Abstract
Urine sediment analysis always includes an evaluation of “urine character.” This means that the odor, color, and cloudiness of a urine sample requires evaluation.
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1 Color
Depending on concentration, urine is light yellow to dark yellow in color. A noticeable deviation in color from the norm can indicate pathology or be harmless in nature.
1.1 Some Examples
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Colorless to light yellow
Cause: polyuria, glycosuria in diabetes mellitus
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Dark yellow to orange
Cause: oliguria, anuria, vitamin preparations
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Dark yellow to brownish-yellow
Cause: hemoglobin and hemoglobin degradation products (bilirubin, porphyrins), drugs
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Milky/cloudy
Cause: leukocyturia, salts, crystals
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Red to reddish-brown
Cause: erythrocytes, myoglobin, urates, drugs, beetroot
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Dark brown to black
Cause: erythrocytes, massive hemolysis
2 Odor
Certain foods, drugs, and bacteria alter the typical odor of urine.
2.1 Some Examples
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Extremely intensive odor
Cause: garlic, asparagus
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Smells like chocolate, highly aromatic
Cause: vitamin preparations, tropical fruits, spices
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Smells of ammonia
Cause: urea-splitting bacteria
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Smells foul, putrid
Cause: urinary tract infection
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Smells of fruit, acetone
Cause: ketonuria
3 Cloudiness
Fresh urine at body temperature is normally clear. The colder and more concentrated a urine sample becomes, the more salts and crystals precipitate and cause turbidity or cloudiness. Urine also becomes visibly cloudy in the case of a pathological accumulation of bacteria or pyuria.
Only by analyzing solid components in urine (as in urinary sediment analysis) is it possible to conclusively identify the cause of cloudiness.
3.1 Some Examples
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Milky white
Cause: bacteriuria, pyuria, phosphaturia, vaginal secretion
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Reddish (brick dust) upon cooling
Cause: uraturia
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Red to reddish-brown
Cause: macrohematuria
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Fat layer on the surface
Cause: lipiduria in nephrotic syndrome, ointments, suppositories
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Neuendorf, J. (2020). Macroscopic Urinalysis. In: Urine Sediment. Springer, Cham. https://doi.org/10.1007/978-3-030-15911-5_4
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DOI: https://doi.org/10.1007/978-3-030-15911-5_4
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