Macroscopic Urinalysis

4.1 Color –– Smells of ammonia

Cause: urea-splitting bacteria
Depending on concentration, urine is light yellow to dark –– Smells foul, putrid
yellow in color. A noticeable deviation in color from the Cause: urinary tract infection
norm can indicate pathology or be harmless in nature. –– Smells of fruit, acetone
Cause: ketonuria

4.1.1 Some Examples

4.3 Cloudiness
–– Colorless to light yellow
Cause: polyuria, glycosuria in diabetes mellitus Fresh urine at body temperature is normally clear. The colder
–– Dark yellow to orange and more concentrated a urine sample becomes, the more
Cause: oliguria, anuria, vitamin preparations salts and crystals precipitate and cause turbidity or cloudi-
–– Dark yellow to brownish-yellow ness. Urine also becomes visibly cloudy in the case of a
Cause: hemoglobin and hemoglobin degradation products pathological accumulation of bacteria or pyuria.
(bilirubin, porphyrins), drugs Only by analyzing solid components in urine (as in uri-
–– Milky/cloudy nary sediment analysis) is it possible to conclusively identify
Cause: leukocyturia, salts, crystals the cause of cloudiness.
–– Red to reddish-brown
Cause: erythrocytes, myoglobin, urates, drugs, beetroot
–– Dark brown to black 4.3.1 Some Examples
Cause: erythrocytes, massive hemolysis
–– Milky white
Cause: bacteriuria, pyuria, phosphaturia, vaginal

4.2 Odor secretion
–– Reddish (brick dust) upon cooling
Certain foods, drugs, and bacteria alter the typical odor of Cause: uraturia
urine. –– Red to reddish-brown
Cause: macrohematuria
–– Fat layer on the surface
4.2.1 Some Examples Cause: lipiduria in nephrotic syndrome, ointments,

suppositories
–– Extremely intensive odor
Cause: garlic, asparagus
–– Smells like chocolate, highly aromatic
Cause: vitamin preparations, tropical fruits, spices

© Springer Nature Switzerland AG 2020 15

J. Neuendorf, Urine Sediment, https://doi.org/10.1007/978-3-030-15911-5_4