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

- Lower urinary tract inflammation, tumors or stones
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 &
Fanconi’s 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 -1-
phosphate 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 :
hemolytic anemia - hepatocellular damage
F) Blood :

I - Hematuria: (Presence of detectable amount of

blood in urine )
a – Acute & chronic glomerulonephritis
b – Local disorders of kidney & genito-urinary
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)
b – Malaria (P. falciparum)
c – Transfusion reaction (Bl. Incompatibility)
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 Amount Amount % of Filtered
Filtered Reabsorbed excreted Load
Reabsorbed
Glucose (g/day) 180 180 0 100

Bicarbonate 4,320 4,318 2 >99.9

(mEq/day)
Sodium 25,560 25,410 150 99.4
(mEq/day)

Chloride 19,440 19,260 180 99.1

(mEq/day)

Potassium 756 664 92 87.8

(mEq/day)
Urea (g/day) 46.8 23.4 23.4 50
Creatinine 1.8 0 1.8 0
(g/day)
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 0

Amino acids 0

Protein 0

Blood 0

Ketones 0

Leukocytes 0

Bilirubin 0
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
 REFERENCES

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.