds
Organic acids
Sugars
Traces of proteins, vitamins, hormones
and pigments

.Composition of urine contd

Chief

inorganic solids:

Sodium
Potassium
Chlorides
Small amounts of Ca, Mg, S & phosphates
Traces of Fe, Cu, Zn and I2

A) Proteins :

Normally less than 200 mg protein is excreted in

the urine daily; more than this level leads to
a condition called Proteinuria.

Proteinuria is either Glomerular or Tubular .

Glomerular proteinuria is due to glomerular
permeability filtration of high molecular weight
proteins ( e.g. glomerulonephritis).

Tubular proteinuria occurs as a result of tubular

reabsorption with normal glomerular permeability

excretion of low molecular weight proteins

(e.g. chronic nephritis)

 Proteinuria is divided into

Prerenal, Renal and Postrenal.

1 - Prerenal proteinuria:
Occurs in:
Bence Jones protein:
This abnormal gamma globulin ( light
chains only) is synthesized by malignant
plasma cells (Multiple myeloma).
It precipitates at 60OC, redissolves at
100OC and reprecipitates on cooling.

2 - Renal proteinuria: is due to

-

Severe muscular exercise

After prolonged standing (Orthostatic proteinuria)
Heart failure
Nephrotic syndrome
Glomerulonephritis
Microalbuminuria:
- Presence of small amounts of albumin in the
urine
(20 200 mg/L) that cannot be
detected by ordinary urine testing & needs
special tests for detection.
- It is an early indicator of glomerular affection
due
to uncontrolled DM or hypertension.

3 - Postrenal proteinuria:

is due to

B) Glycosuria : (Presence of any sugar in urine)

1 - Glucosuria: (Presence of detectable amount of
glucose in urine )
- Uncontrolled DM :The concentration of glucose
in the plasma exceeds the renal threshold.

- Renal glucosuria : Normal plasma glucose

concentration with proximal tubular malfunction

renal threshold (Gestational Diabetes &
Fanconis syndrome).

2 - Fructosuria: (Presence of fructose in

urine)
- Alimentary
causes : fructose intake
- Metabolic :
fructokinase or aldolase B in the

liver.

3 Galactosuria: (Presence of galactose in

urine)
- Alimentary : galactose intake
Metabolic : galactokinase or galactose -1phosphate uridyl transferase in the liver.

C) Ketonuria : (Presence of ketones Acetone,

Acetoacetic acid & Hydroxybutyric acid in urine)

1 Diabetic ketoacidosis
2 Glycogen storage disease
3 Starvation
4 Prolonged vomiting
5 Unbalanced diet: high fat & Low CHO diet

D) Nitrite :
Positive nitrite test is significant of bacteria in urine

E) Choluria : ( Presence of bile in urine)

1 Bilirubin / Bile salts : in cases of

- Hepatocellular damage.
- Obstruction of bile
ducts either extrahepatic
(stone) or
intrahepatic (hepatic tumors)
2 - Urobilinogen:
- Normally present in trace amounts in urine
- Marked in :

F) Blood :
I - Hematuria: (Presence of detectable amount of
blood in urine )
a Acute & chronic glomerulonephritis
b Local disorders of kidney & genitourinary
tract (Trauma , cystitis , renal calculi and
tumors)
c Bleeding disorders (Hemophilia).

II - Hemoglobinuria: (Presence of hemolysed

blood in urine)
a Hemoglobinopathies (Sickle cell anemia&
Thal)
falciparum)

b Malaria (P.
c Transfusion

G) Chyluria :

(Presence of lymph / fat in urine)

- Due to abnormal connection between the

intestinal lymphatic system and urinary

tract, which may be:
- Congenital
- Acquired (Filariasis)

Filtration, Reabsorption, and Excretion Rates of Different Substances by

the Kidneys
Amount
Filtered

Amount
Reabsorbed

Amount
excreted

% of Filtered
Load
Reabsorbed

Glucose (g/day) 180

180

100

Bicarbonate
(mEq/day)

4,320

4,318

>99.9

Sodium
(mEq/day)

25,560

25,410

150

99.4

Chloride
(mEq/day)

19,440

19,260

180

99.1

Potassium
(mEq/day)

756

664

92

87.8

Urea (g/day)

46.8

23.4

23.4

50

Creatinine
(g/day)

1.8

1.8

Table 41-2 Composition of urine

Substance

Concentration

Na+

50-130 mEq/L

K+

20-70 mEq/L

NH4+

30-50 mEq/L

Ca++

5-12 mEq/L

Mg++

2-18 mEq/L

Cl-

50-130 mEq/L

Pi

20-40 mEq/L

Urea

200-400 mM

Creatinine

6-20 mM

pH

5.0-7.0

Osmolality

500-800 mOsm/kg H2O

Glucose

Amino acids

Protein

Blood

Ketones

Leukocytes

Bilirubin

Chemical Examination
pH
: can range from
4.5-8.0
Specific Gravitiy : 1.015-1.025
Protein
: negative or trace
Sugar
: negative or trace
Blood
: negative
Bilirubin
: negative
Urobilinogen
: positive
Nitrite
: negative
Ketone
: negative
Leukocyte
: negative

RESOURCE
. Ahmed Al Mutairi, Ahmed Albanna, Abdulrahaman Al Qarni
Micturation and urine composition
Elaine N. Marieb. The Urinary System
Jethro Macallan. Urine Formation: Tubular Processing of the
.Glomerular Filtrate