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Urinalysis (General Urine Test)

12 Azn
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A general urine test is used to diagnose and monitor a wide range of conditions. It includes the assessment of the physical and chemical properties of urine and the microscopic examination of urinary sediment.

The test includes the evaluation of the following parameters:

  • General characteristics

  • Microscopic examination of the urine sediment

  • For 24 hours prior to testing, avoid fruits and vegetables that may alter urine color (e.g., beets, carrots), as well as diuretics.

  • Genital hygiene must be performed before collecting the sample.

  • Urine collection is not recommended during menstruation.

  • The sample should be collected in a sterile disposable container. If collected outside the clinic, it should be delivered within 2 hours.

  • Certain medications (e.g., aspirin, antibiotics, uroseptics) should be discontinued 24 hours before testing.

  • Alcohol consumption should also be avoided at least 24 hours prior to the test.

  • Avoid sexual activity 12 hours before testing.

  • The test should not be performed within 1 week after cystoscopy.

  • Diagnosis of urinary tract diseases

  • Routine medical check-ups

  • Monitoring disease progression and evaluating treatment effectiveness

  • In patients with streptococcal infections (e.g., tonsillitis, scarlet fever), the urine test is recommended 1–2 weeks after recovery

Urine Volume

A healthy adult typically excretes between 0.8 to 2.0 liters of urine per day (average ~1.5 L).
Increased urination (polyuria) can be observed in diabetes mellitus as well as in non-diabetic conditions.
Decreased daily urine output (oliguria) may occur due to excessive sweating, vomiting, or diarrhea.
 

Urine Color

Normal urine color is straw yellow, due to the pigment urochrome.
Color changes may occur due to food, medications, or contrast agents.

Color

Possible Conditions

Cause/Pigment

Straw yellow

Edema, burns, vomiting, diarrhea, heart failure

—

Dark yellow

Same as above

High concentration of urochromes

Pale/colorless

Diabetes insipidus, reduced kidney concentration function, diuretics

Low concentration of urochromes

Orange-yellow

Vitamin intake, furagin

—

Reddish-pink

Beets, carrots, blueberries; antipyrine, aspirin

—

Red

Renal spasm, kidney infarction

Hematuria, hemoglobin, porphyrin, myoglobin

"Meat rinse" appearance

Acute glomerulonephritis

Hematuria

Dark brown

Hemolytic anemia

Urobilinuria

Reddish-brown

Metronidazole, sulfa drugs, bearberry extract, phenol poisoning

—

Black

Paroxysmal nocturnal hemoglobinuria, alkaptonuria, melanoma

Hemoglobinuria, homogentisic acid, melanin

Beer-colored

Parenchymal jaundice (e.g., viral hepatitis)

Bilirubinuria, urobilinogenuria

Yellow-green

Obstructive jaundice, gallstones, pancreatic head tumors

Bilirubinuria

Whitish

Phosphates, lipids

—

Milky

Renal lymphatic stasis, UTI

Chyluria, pyuria



 

Urine Clarity

Normal urine should be clear.
Cloudiness may be caused by red or white blood cells, epithelial cells, bacteria, fat droplets, salts (urates, phosphates, oxalates), temperature changes, pH, or bacterial growth due to improper storage.

 

Specific Gravity (Relative Density)

Depends on the concentration of excreted substances: urea, uric acid, salts, electrolytes (Cl, Na, K) and water.
More urine = lower density, less urine = higher density.

Increased specific gravity:

  • Glucose in uncontrolled diabetes

  • Protein in glomerulonephritis or nephrotic syndrome

  • IV contrast media, mannitol, dextran

  • Dehydration (vomiting, diarrhea)

  • Toxicosis in pregnancy

  • Oliguria

Decreased specific gravity:

  • Diabetes insipidus (nephrogenic, central, idiopathic)

  • Chronic renal failure

  • Acute tubular damage

  • Polyuria (due to diuretics)

     

    Chemical Examination of Urine

    Urine pH

    Normal pH ranges from 4.5 to 8.0, typically slightly acidic (5–6).
    Affected by diet: meat = acidic, dairy/plant-based = alkaline.

    High pH:

  • Metabolic/respiratory alkalosis

  • Chronic kidney disease

  • Low pH:

  • Metabolic/respiratory acidosis

  • Hypokalemia

  • Dehydration

  • Fasting

  • Diabetes

  • Tuberculosis

  • Fever

  • Severe diarrhea

  • Certain drugs (ascorbic acid, corticotropin, methionine)

  • High meat intake

  •  

  • Renal tubular acidosis (types I & II)

  • Hyperkalemia

  • Hyperparathyroidism

  • Carbonic anhydrase inhibitors

  • High fruit/vegetable intake

  • Prolonged vomiting

  • UTI with urease-producing bacteria

  • Certain medications (epinephrine, nicotinamide, bicarbonate)