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Abrmal Urine Biochemistry Tests

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CONSTITUENTS OF ABNORMAL OR PATHOLOGICAL URINE. 

The abnonnal or pathological constituents found in th~ urine are: 

1. Proteins, . . 

2. Glucose, 

3. Ketone bodies, 

4. -Blood, . 

5. Bile salts, 

6, Bile pigments, and 7. Fats. 

J~ PROTEINS: \ 

. A .nun'lber of proteins may appear in the urine in a variety 'of pathological 

conditions. This may occur either d~e to: . . 

a - Increa.se in the penneability of the glomerular capillaries, as 

. in'n~phrotic syndrome, or I ., 

b - Damage to the capillary membrane, a condition called . 

glomeI:Ulonephritis. . 

. The proteins detectedin the urine under pathological conditions are: 

. a - Albumin, . . 

b .: qlobulins, 

c - Haemoglobin, . . 

d - Myoglobin, and 

. e - N{)n-blood proteins such .as Bence-Jones Proteins. 

The tenn "Proteinuria" is better name given to the cpndition in which a heat 

'~gulable'protein is found in the urine, it may be albumin or globulin. The commonly used 

clinical tenn "Albuminuria" instead' of "Proteinuria" is. i~correct in view of the fact that 

. alblimin and globulins both are present in abnonnal urine though albumin is generally in 

excess. of globulins.. .. .

" /

1. HEAT COAGULATION TEST~ 

 

 

 

PROCEDURE: 

Fill 2/3 of a test tube with urine. Heat the upper 1/3 to boil. Appearance 

. of turbidity or a flocculent precipitate indicates the presence of either albumin or earthy./ 

phosphates. ... . . .' 

. . Add 6 drops of 5% acetic acid to it. The phosphates, if present, will get dissolved . 

and if the turbidity persists even after the addition of acetic acid, it indicates the presence of .proteins (albumin and globulins). 

Note: 

I!. I 

 

a) Heat coagulation and addition of acetic acid" is a very sensitiv~ test and it can detect the presence of proteins at a concentration CjS low as 2-3mg/dL in urine. . 

 

b) Bence-Jones Proteins are abnormal proteins found jn.:the urine of patients suffering from multiple myeloma. These proteins do not give a positive heat coagulation test. . Ajldcculant precipitate appears, on heating a urine containing Bence-jones proteins, around 5(f-6(fC and it disappears at.lOO┬░C. It re-appears on cooling the urine. 

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EVALUATION OF HEAT COAGULATION TEST. 

APPEARANCE OF BOILED INFERENCE. 

PORTION OF URINE  

1. Remains clear with or without Proteins ABSENT. 

The addition of acetic acid.  

2 Clear but becomes turbid on the Proteins PRESENT. 

Addition of acetic acid.  

3. Urine becomes turbid: Phosphates or Proteins 

PRESENT. . . 

a - Turbidity persists after the  

addition of acetic acid. Proteins PRESENT. 

b - Turbidity clears out after the Proteins ABSENT. 

addition of acetic acid. (Precipitates were due to 

phosphates) 

. 2. SALICYLSULPHONIC ACID TEST: 

PROCEDURE: 

To 3ml of urin~ add Im1 of 20% salicylsulphonic acid. Mix thoroughly. Turbidity will appear if albumin and globulin are present. It will however persist 

even 01;1 heating. . . . 

. . CLINICAL ASSESSMENT OF THE AMOUNT OF PROTEIN IN URINE. 

OBSERVATION. 

GRADING~ o +/ 

1. No tUrbidi.J. 

2. Faint precipitate visible against 

a black background. 

3. DefInite but little precipitate, . 

through which things can be seen. 

4. Dense precipitate which is 

semi-opaque. . 5. Dense opaque precipitate. 6. Dense opaque and flocculant 

PreciDitate. . 

++ 

.+++ 

++++ 

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2. GLUCOSE & REDUCING SUGARS: 

Glucose is usually present iri the abnormal urine. Other reducing sugars 

like lactose may be present in the urin~ during pregnancy or lactation. Glucose is present in 

the urine of patients suffering from diabetes mellitus and in renal glycosuria.

BENEDICT'S TEST FOR SUGARS: 

, , 

PROCEDURE: 

To Sml ofB~nedict's reagent in a test tube, add 8 drops of urine. Mix 

thoroughly and 'heat to boil for 2 minutes. Allow the test tube to cool spontaneously. The 

colour of the solution will change from blue. to green, yellow or red having precipitate 

depending upon the amount of reducing sugars present. '

Note: This test c.ail serve as a rough quantitative test, for clinical purposes, as shown in the 

table on page No: 14

Osazone Test may be done to recognize individual sugars.

3. 'KETONE BODIES: 

The following "Ketone bodies" or '''Acetone bodies"are found in the urine 

during a condition called "Ketosis":

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