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 :
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
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
 RESOURCE

. 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