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Urine is a very interesting liquid with a complex composition. Urine's characteristics have helped clinicians in the diagnosis of diseases that affect the urinary tract and other organs. Get to know more about what your urine can tell about your health.

An underestimated liquid

We think of urine as a way of getting rid of toxins that accumulate in our system, and we never pay too much attention to it. Well, urine, just as blood, provides clinicians with lots of information about our health state. Just by looking at it, your doctor can tell if you are dehydrated or if you have a bacterial infection.

Urine production

How is urine produced? The kidneys are the filters of our body. They are specially designed to let water and small molecules, like urea, pass from the blood to the urinary tract, and to hold bigger molecules, like proteins, in order for them to keep circulating in the bloodstream.

In total, our kidneys produce 1.7 liters of urine every day.

Urine is stored in the bladder and it is released when the bladder has expanded enough to let the brain know that it needs to be emptied, or in other words, that you need to pee.

In healthy people, urine tends to have a light yellow or amber color and it is odorless.

Every time you pee you release from 250 to 500 milliliters of urine, depending on how much liquid you have consumed during the day.

Urine also has a natural content of salts and other substances, such as urea and creatinine, which are both products of metabolism. Urine has a pH ranging from 5 to 7, meaning that it is slightly acid, but tends more to neutrality.

Urine volume, aspect and odor

Have you noticed that sometimes your urine looks almost transparent, and some others it looks very yellow? How it smells also changes, as well as the volume of urine you release. Why? Changes in volume, color and smell of the urine are caused by different situations, but all of them have to do with the amount of water present in urine, certain foods that we eat and the presence of bacteria.

When you are overhydrated and your body needs to get rid of water, your will certainly pee several times a day and your urine will look very pale, almost without color. On the other hand, if your body is dehydrated, it will tend to hold on to all the water it can, so your kidneys will obviously produced very concentrated urine, resulting in an intense yellow-orange color and a detectable smell, perhaps.

See Also: Urine odor: Is smelly urine a symptom of Urinary Tract Infection (UTI)?

Sometimes, overhydration or dehydration can give signs of kidney problems or other illnesses, because certain substances present normally in urine are either very diluted or too concentrated.

Because of this, clinicians match urine analysis results with the symptomatology and medical history of the patient, in order to avoid making a wrong diagnosis. 

The Urine Analysis Explained

When your doctor requires a urine sample analysis you are given a sterile plastic container and are told to fill it with the first urine of the morning. This is the standard urine sample that is used by clinical chemists for analysis, but there are other specifications that they may ask you to fulfill, depending on what the suspected diagnosis is.

For example, sometimes doctors need to evaluate how our kidneys work during a whole day, so you are asked to collect the urine during 24 hours. In any case, it is important to follow your doctors instructions, otherwise you could be altering your sample and affecting the results.

Checking for cells and substances in urine

When a sample reaches the laboratory, it is imperative that it is analyzed right away. It can be stored for an hour or so in the fridge but no more than that. The reason is because if there are bacteria in the sample, they can reproduce and give false results. Also, some chemical components can start degrading or forming crystals that will also affect the final analysis.

The first thing the analyst does is to observe the color, amount and identify any smell in the urine. This is known as a macroscopic analysis. 

After this, the chemical analysis is performed using small strips that change color depending on the contents of the urine. These strips are designed to tell the acidity level and confirm the presence of proteins, glucose, nitrites or cells in the urine. The strip tests are very easy to perform, because strips just need to be in contact with the urine sample for a few seconds. 

The contents of the sample will activate specific substances present on the strip and give as a result changes in color that can be interpreted by using a color code, which is provided with the strips. 

Here is an example of an abnormal chemical test result: high levels of nitrites, basic pH and the presence of white blood cells, also called leukocites. All these could be a sign of bacterial infection. 

Microscopic and microbiological analysis

Urine is also observed under the microscope in order to confirm the presence of bacteria and red or white blood cells. Analysts have the required experience to differentiate between cells and to know when they are present in an abnormal quantity. 

Finally, a very small volume of urine is cultured in order to determine if bacteria are present or not. How?

See Also: Protein in urine: Causes & Risk factors

Microbiological analysis is performed in small plates filled with a substance similar to gelatin, which provides bacteria with a nice and cosy environment to grow in.

For this type of analysis, the analyst takes a drop of urine and puts it on the surface of the gelatin, or agar. Then, agar plates are stored at a proper temperature for bacteria to grow and are analyzed during the next three consecutive days. Urine is a sterile liquid, so there should be no bacteria or very few non-pathogenic bacteria present in the urine culture; otherwise, bacterial growth will indicate a bacterial infection of the urinary tract.

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