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urine

(ūr′ĭn) [Fr. urine, fr. L. urina, urine] The fluid and dissolved solutes (including salts and nitrogen-containing waste products) that are eliminated from the body by the kidneys. SEE: tables.

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Significance of Changes in Urine
QUANTITY
Normal Abnormal Significance
1000–3000 mL/day Varies with fluid intake, food consumed, exercise, temperature, kidney function
High (polyuria >3000 mL/day) Diabetes insipidus, diabetes mellitus, water intoxication, chronic nephritis, diuretic use
Low (oliguria) Dehydration, hemorrhage, diarrhea, vomiting, urinary obstruction, or many intrinsic kidney diseases
None (anuria) Same as oliguria
COLOR
Normal Abnormal Significance
Yellow to amber Depends on concentration of urochrome pigment
Pale Dilute urine, diuretic effect
Milky Fat globules, pus, crystals
Red Drugs, blood or muscle pigments
Green Bile pigment (jaundiced patient)
Brown-black Toxins, hemorrhage, drugs, metabolites
HEMATURIA (blood in urine)
Normal Abnormal Significance
0–2 RBC/highpowered field (hpf) Normal (physiological) filtration
3 or more RBCs/hpf Extrarenal: urinary tract infections, cancers, or stones. Renal: infections, trauma, malignancies, glomerulopathies, polycystic kidneys
PYURIA (leukocytes in urine)
Normal Abnormal Significance
0–9 leukocytes/hpf
10 or more leukocytes/hpf Urinary tract infection, urethritis, vaginitis, urethral syndrome, pyelonephritis, and others
PROTEINURIA
Normal Abnormal Significance
10–150 mg/day
30–300 mg/day of albumin Indicative of initial glomerular leakage in diabetes mellitus or hypertension (microalbuminuria)
>300 mg/day Macroalbuminuria. Indicative of progressive kidney failure. Injury to glomeruli or tubulointerstitium of kidney.
>3500 mg/day Nephrotic range proteinuria. Evaluation may include kidney biopsy.
SPECIFIC GRAVITY
Normal Abnormal Significance
1.010–1.025 Varies with hydration
1.010 (Low) Excessive fluid intake, impaired kidney concentrating ability
>1.025 (High) Dehydration, hemorrhage, salt-wasting, diabetes mellitus, and others
ACIDITY
Normal Abnormal Significance
Acid (slight) Diet of acid-forming foods (meats, eggs, prunes, wheat) overbalances the baseforming foods (vegetables and fruits)
High acidity Acidosis, diabetes mellitus, many pathological disorders (fevers, starvation)
Alkaline Vegetarian diet changes urea into ammonium carbonate; infection or ingestion of alkaline compounds

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Common Disorders of Urination
Anuria Complete (or nearly complete) absence of urination
Diversion Drainage of urine through a surgically constructed passage, e.g., a ureterostomy or ileal conduit
Dysuria Painful or difficult urination, e.g., in urethritis, urethral stricture, urinary tract infection, prostatic hyperplasia, or bladder atony
Enuresis Involuntary discharge of urine, esp. by children at night (bedwetting)
Incontinence Loss of control over urination from any cause, e.g., from involuntary relaxation of urinary sphincter muscles or overflow from a full or paralyzed bladder
Nocturia Excessive urination at night
Oliguria Decreased urinary output (usually less than 500 mL/day), often associated with dehydration, shock, hemorrhage, acute renal failure, or other conditions in which renal perfusion or renal output are impaired
Polyuria Increased urinary output (usually more than 3000 mL/day), such as occurs in diabetes mellitus, diabetes insipidus, and diuresis

COMPOSITION: Urine consists of approx. 95% water and 5% solids. Solids amount to 30 to 70 g/L and include the following (values are in grams per 24 hr unless otherwise noted): Organic substances:...

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