VI. Turbidity

Normal urine is almost always perfectly clear and transparent when voided. On standing, there is likely to separate out a faintly cloudy flocculation, believed to be mucoprotein or nucleoprotein, which is present only in traces, together with some epithelial cells.

Mucus

It appears as a flocculent precipitate, which gradually sinks to the bottom of the urine. Mucus occurs in greater amounts in

(i) in inflammatory conditions of urinary tracts,

(ii)after prostatic massage, or

(iii)when the urine contains semen or vaginal discharge.

Types of turbidities

1.Urates: ammonium urate may precipitate, from alkaline urine whereas other urates are found only in acid urines. Ammonium urates dissolve on acidification, whereas other urates on warming.

2. Phosphates: calcium PO4 and NH4-Mg-PO4 (or so called Triple phosphates) are found only in alkaline urine or they may form a cloudy precipitate from an alkaline urine on warming. They dissolve on acidification.

Note:

(i) it is essential that a urine sample is slightly acidified, when making a test for heat-coagulable proteins.

(ii) Furthermore, the iso-electric points (pI) of most proteins that may appear in urine are slightly acidic.

3. Cellular deposits: a sediment in urine that may account for turbidity and does not dissolve on adding acid or on heating is most likely made up of cellular matter, “organised deposit” eg. Pus cells leukocytes, R.B. Cells, epithelial cells or microorganisms etc.

INORGANIC CONSTITUENTS

I. Chlorides

Normal value: next to urea, clorides make up the chief solid constituents of urine, generally amounting to 6.0 to 9.0gm per day of Cl, and equivalent to 10-15gms of NaCl, which is the predominant chloride present. However, the daily excrtetion varies with the dietary intake.

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Clinical Significance	\|	Clinical significance

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