WBC or RBC casts in the urine can yield a positive protein test. 1 Proteinuria may also indicate heart failure, gout, infection, or nephrotoxic drugs. Excretion of >150 mg of protein per day (10-20 mg/dL) is defined as proteinuria and is the hallmark of renal disease. Dipsticks are most sensitive to albumin and do not detect immunoglobulin light chains or Bence Jones protein. Trace amounts of other proteins may also be found. Proteins: The major protein found in urine is globulin, followed by albumin.
Uncontrolled diabetes mellitus is the most common cause, but other causes include vomiting, diarrhea, acute fever, carbohydrate-free diets, starvation and cachexia, or eclampsia. This most often occurs when fat metabolism is stimulated by inadequate carbohydrate intake or a carbohydrate-metabolism defect. Ketones: Ketonuria results when excessive circulating intermediary products of fat metabolism appear in the blood. Dipsticks using the glucose oxidase reaction can miss other sugars. Other signs of proximal dysfunction are often seen, including hypophosphatemia, hypouricemia, renal tubular acidosis, and aminoaciduria. Renal glycosuria is the rare result of a decreased renal threshold for glucose. Other causes include hemochromatosis, hyperthyroidism, Cushing syndrome, steroid therapy, or sudden shock. Diabetes mellitus is the major pathologic cause. 3 Benign glycosuria may result from a heavy meal or stress. Glucose: Less than 0.1% of glucose filtered by the renal glomerulus appears in urine the rest is reabsorbed in the proximal tubule until the plasma glucose rises. A low specific gravity may indicate diabetes insipidus, glomerulonephritis, pyelonephritis, or other anomalies that reflect an inability to concentrate urine. A high specific gravity is also seen in shock, nephrotic syndrome, dehydration, acute glomerulonephritis, heart failure, or liver failure. A value >1.035-1.040 suggests possible contamination, very high levels of glucose, or recently received low-molecular-weight dextran or high-density radiopaque dyes. Acid urine (pH 1.025 indicates normal concentrating ability. An alkaline pH may also indicate a systemic metabolic or respiratory alkalosis. Infection with any pathogen that produces urease, e.g., Proteus mirabilis and Pseudomonas, can result in a pH >7.0-7.5. Urinary pH: The body’s ability to maintain normal acid-base balance is reflected in the urinary pH, typically 5.5-6.5 (normal range: 4.5-8). Is urine usually more dense or less dense than water? Why?. Describe the general procedure for using a “dipstick” to assess a urine sample. What might turbid urine suggest? Please watch this second video about Urinalysis, focusing on the use of a commercially available “dipstick” for chemical analysis of a urine sample, and answer the questions below (Video approximately 16 minutes in duration) 6. What is meant by the turbidity of urine? 5. What medical condition might orange urine suggest? What might be the cause of this? 4. Beets aside, what might red urine suggest? b. Apart from hydration status, what other factors may influence urine color? a. What are the 3 categories of information that can be obtained from a UA? a. What is a urinalysis (UA), and what can it evaluate? 2. Name: _ Community College of Philadelphia Biology 110: Anatomy and Physiology II Urinary Physiology (Unit 30) Please watch this video about Urinalysis, focusing on gross examination of the sample, and answer the questions below (Video approximately 6 minutes in duration).
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