Overview and Objectives
Main Topic
Subtopic 1: Physical Examination of Urine
1.1, 1.2, 1.3
  Subtopic 1 Summary
Subtopic 2: Chemical Testing
2.1, 2.2, 2.3
  Subtopic 2 Summary
Subtopic 3: Microscopic Examination of Urine Sediment
3.1, 3.2
  Subtopic 3 Summary
Module Summary

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Module Main Topic

A. Background

Urinalysis is often part of an initial data base for case work up of a clinically ill patient. It is a very useful indicator and can provide information on the patient's carbohydrate metabolism, kidney and liver function, and acid-base balance. A urinalysis typically is accompanied by a complete blood count and or a screening of chemical panel for complete interpretation of the serum chemistries. When properly performed, the urinalysis is an enormously powerful tool. This simple set of tests remains a key element for the laboratory data base for every patient admitted to the hospital. It is also a key screening test for the diagnosis of many common diseases such as diabetes. The urinalysis is a test that many competent healthcare providers must be able to perform and interpret.

B. Definitions

Anuria—Complete suppression of urinary excretion by the kidneys

Bacteriuria—Bacteria in urine due to urinary tract infection. Bacteriuria is considered significant (pathogenic) by most physicians when cultures show the present of 105 (100,000) or more bacteria per milliliter (mL) of urine when culturing a midstream specimen.

Bence Jones protein—A low-molecular-weight globulin resembling protein (referred to as a pseudo-protein) found in certain diseases such as multiple myeloma

Bilirubinuria—The presence of bilirubin in urine

Functional proteinuria—Increased amount of protein excreted in the urine in association with high temperature, exposure to heat or cold, emotional stress and from excessive exercise. This type of proteinuria is due to renal vasoconstriction.

Glycosuria—Abnormal amounts of glucose in urine (also known as glucosuria)

Hematuria—The presence of intact red blood cells in the urine

Hemoglobinuria—Presence of hemoglobin in urine that could be due to infection such as malaria or even incompatible transfusion

  • Paroxysmal cold hemoglobinuria is the presence of hemoglobin in urine after exposure to cold.

  • Paroxysmal nocturnal hemoglobinuria is a rare disorder in which slightly increased acidity of the plasma during sleep causes hemolysis of the red cells, causing hemoglobinuria to occur. It is more marked during and after sleep. There is also hemosiderin present (hemosiderinuria).

  • March hemoglobinuria is a rare disorder that is found in patients engaged in unaccustomed and excess exercise who have a low renal threshold.

Hypersthenuria—The excretion of urine with an extremely high specific gravity. This can be due to severe restriction of water.

Hyposthenuria—Urine with a consistently low specific gravity (<1.007). This indicates a concentration problem.

Isosthenuria—A urine with a fixed low specific gravity that is approximately 1.010 and varies very little from specimen to specimen. This indicates poor tubular reabsorption.

Ketonuria—The presence of ketone bodies in urine. Ketone bodies found in urine are acetone, diacetic acid (aceto-acetic acid) and beta-hydroxybutyric acid.

Nocturia—Secretion of more than 500 mL or urine at night with specific gravity less than 1.018

Oliguria—Decreased secretion of urine

Orthostatic proteinuria or postural proteinuria—The excretion of protein by patients who are in the erect (standing) or lordotic (upright) position. The proteinuria is intermittent and will disappear whenever the patient lies down.

Polyuria—Increased secretion of urine

Porphyrinuria—The presence of cyclic tetrapyrrole compounds, known as porphyrins, in urine

Proteinuria (albuminuria)—An abnormal or increased amount of protein, predominately in the form of albumin, in urine

C. Sources


    McBride, L. J. (1998). Textbook of urinalysis and body fluids. Philadelphia: Lippincott.

    Strasinger, Susan King, and Di Lorenzo Schaub. (2001). Urinalysis and body fluids. (4th edition) Philadelphia: F.A. Davis.


    Urinalysis Tutor. (1995). Department of Laboratory Medicine and the Center for Bioengineering, University of Washington, Seattle, WA. Philadelphia: Lippincott

    Microscopy Tutor. (1997). Department of Laboratory Medicine and the Center for Bioengineering, University of Washington, Seattle, WA. Philadelphia: Lippincott.


    Haber, M.H. (1978). Urinalysis: Its use in clinical diagnosis. ASCP Press.

    Urinalysis in medical practice. (1983). Presentation of Ames, a Division of Miles Laboratories.

    NCCLS. (1992). Urinalysis: The inside story. Collection. NCCLS Educational Videotape Series.

    NCCLS. (1992). Urinalysis: The inside story. Evaluation. NCCLS Educational Videotape Series.


    Mini Module

    Introduction to Urinalysis (Powerpoint)

    Renal Anatomy and Physiology

Web Services

    MTS Lab Training Library (University of Washington), 1707 North 45th St., Suite 100, Seattle, WA, 98103 Phone: 206.632.6700 Fax: 206.632.6701 Website: www.medtraining.org


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D. Relevance to Academic Industry

Urinalysis is a fundamental test in the delivery of quality diagnosis and treatment of disease in today's healthcare system. People in charge of caring out this testing must be knowledgeable and competent of both the processes involved in testing and the clinical significance associated with related renal and metabolic disease.This learning module can serve useful in the teaching the main facets of urinalysis to both the beginning student entering the laboratory career field and the experienced laboratory technologist who may seek continuing education to improve both skill and understanding of this area of laboratory science.