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viewed while held up to a light source.This operates on the principle that the refractive index of a urine specimen will vary directly with the total amount of dissolved solids in the sample.This instrument mea?sures the refractive index of the urine as compared with water on a scale that is calibrated directly into the ocularUrinary tract infections and bacterial contamination also will alkalinize pH. Medications such as potassium citrate and sodium bicarbonate will reduce urine pH. Alkaline urine is also found in Fanconi syndrome, a congenital gener?alized aminoaciduria resulting from defective proximal tubular function.This generally occurs after an initial period of anuria because the damaged tubules are unable to concentrate or dilute the glomerular filtrate.16 pH Determinations of urinary pH must be performed on fresh specimens because of the significant tendency of urine to alkalinize on standing.In alkaline urine, suspended precipitates of amorphous phosphates and carbonates may be responsible for turbidity, whereas in acidic urine, amorphous urates may be the cause.16 Volume The volume of urine excreted indicates the balance between fluid ingestion and water lost from the lungs, sweat, and intestine.Polyuria is observed in diabetes mellitus and insipidus (in insipidus, as a result of lack of ADH), as well as in chronic renal disease, acromegaly (overproduction of the growth hor?mone somatostatin), and myxedema (hypothyroid edema).Alkaline urine (pH > 7.0) is observed postprandially as a normal reaction to the acidity of gastric HCl dumped into the duodenum and then into the circulation or fol?lowing ingestion of alkaline food or medications.Acidity in urine (pH < 7.0) is primarily caused by phosphates, which are excreted as salts conjugated to Na+, K+, Ca2+, and NH4
viewed while held up to a light source. Correct calibration is vital for accuracy. Most recently, an indirect
colorimetric reagent strip method for assaying SG has
been added to most dipstick screens. Unlike the refractometer, dipsticks measure only ionic solutes and do not
take into account glucose or protein.
The normal range for urinary SG is 1.003 to 1.035 g/mL.
SG can vary in pathologic states. Low SG can occur in diabetes insipidus, pyelonephritis, and glomerulonephritis,
in which the renal concentrating ability has become
dysfunctional. High SG can be seen in diabetes mellitus,
congestive heart failure, dehydration, adrenal insufficiency, liver disease, and nephrosis. SG will increase about
0.004 units for every 1% change in glucose concentration
and about 0.003 units for every 1% change in protein.
Fixed SG (isosthenuria) around 1.010 is observed in severe
renal damage, in which the kidney excretes urine that is
iso-osmotic with the plasma. This generally occurs after an
initial period of anuria because the damaged tubules are
unable to concentrate or dilute the glomerular filtrate.16
pH
Determinations of urinary pH must be performed on
fresh specimens because of the significant tendency of
urine to alkalinize on standing. Normal urine pH falls
within the range of 4.7 to 7.8. Acidity in urine (pH < 7.0)
is primarily caused by phosphates, which are excreted
as salts conjugated to Na+, K+, Ca2+, and NH4
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