by Aaqifa Shaikh and Ariba Khan
T.Y.B.Sc Department of Biotechnology DES Fergusson College, Pune. For BTH3507
Blog Category: Diagnostic testing
Millions of people around the world are suffering from urine problems, but a very few gather the courage to talk about it openly. It is still considered as a taboo in some parts of the world. They do talk about it when things get out of their hands i.e. once the infection or the problem reaches a severe stage. As it is said “A stitch in time saves nine” which rightly shows that If people consult the doctor on time, they may save themselves from the upcoming diseases and dysfunctions.
Apart from the lifestyle diseases, why would one want to know more about Urine? Urine is the portal via which the human body removes toxic wastes wherein Kidneys plays a crucial role by helping in Urine formation. Getting to know about Urine and the initial symptoms of Kidney disorder, will help create awareness and vigilance among people. Human body is a miraculous creation. It hides amazing secrets and if one thing or pathway goes wrong, it leads to dysfunction of organs and ends up turning into a severe disease. If one is aware of the initial symptoms of a disease, it can help in early detection. In this blog we talk about the origins of Urine analysis, the factors and food responsible for colour change, how in modern times Urine analysis has evolved, tips on how to keep the Kidneys healthy and much more!
History
Urine analysis was discovered back in the land of Persia. In traditional Persian medicine, the importance of urine was considered as a diagnostic tool to such an extent that it was called Tafsareh, which is translated as “by means of which diagnosis is to be known.”
Persian Sages like Avicenna and Rhazes examined the urine for testing the Kidney and diagnosing diseases, See Fig. 1(a). A glass jar called Qarooreh (phial) was used initially to collect urine sample, See Fig. 1(b). Evaluation of colour, density, transparency, sediments, volume and odour was done.
Let’s dive deeper into the human anatomy and get to know how Urine formation occurs?
Nephron is the functional unit of Kidney. Each kidney contains nearly 1 million nephrons. Nephron is the site where urine formation occurs.
Nephron consists of 4 different parts-
Bowman’s Capsule.
Proximal Convoluted Tubule [PCT].
Loop of Henle.
Distal Convoluted Tubule [DCT].
Reasons for doing Urinalysis
Evaluation of Urine sample:
Urine Sample is evaluated in 3 ways-
1. Gross Inspection/ Visual exam:Colour and turbidity of Urine is inspected during this test. See figure 5(a) and 5(b) to know more about the urine colour, factors and food responsible for the colour change.
2. Dipstick test: This test consists of a reagent strip which is dipped into the urine sample triggering a series of colour changes which corresponds to the presence and concentrations of specific molecules:
A comic dialogue between 2 kidneys-
A urine test is important for people who are at risk for kidney problems, or other health conditions. Finding a health problem is an initial step towards making it better.
If blood and protein is present in the urine, it indicates a sign of kidney disease.
There are two simple tests for kidney disease:
• A blood test to estimate GFR:
GFR means Glomerular Filtration Rate.” GFR number tells us how well the kidneys are working. GFR is estimated from a simple blood test for a waste product called creatinine. Creatinine number is used along with the age, race, and gender to find your GFR.
• A test called ACR:
ACR stands for “Albumin-to-Creatinine Ratio. It checks for the presence of albumin in urine. Albumin is a type of protein that is normally found in your blood. Having albumin in your urine is a sign of kidney disease.
Other tests which can be done include:
1. Imaging tests (Ultrasound or CT scan).
This shows a picture of kidneys and urinary tract. It shows whether your kidneys are too small or too large, kidney stones, tumours, or other problems.
2. A kidney biopsy.
This finds out the cause of kidney disease and how much damage has happened to the kidneys. A biopsy is a procedure to remove tiny pieces of kidney tissue, which are looked at under a microscope.
Who is at risk for kidney disease?
You may have a higher risk for kidney disease if you:
• Have Diabetes or high blood pressure
• Have a family history of kidney disease or kidney failure
• Are over 60 years of age
People who are at risk for kidney disease are tested for protein in their urine. This is included in a standard urine test.
A urinalysis is a rapid, non-invasive test that requires no special preparation. It is an easy test to perform. Urinalysis is a very effective test in determining kidney disorders. Paying attention and being more conscious towards the changing urine colour may lead to prevention of severe infections or diseases. Practicing healthy sanitation and tips for good health should be followed by everyone in order to avoid any disease since as we all know “Prevention is better than cure”. Urinating is an everyday thing, it’s a trivial matter but we need to look more closely at the Urine colour to keep problems at bay. So, the next time you pee, before you flush don’t forget to keep a look out on the colour of the urine. In the end we would like to leave you all with a quote to ponder upon-
“Every Human being is the author of his own health or disease”- Gautama Buddha.
To get to know more about urinalysis, its history, the different tests in detail please refer the following sites-
References:
1. Khaled Fareed, MD. “Urinalysis (Urine) Test: Types, Drugs, Alcohol, Results and Interpretation.” MedicineNet, MedicineNet, 11 Sept. 2019,
2. Kolouri, Sepideh, et al. “Green Urine in Traditional Persian Medicine: Differential Diagnosis and Clinical Relevance.” Journal of Evidence-Based Complementary & Alternative Medicine, SAGE Publications, Apr. 2017,
3. Krans, Brian. “Urinalysis: Process, Results, and More.” Healthline, Healthline Media, 20 Sept. 2018, www.healthline.com/health/urinalysis
4. Sands, Jeff M, and Harold E Layton. “The Physiology of Urinary Concentration: an Update.” Seminars in Nephrology, U.S. National Library of Medicine, May 2009,
5· Sangu, Pavan Kumar, et al. “A Study on Tailabindu Pariksha - An Ancient Ayurvedic Method of Urine Examination as a Diagnostic and Prognostic Tool.” Ayu, Medknow Publications Pvt Ltd, Jan. 2011,
6. “Urinalysis.” HealthEngine Blog, 20 Mar. 2019,
7. “Urinalysis.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 23 Oct. 2019,
8· “Urinalysis.” MedlinePlus, U.S. National Library of Medicine, 9 June 2020,
medlineplus.gov/urinalysis.html.
9· “Urine Sample Collection Kit.” BD Vacutainer, BD,
www.bd.com/assets//images/our-products/blood-and-urine-collection/urine-collection/vacutainer-complete-urine-kit_RC_PAS_UC_0616-0007.png.
10· “What Is Urinalysis?” Byram Healthcare,
www.byramhealthcare.com/blogs/what-is-a-urinalysis.
11· “What Is Your Urine Trying to Tell You?” U.S. News & World Report, U.S. News & World Report,
health.usnews.com/health-care/for-better/articles/what-your-urine-color-odor-and-frequency-mean.
Image citations
1. Masur, S cerevisiae under DIC microscopy, marked in the public domain, details on Wikimedia Commons Retrieved from
2. Wen F, Xing X, Bao S, Hu Y, Hao BC, Corynebacterium xerosis Gram stain, CC BY 4.0 Retrieved from-
https://commons.wikimedia.org/wiki/File:Corynebacterium_xerosis_Gram_stain.jpg
3. Nephron, Crystals in urine - uc - very high mag, CC BY-SA 3.0 Retrieved from-
https://commons.wikimedia.org/wiki/File:Crystals_in_urine_-_uc_--_very_high_mag.jpg
4: Rieder, Hermann, 1858-1932 Delépine, Sheridan, Retrieved from-
https://www.flickr.com/photos/internetarchivebookimages/14783084835
5. Prof Osaro Erhabor, Acute lymphoblastic leukaemia, CC BY-SA 4.0. Retrieved from-
https://commons.wikimedia.org/wiki/File:Acute_lymphoblastic_leukaemia.jpg
6. “Urine Sample Collection Kit.” BD Vacutainer, BD, Retrieved from- www.bd.com/assets//images/our-products/blood-and-urine-collection/urine-collection/vacutainer-complete-urine-kit_RC_PAS_UC_0616-0007.png.
7 Gerardus Cremonensis, Al-RaziInGerardusCremonensis1250, marked in the public domain, details on Wikimedia Commons.
8. Kolouri, S., Daneshfard, B., Jaladat, A.-M., & Tafazoli, V. (2017). Green Urine in Traditional Persian Medicine: Differential Diagnosis and Clinical Relevance. Journal of Evidence-Based Complementary & Alternative Medicine, 22(2), 232–236. Colin , Ketonuria , marked in the public domain, details on
9. J3D3 , Chemstrip1 , CC BY-SA 3.0
Video links:
1. Strong Medicine. Sep 28, 2015. “Interpretation of the Urinalysis (Part 2)”
2. Self-made video link on Urine Formation
Interesting
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