What does acidic urine mean. What acidity of urine is considered normal

The acidity of the environment, or rather its “pH”, is an indicator of the concentration and activity of hydrogen ions. Life is unthinkable without water. Water forms solutions in which all biochemical processes take place. Intracellular and extracellular environments contain hydrogen ions, which determine their acidity. Evolutionarily, it was formed in such a way that the human body for normal existence requires a strictly limited range of blood pH - from 7.35 to 7.45. The acidity of urine fluctuates in a wider range: from 4.5 to 8. This is due to the fact that the kidneys are involved in the regulation of acid-base balance and, if necessary, remove hydrogen ions from the body.

So, let's consider what causes can affect the pH of urine and whether it is possible to change this indicator with the help of a diet.

Urine acidity rate

Depending on the function of the organ, the acidity in the human body varies greatly. For example, in the stomach, the pH is 1.3-3.5 (very acidic). Pancreatic juice, on the contrary, has an alkaline index of 8.8. The intracellular environment and blood are characterized by indicators close to neutral pH (7.4).

Urine acidity level, which is a product of the excretory system, can range from acidic (4.5) to alkaline (8.5) depending on the need to maintain pH balance in other organs. Most often, in a healthy person with a balanced diet, urine pH is within 6 units.

High acidity of urine may be due to:

acidosis,
dehydration,
diabetic ketoacidosis,
diarrhea
fasting.

If the urine sample has a pH shift towards the alkaline side, this may be due to the following reasons:

impaired secretion of gastric juice,
kidney failure,
tubular acidosis,
pyloric obstruction,
respiratory alkalosis,
urinary tract infections.

How to determine the acidity of urine?

Severe nephrological diseases, such as urolithiasis and kidney failure, require strict control and regulation of the body's acid-base balance. In addition, this indicator is directly related to the state of the bone tissue, because with acidosis, calcium is drained from the bones.

For example, modern research has established a strong correlation between the incidence of hip fracture in women and the amount of animal protein consumed, which is one of the main sources of endogenous acidity. In contrast, eating a meal alkalized with bicarbonate to neutralize acid improved and decreased osteoresorption and also increased the rate of bone formation in postmenopausal women.

In order to follow the instructions of a nutritionist and monitor the acid-base balance of the body, it is necessary to control urine pH.

How to determine the acidity of urine at home? There is a fairly simple way - to measure the pH using test strips. You can buy them in the pharmacy chain. For example, produced by Russian firms Bioscan and Biosensor. They are available in packs of 10, 25, 50, 100 pieces. The price ranges from 130 to 350 rubles.

pH test strips "Bioscan" and "Biosensor"

Urine acidity is determined as follows. You need to dip the strip in freshly collected urine for a few seconds (check the time in accordance with the instructions, because it may vary depending on the manufacturer). The color will change after a certain time, which is also indicated in the instructions. Compare the color you get with the one on the test strip box and write down the value.

Comparison of the resulting color of the test strip with the scale

Do not be alarmed immediately if the readings go beyond the average norm. Check your readings every day for a week. The acidity of urine can vary depending on the time of day and food consumed. In addition, some drugs (ascorbic acid, diuretics, tromethamine, laxatives, antacids, aspirin, tetracycline, cyclosporine) affect it. If there is a constant shift in pH towards alcaluria (7.0-9.0) or aciduria (4.5-5.0), then this is a reason to seek medical advice.

By the way, test strips quickly deteriorate during storage if they come into contact with air, so close the package tightly after removing them. Trust only those measurement results that are strictly maintained in accordance with the instructions. If the reaction time is increased (they forgot the test strip and looked at it only after half an hour), then this will give a deliberately false result. Do not use expired strips for analysis.

How to lower the acidity of urine?

Increased acidity of urine is pH values from 4.5 to 5.0. A permanent urine reaction within these limits is a predictor of stone formation. For example, urate and oxalate stones form at a pH of about 5.5 and below.

It is generally accepted that diet affects the acid-base balance of the body. If people are conditionally divided into “hunters” and “farmers”, then it is hunters who have a high tendency to acidic urine, since they eat more meat. To date, the clinic has even created a method for calculating potential acid load of the kidneys (PRAL), which includes an estimate of the amount of protein entering the body.

Thus, the first step in the direction of how to reduce the acidity of the urine is to reduce the intake of protein foods. For example, it is estimated that the PRAL of 100 g of pork, beef and poultry meat is in the range of 8.5 to 13 mEq.

If we evaluate products that increase the acidity of urine, according to the PRAL indicator, then cheeses, eggs and meat products will be at the top of the rating. Parmesan has the highest PRAL value, it is 34 mEq.

The second step is to increase your intake of foods that have a neutral or negative acid load. These include almost all vegetables and fruits, and the champion among them is raisin. Its PRAL is -21 mEq. By the way, despite the fact that nuts are representatives of the plant kingdom, they have a high PRAL (6-8 mEq) due to their high protein content.

We should not forget about alkaline mineral waters, especially those rich in potassium and magnesium ions. These substances are involved in the regulation of the acid-base balance of the body and are very effective in reducing the acidity of the urine. Therefore, the third step is to use such brands of mineral waters as Essentuki, Narzan, Borjomi.

Diet with high acidity of urine

So, a diet for acidic urine should include many foods with zero or negative acid formation. However, it is not necessary to completely abandon meat and cheese. A balanced diet can compensate for their consumption. Daily monitoring of urine pH using test strips will help you choose your diet individually.

For many foods, PRAL indices have been determined by nutritionists. The list of main products with zero PRAL is as follows:

milk,
oil,
ice cream,
vegetable oil,
cucumber,
beer,
Coca Cola.

Products with a negative PRAL score:

fruits (bananas, apricots, apples, black currants, oranges, pineapple, strawberries, kiwi, peaches, pears, watermelon),
fruit juices (apple, grape, lemon, orange),
vegetables (potatoes, zucchini, cabbage, tomatoes, radishes, peppers, onions, carrots, eggplant),
greens (spinach, lettuce, celery),
mushrooms,
coffee,
mineral water,
red and white wines.

Products with negative PRAL

Legumes and grain products, flour and bread products have an acid-forming capacity ranging from 3 to 12 mEq. Therefore, those who love breakfast of oatmeal (PRAL=10.7) can balance it with the addition of dried fruits.

Table of some vegetables and fruits with a negative PRAL index

Product	PRAL index
Carrot	-4,9
Potato	-4
Tomatoes	-3,1
Spinach	-14
Celery	-5,2
Eggplant	-3,4
Cucumber	-0,8
Onion	-1,5
Spinach	-14
Fruits
Apples	-2,2
Pears	-2,9
oranges	-2,7
apricots	-4,8
Kiwi	-4,1
Bananas	-5,5
Berries
Cherries	-3,6
Strawberry	-2,2
Watermelon	-1,9
Black currant	-6,5
Raisin	-21

It must be said that the division of products into "acidic" and "alkaline" is very arbitrary, since there are also individual characteristics of the body regarding the digestion, assimilation and tolerance of certain products. In addition, the ability of a healthy body to maintain an acid-base balance within the physiological framework is quite large due to the compensatory mechanisms of metabolism. It is hard to imagine that one steak will be the culprit of a strong shift in the pH of intra- and extracellular environments.

So, although the possibility of regulating urine acidity through diet exists, the range of change will be small. For example, clinical studies have shown that people who have consumed foods with PRAL=0 mEq for some time have a 24-hour urine reaction of 6.0. On a diet with a low acid-forming load (potatoes, tomatoes, carrots, butter), even with the consumption of turkey meat and bread (total diet index PRAL = 10 mEq), the level of urine acidity in the subjects was 6.6. However, on a diet with a total PRAL index 6 times higher, which included bread, butter, cheese, meat, spaghetti and cucumbers, patients also had normal urine acidity (5,9).

If you feel well, then urine pH slightly above or below normal should not be a cause for concern. However, with recurring nephrological symptoms, you need to contact a specialist who will prescribe a more complete analysis and the necessary treatment.

Acidic urine is an indicator that is determined by specialists in the course of laboratory diagnostics. The indicator can be regarded as a quantitative characteristic of the liquid. The manifestation of this characteristic is associated with disturbances in the metabolic process.

The characteristic of the acidity of urine in scientific terminology is referred to as a pH indicator. There are standard indicators for this characteristic and deviations in one direction or another. In general, the pH indicator gives an idea of the ratio of acidic and alkaline environment in urine. Deviations from the norm, as a rule, indicate pathological changes in a certain area of human life.

In relation to the generally accepted definition, it can be argued that the acidity of urine is the ratio of hydroxyl and hydrogen ions in it.

The metabolic process is inherent in people throughout their lives, during which compounds enter the body, during the decay of which certain substances are formed that can shift the pH to the acidic or alkaline side. This indicator cannot be neglected, this is due to the fact that when recommending diets and prescribing medications, in many cases, urine acidity is taken into account. If during the diagnostic process an acid reaction of urine was established, then the doctor will definitely prescribe an additional course of examination, which will help to establish the cause of the deviation.

It should be borne in mind that a low pH indicates a malfunction of the kidneys. Elevated levels indicate the so-called acidic urine. In this case, the risk of accelerated salt crystallization is high. An acidic environment can lead to the formation of kidney stones, which will aggravate the vital processes of the patient's body.

If we turn to deciphering the acidity of the indicator, then everything is very simple and clear:

pH 5–7 - indicates the normal state and functioning of the kidney system;
pH 4.5 and below - indicates acidic urine;
pH 7.5 and above indicates alkaline urine.

If acidic urine is detected during the diagnosis, the doctor must require an analysis in 2-3 days. In this case, a certain diet must be prescribed, which must be followed during this time. This is due to the fact that some elements of food can significantly deviate the acidity index. For a 100% correct diagnosis, it is necessary to compare several indicators, taking into account the patient's daily nutrition.

Factors affecting deviations

The cause of acidic urine is often a metabolic disorder. Changes may be due to the use of products that adversely affect this indicator. The problem may be hidden in violation of the water regime. Lack of fluid in the body can lead to a high concentration of urine and cause a sour smell.

At the first stages of rehabilitation, doctors prescribe a special diet, which should normalize the acidity of urine. The diet must necessarily include products that, after decay, will supply the body with both alkaline and acidic elements. Speaking about the ratio of proteins, fats and carbohydrates in the process of digestion, it should be understood that:

An increase in the concentration of proteins and fats leads to a shift in indicators to the acid side.
Increasing the intake of carbohydrates will lead to changes in the alkaline side.

The most common symptom of acidic urine occurs in people with diabetes. This is due to the fact that with this disease in the patient's urine, as a rule, there are ketone bodies that can reduce the pH level. As a result, due to elevated glucose levels and low pH in people with diabetes, disturbances in the endocrine system are found.

The treatment of many ailments is based on a urine test. The importance of this indicator cannot be overestimated, because it allows you to detect a large number of diseases at an early stage and thus eliminate the problem at the very beginning of its development.

Reasons for the shift in the indicator to the acid side

It should be understood that in addition to pathological causes, there are also natural factors that affect the change in pH to the acid side. Many people use various biological supplements to improve their health. However, often they are simply not aware of the chemical side of these additives. Often, such preparations contain compounds that can provoke changes in the direction of acidic urine. The natural causes of the development of the disease include the content of foods in the diet that are rich in acids, lipids and proteins.

The following causes of the development of the disease can also be distinguished:

Congenital kidney disease in a child or acquired by a person during life.
The use of drugs with a high content of sodium chloride in the treatment of any disease.
If inflammatory processes begin in the urinary system, which were provoked by an infection of various kinds of origin.
General decrease in immunity. As a rule, the reason for this is the frequent manifestation of allergic reactions and respiratory diseases, especially in children.
Excessive use of drugs, during the decay of which substances with high acidity are formed.

Doctors say that if urine has a sour smell, then the presence of uric acid diathesis in the body may be the reason for this. This means that in the process of metabolic disorders, deviations occurred that led to the malfunction of the kidney tubules.

The high content of protein in food is also fatal. With an excess of this element in the diet, the accumulation of uric acid begins. According to experts, this type of disease is most often manifested in people who have a monotonous diet.

In order to prescribe the correct treatment, it is necessary to determine the causes of acidification of urine. Typically, these factors include:

Metabolic disorders, which are caused by shifts in the work of the endocrine system.
Excessive consumption of alcoholic beverages.
Received severe injuries or burns that lead to the extreme stage of stress.
Excessive workload or too active lifestyle.
Refusal to eat food of animal origin.

To eliminate the above factors, it is enough to reduce physical activity or change your diet. In general, deviations from the usual mode of life for the better can overcome a large number of factors that provoke a pH shift.

acidic urine in children

Urine analysis is a mandatory part of a medical examination when it comes to children. In addition to acidity, an analysis of color, sediment, density, etc. is carried out. This is due to the fact that urine carries a huge number of indicators that may indicate many deviations in a child's life.

This issue should be given great attention, since children are not always able to tell their parents about their pains or problems, especially when it comes to newborns. Moms and dads should be very attentive to the health of their child, pay attention to all the changes that occur in the process of his life.

Parents should pay attention to the color and smell of the child's urine. If it has an unpleasant, pungent and sour smell, then you should immediately contact a specialist to diagnose and identify the disease. A downward deviation in the pH value may indicate serious and dangerous diseases, such as kidney failure, diabetes mellitus, or a feverish state. Often the reason for the deviation can be starvation, which is unacceptable for a child at an early age.

All of these diseases are dangerous to health, and their treatment should be started immediately. It is strictly forbidden to self-medicate, this can only aggravate the situation.

Sour smell of urine in women may be present during pregnancy. In this case, you should not go to extremes and worry. During the bearing of a child, various malfunctions often occur in the body, one of these factors may be a change in the pH value.

Treatment Methods

With a low pH level, depending on the cause of the occurrence, doctors prescribe a set of drugs that not only affect the normalization of acidity, but also fight the main cause of the manifestation of the disease. A special diet is also compiled, which is able to normalize the ratio of the acidic and alkaline environment and thereby normalize the processes in the urinary system. In order for this to happen, it is necessary to enrich the diet with alkaline foods and reduce the intake of foods that can increase acidity.

First of all, all citrus fruits are eliminated from the diet. And the following products must be present in the daily menu:

vegetables (potatoes, cabbage, carrots, beets, etc.);
legumes (lentils, peas, beans, etc.);
various cereals, mainly cereals;
rice is a necessary element of the diet.

An important factor is that overweight people often suffer from the problem of acidic urine. They are prescribed a diet that is aimed not only at normalizing the pH index, but also at a general reduction in body weight. Such a diet will have a positive effect on the functioning of the whole organism. Be sure to remember the benefits of plain water. With regular use of at least 2 liters per day, most of the diseases of the urinary system will never be disturbed.

When identifying the first symptoms of a violation, you can analyze yourself. As a result of the examination, diagnostic indicators will be provided. However, in no case is it allowed to decipher them. Only a qualified specialist can correctly analyze the situation and prescribe a suitable course of rehabilitation measures. And this means that in case of any violations, it is worth contacting a urologist to draw up a comprehensive treatment and subsequently strictly adhere to the doctor's instructions.

Summing up all of the above, I would like to note that urine pH analysis is an extremely important factor in identifying ailments of various origins. Even if the reason for the deviation does not lie in any disease, but it is associated with an improper diet, then the problem that has arisen should be taken very seriously. Regular violations of the acidity of urine can lead to more serious diseases associated with both the kidneys and the endocrine system. If the first symptoms are detected, it is necessary to conduct a thorough diagnosis in order to clearly understand why such deviations occurred and what methods should be used to deal with them.

The reaction or acidity of urine reflects the ratio of hydrogen and hydroxyl ions in it, in other words, the balance of acidic and alkaline substances. This indicator is the most incomprehensible to a simple layman, but for a doctor this criterion is very important. Moreover, paradoxically, the value of urine acidity is not so much as a diagnostic indicator, but as a condition that strongly affects the treatment regimen for various kidney pathologies.

The reaction rate of urine is approximately 4-7 pH. A completely neutral environment corresponds to the number 7, with a decrease in this value, the acidity of the medium increases, and with an increase, the alkaline component increases.

Why does the acidity of urine change?

This criterion depends on the general condition of the body and the level of metabolism. But no less significant influence on the reaction of urine is exerted by the nature of human nutrition and its drinking regimen. Therefore, doctors have the ability to adjust the pH of the urine by simply prescribing a diet. For example, an increase in the proportion of fats and proteins in food contributes to a decrease in pH or an increase in acidity. And foods rich in carbohydrates increase the pH and alkalinize the environment.

A decrease in pH develops with the accumulation of acidic products in the urine. One example of such a condition is ketonuria in diabetes mellitus - ketone bodies are acids, so they increase acidity. Conversely, urinary stasis and some urinary tract infections increase the pH and alkalinize the environment.

However, as already mentioned, urine acidity does not play such a big role in the diagnosis of diseases. However, its influence on the processes in the urinary system is very large. The following is only a brief description of the main processes that can change under the influence of urine pH:

The solubility of various salts and acids is directly dependent on the acidity of the medium in which they are located. For example, uric acid dissolves in an alkaline environment and precipitates in an acidic one. And phosphates and oxalates, on the contrary, are more soluble in an acidic environment. This is of great importance in urolithiasis - the excessive accumulation of any substance in combination with the "wrong" pH creates ideal conditions for the formation of stones. At the same time, a change in the acidity of urine contributes to the dissolution and removal of stones.
Many microorganisms more often cause inflammation of the urinary tract only with a certain reaction of urine that is suitable only for them. For example, E. coli is more dangerous in an acidic environment, and staphylococcus is more dangerous in an alkaline one. Determining the reaction of the environment helps to identify the pathogen.
A number of antibiotics can also work only within a fairly narrow pH range. This makes it necessary to take into account or adjust the acidity of urine in the treatment of urinary tract infections. For example, macrolides and penicillins are more effective in an alkaline environment, and tetracyclines and nitrofurans in an acidic one.

A feature of this

They can fluctuate within fairly wide limits, and these fluctuations can be physiological or pathological. Physiological fluctuations are a variant of the norm, and pathological fluctuations reflect a disease.

An increase or decrease relative to the norm of any indicator cannot be assessed unambiguously, and it is impossible to draw a conclusion about the presence of a disease. The results of the analyzes can help to find out the possible cause of the disorders, which can only be at the stage of the syndrome, and not the formed disease. Therefore, timely detection of deviations in the analyzes will help to start treatment and prevent the progression of the disease. Also, test indicators can be used to monitor the effectiveness of treatment.

Consider the probable causes of changes in various indicators of the general analysis of urine.

Reasons for changing the color of urine

In the presence of pathology, urine can change its color, which indicates a certain syndrome and disease.

The correspondence of urine colors to various pathological conditions of the body is reflected in the table:

pathological color urine	Possible disease (cause of discoloration of urine)
Brown, black	Hemolytic anemias (sickle cell, thalassemia, Minkowski-Choffard anemia, Marchiafave-Michelli disease, marching anemia, syphilitic, hemolytic disease of the newborn) Malignant neoplasms (melanosarcoma) Alkaptonuria Poisoning by alcohol, salts of heavy metals, phenol, cresol, etc.
Red (color of meat slop)	Damage to the kidneys as a result of trauma (blow, bruise, rupture, etc.) Renal colic Kidney infarction Acute inflammation of the kidneys (glomerulonephritis, pyelonephritis)
Dark brown frothy (urine color beer)	Botkin's disease Obstructive jaundice (blockage of bile ducts by a stone)
Orange, rose red	Hemolytic jaundice (hemolytic disease of the newborn) Porphyrias (impaired hemoglobin synthesis)
Brown (color of strong tea)	Hemolytic jaundice Some types of hemolytic anemia
Colorless or white-yellow	Diabetes mellitus types 1 and 2 diabetes insipidus
Dairy (color of milk, cream)	High levels of fat in the urine (lipuria) Pus in the urine (pyuria) High concentration of phosphate salts

These color variations will help you orientate, but for an accurate diagnosis, you should take into account data from other examination methods and clinical symptoms.

Causes of turbidity in the urine

Violation of the transparency of urine is the appearance of turbidity of varying severity. Turbidity in the urine can be represented by a large amount of salts, epithelial cells, pus, bacterial agents, or mucus. The degree of turbidity depends on the concentration of the above impurities.

From time to time, every person has cloudy urine, which is formed by salts. If you are unable to pass this urine to analysis to the laboratory, then you can conduct a test to determine the nature of the turbidity.

To distinguish salts in urine from other variants of turbidity at home, you can slightly warm the liquid. If the turbidity is formed by salts, then it can either increase or decrease until it disappears. Turbidity, formed by epithelial cells, pus, bacterial agents or mucus, does not change its concentration at all when urine is heated.

Causes of change in the smell of urine

The smell of fresh urine is normal - not sharp and not irritating.

Most often, the following pathological odors of urine are noted:
1. The smell of ammonia in the urine is characteristic of the development of inflammation of the mucous membrane of the urinary tract (cystitis, pyelitis, nephritis).
2. The smell of fruits (apples) in the urine develops in the presence of ketone bodies in people with type 1 or type 2 diabetes.

Causes of changes in the acidity of urine

The acidity of urine (pH) can change into an alkaline and into an acidic region, depending on the type of pathological process.

The reasons for the formation of acidic and alkaline urine are shown in the table:

Causes of changes in the density of urine

The relative density of urine depends on the function of the kidneys, therefore, a violation of this indicator develops with various diseases of this organ.

Today, the following options for changing the density of urine are distinguished:
1. Hyperstenuria - urine with a high density, more than 1030-1035.
2. Hypostenuria - urine with a low density, in the range of 1007-1015.
3. Isosthenuria - low density of primary urine, 1010 or less.

A single excretion of urine with high or low density does not give grounds for identifying the syndrome of hypostenuria or hyperstenuria. These syndromes are characterized by prolonged urine output during the day and at night, with high or low density.

Pathological conditions that cause violations of the density of urine are reflected in the table:

Hyperstenuria	Hypostenuria	Isosthenuria
Diabetes mellitus type 1 or 2 (the density of urine can reach 1040 and above)	diabetes insipidus	Chronic renal severe insufficiency degrees
Acute glomerulonephritis	Resorption of edema and inflammation infiltrates (the period after the inflammatory process)	Subacute and chronic jade severe
congestive kidney	Nutritional dystrophy (partial starvation, nutritional deficiencies, etc.)	Nephrosclerosis
nephrotic syndrome	Chronic pyelonephritis
Edema formation	chronic nephritis
Convergence of edema	Chronic renal failure
Diarrhea	Nephrosclerosis (degeneration of the kidney tissue into connective)
	Glomerulonephritis
	Interstitial nephritis

Determination of chemicals in urine for various diseases

As we can see, the physical properties of urine in the presence of any diseases can change quite significantly. In addition to changes in physical properties, various chemicals appear in the urine that are normally absent or present in trace amounts. Consider, in which diseases there is an increase in concentration, or the appearance in the urine of the following substances:

protein;
bile acids (pigments);
indican;
ketone bodies.

Causes of protein in the urine (proteinuria)

The appearance of protein in the urine can be caused by various reasons, which are classified into several groups, depending on the origin. An abnormal increase in the concentration of protein in the urine above 0.03 g is called proteinuria. Depending on the protein concentration, moderate, moderate and severe degrees of proteinuria are distinguished. Moderate proteinuria is characterized by a loss of protein up to 1 g/day, medium - 1-3 g/day, severe - more than 3 g/day.

Types of proteinuria

Depending on the origin, the following types of proteinuria are distinguished:

renal (kidney);
congestive;
toxic;
feverish;
extrarenal (extrarenal);
neurogenic.

The reasons for the development of various types of proteinuria are presented in the table:

Type of proteinuria	Reasons for the development of proteinuria
Renal (kidney)	pyelonephritis renal amyloidosis nephrolithiasis kidney abscess kidney tuberculosis tumor or metastasis to the kidney nephritis (acute and chronic) nephrosis nephrotic syndrome eclampsia pregnant nephropathy of pregnant women paraproteinemic hemoblastoses (multiple myeloma, Waldenström's macroglobulinemia, heavy chain diseases, immunoglobulin-secreting lymphomas)
stagnant	chronic heart failure neoplasms localized in the abdominal cavity
toxic	Use of the following medications at very high doses: salicylates, isoniazid, painkillers, and gold compounds
feverish	A severe increase in body temperature caused by any disease
Extrarenal (extrarenal)	cystitis urethritis pyelitis prostatitis vulvovaginitis chronic constipation long diarrhea
neurogenic	skull trauma meningeal hemorrhage myocardial infarction renal colic

Causes of glucose (sugar) in the urine

The presence of glucose in the urine is called glucosuria. The most common cause of glucosuria is diabetes mellitus, but there are other pathologies that lead to this symptom.

So, glycosuria is divided into the following types:
1. Pancreatic.
2. Renal.
3. Hepatic.
4. Symptomatic.
Pancreatic glucosuria develops against the background of diabetes mellitus. Renal glucosuria is a reflection of the pathology of metabolism, and occurs from an early age. Hepatic glucosuria can develop with hepatitis, traumatic organ damage, or as a result of poisoning with toxic substances.

Symptomatic glucosuria is caused by the following pathological conditions:

concussions;
hyperthyroidism (increased concentration of thyroid hormones in the blood);
acromegaly;
Itsenko-Cushing's syndrome;
pheochromocytoma (tumor of the adrenal glands).

In childhood, in addition to glucose, other types of monosaccharides can be determined in the urine - lactose, levulose or galactose.

Causes of bilirubin in urine

Bilirubin in the urine appears with parenchymal or obstructive jaundice. Parenchymal jaundice includes acute hepatitis and cirrhosis. Obstructive jaundice includes various types of blockage of the bile ducts with an obstruction to the normal outflow of bile (for example, cholelithiasis, calculous cholecystitis).

Reasons for the appearance of urobilinogen in the urine

Urobilinogen at a concentration exceeding 10 µmol / day is determined in the urine with the following pathologies:

infectious hepatitis;
chronic hepatitis;
cirrhosis of the liver ;
tumors or metastases to the liver;
hemoglobinuria (hemoglobin or blood in the urine);
hemolytic jaundice (hemolytic disease of the newborn, hemolytic anemia);
infectious diseases (malaria, scarlet fever);
fever of any cause;
the process of resorption of foci of hemorrhage;
volvulus;
bile acids (pigments);
indican.

Causes of Bile Acids and Indican in Urine

Bile acids (pigments) appear in the urine with an increase in the concentration of direct bilirubin in the blood above 17-34 mmol / l.

Causes of bile acids in urine:

Botkin's disease;
hepatitis;
obstructive jaundice (calculous cholecystitis, cholelithiasis);
cirrhosis of the liver.

Indican is a product of decay of protein structures in the small intestine. This substance in the urine appears with gangrene, chronic constipation, all kinds of abscesses, ulcers and intestinal abscesses, malignant tumors or obstruction. Also, the appearance of indican in the urine can be triggered by metabolic diseases - diabetes mellitus or gout.

Causes of ketone bodies in urine

Ketone bodies include acetone, hydroxybutyric acid, and acetoacetic acid.

Reasons for the appearance of ketone bodies in the urine:

diabetes mellitus of moderate and high severity;
fever;
severe vomiting;
therapy with large doses of insulin for a long period of time;
eclampsia of pregnant women;
hemorrhage in the brain;
traumatic brain injury;
poisoning with lead, carbon monoxide, atropine, etc.

In the postoperative period, after a long stay under anesthesia, ketone bodies can also be detected in the urine.

Deciphering the microscopy of the urinary sediment

One of the most informative fragments of a general urine test is sediment microscopy, in which the number of different elements in one field of view is counted.

Leukocytes, pus in the urine - possible causes of the appearance

An increase in the number of leukocytes more than 5 in the field of view indicates a pathological process of an inflammatory nature. An excess of white blood cells is called pyuria - pus in the urine.

Reasons for the appearance of leukocytes in the urine:

acute pyelonephritis;
acute pyelitis;
acute pyelocystitis;
acute glomerulonephritis;
treatment with aspirin, ampicillin;
heroin use.

Sometimes, urine is stained to clarify the diagnosis: the presence of neutrophilic leukocytes is typical for pyelonephritis, and lymphocytes for glomerulonephritis.

Erythrocytes, blood in the urine - possible causes of the appearance

Erythrocytes in the urine can be present in various quantities, and at their high concentration they speak of blood in the urine. By the number of erythrocytes in the urinary sediment, one can judge the development of the disease and the effectiveness of the treatment used.

Reasons for the appearance of red blood cells in the urine:

glomerulonephritis (acute and chronic);
pyelitis;
pyelocystitis;
chronic renal failure;
injury (bruise, rupture) of the kidneys, urethra or bladder;
tuberculosis of the kidney and urinary tract;
tumors;
taking certain medications (sulfa drugs, urotropin, anticoagulants).

In women, in the first days after childbirth, erythrocytes are also detected in large numbers, but this is a variant of the norm.

Cylinders in the urine - possible causes of the appearance

Among all types of cylinders, the appearance of hyaline is most often noted in the urinary sediment. All other types of cylinders (granular, waxy, epithelial, etc.) appear much less frequently.

The reasons for the detection of various types of cylinders in the urine are presented in the table:

Type of cylinders urinary sediment	Causes of the appearance of cylinders in the urine
hyaline	nephritis (acute and chronic) nephropathy of pregnant women pyelonephritis kidney tuberculosis kidney tumors nephrolithiasis diarrhea epileptic seizure fever poisoning with sublimate and salts of heavy metals
grainy	glomerulonephritis pyelonephritis severe lead poisoning viral infections
waxy	chronic renal failure kidney amyloidosis
Erythrocyte	acute glomerulonephritis kidney infarction thrombosis of the veins of the lower extremities high blood pressure
epithelial	renal tubular necrosis poisoning with salts of heavy metals, sublimate intake of substances toxic to the kidneys (phenols, salicylates, some antibiotics, etc.)

Epithelial cells in the urine - possible causes of the appearance

Epithelial cells are not just counted, but also divided into three types - squamous epithelium, transitional and renal.

Squamous epithelial cells in the urinary sediment are detected in various inflammatory pathologies of the urethra - urethritis. In women, a small increase in squamous cells in the urine may not be a sign of pathology. The appearance of squamous epithelial cells in the urine of men no doubt indicates the presence of urethritis.

Transitional epithelial cells in the urinary sediment are detected with cystitis, pyelitis, or pyelonephritis. The hallmarks of pyelonephritis in this situation is the appearance of transitional epithelial cells in the urine, in combination with protein and a shift in the reaction to the acid side.

Cells of the renal epithelium appear in the urine with a serious and deep lesion of the organ. So, most often, renal epithelial cells are detected with nephritis, amyloid or lipoid nephrosis, or poisoning.

Pathologies leading to the release of salts into the urine

Crystals of various salts may appear in the urine and are normal, for example, due to dietary characteristics. However, in some diseases, the excretion of salts in the urine is also noted.

Various diseases that cause the appearance of salts in the urine are presented in the table:

The table shows the most common salts that have diagnostic value.

Mucus and bacteria in the urine are possible causes

Mucus in the urine is determined with urolithiasis or long-term chronic inflammation of the urinary tract (cystitis, urethritis, etc.). In men, mucus may appear in the urine with prostatic hyperplasia.

The appearance of bacteria in the urine is called bacteriuria. It is caused by an acute infectious and inflammatory process occurring in the organs of the urinary system (for example, pyelonephritis, cystitis, urethritis, etc.).
A general urinalysis provides a sufficiently large amount of information that can be used to make an accurate diagnosis in combination with other methods. However, remember that even the most accurate analysis does not allow diagnosing any disease, since this requires taking into account clinical symptoms and objective examination data.

Before use, you should consult with a specialist.

You can determine the state of the body and the work of certain organs. Urine acidity (pH) is an important indicator by which you can assess the acid-base balance. It plays a special role in the diagnosis of many pathological conditions.

The kidneys are an important organ that filters and removes many toxins, decay products of vital activity in the urine. The pH level is one of the main indicators that must be checked during any examinations.

The acidity of urine allows you to determine the processes occurring in the body and assess the general condition. In medical practice, it is called urine pH. This is a pH indicator that allows you to calculate the amount of hydrogen ions in a urine sample. It can change throughout the day. With some pathologies of the urinary system, the pH may decrease or increase.

The pH level can indicate the extent to which the kidneys process the minerals that enter the body. Magnesium, calcium, are responsible for the level of acidity.

When acid levels are high, the body neutralizes the accumulated acid in the tissues and borrows the minerals it needs from the bones or organs.

The chemical composition of urine can change depending on many factors:

Metabolism.
Acidity of the stomach.
Wrong nutrition.
Diseases of the genitourinary system.
Features of the functioning of the renal tubules.
The amount of liquid consumed.

Determining the pH level in the urine is very important when using litholytic drugs - medicines that dissolve kidney stones.

Diagnosis and norm

It is important to collect urine for analysis correctly, otherwise the results may be unreliable. The day before, it is not recommended to eat foods that can change the physical properties of the liquid.

Do not take diuretics. Before the study, be sure to wash the genitals. You need to be able to properly toilet the genitals in children: girls are washed from front to back, and in boys they expose the head of the sexual man.Collect an average portion of urine in a clean glass container. The first portion is released into the toilet, the middle one is collected in a container and the remaining one is again in the toilet.

Urine collection is performed in the morning, on an empty stomach. Therefore, it should be delivered to the laboratory immediately. With prolonged storage of urine, the destruction of the cylinders also occurs, the pH changes.During menstruation, a woman is not recommended to take, as this can distort the results.

Urinalysis is prescribed to all patients with suspected diseases of the genitourinary system and other disorders in the body.

The acidity of urine is determined using special indicators - litmus paper. It changes its color depending on the reaction of the solution. Each color corresponds to a specific pH value. If the strip changes color to red, then this indicates an acidic pH of the urine, and if it turns blue, then it indicates an alkaline reaction. If the strips have not changed color, then the acidity is neutral.

There is another way to determine the acidity of urine - using an ionomer. This method is more convenient and highly informative.

Useful video: how to correctly and quickly determine the pH level

Urine acidity:

Normally, in a man and a woman, the acidity of urine has the same value. In the morning, urine in an adult is slightly acidic, due to the release of toxins. The normal pH for an adult is 6.5-7 units.
In a child, normal values \u200b\u200bare slightly different from the pH level of adult urine. The acidity of urine in a newborn is 5.5-6, in a premature baby - 4.8-5.4, and in a bottle-fed baby - 5.4-6.9.
After the baby has been weaned, the pH of the urine has the same value as in adults.

If urine contains substances with acidic properties, then it is acidic (pH level less than 7). If a large amount of alkaline substances is detected in the urine, then this indicates alkalization of the urine (pH level more than 7). In the urine, acidic and alkaline substances can be in equal amounts, then the acidity is neutral (pH is 7).

Why does urine become acidic?

An increase in the acidity of urine occurs with excessive consumption of vegetable or dairy foods, mineral water. An upward shift in pH may be the result of taking certain drugs: adrenaline, bicarbonates, nicotinamide.

Increased acidity may indicate a violation of the secretion of gastric juice, pyloric obstruction.

The acidity of urine above normal can be observed in the following cases:

When dehydrated.
With diarrhea.
With diabetic ketoacidosis.
With acidosis.
When fasting.
For urinary tract infections.
With chronic renal failure.

The alkaline reaction of urine can increase with chronic urinary tract infections, feverish conditions, and kidney tuberculosis.Chronic increase in urine acidity contributes to the formation of phosphate stones.

It is important to establish the cause of increased acidity of urine and only then carry out treatment. It is necessary to conduct an additional examination and identify possible deviations.

How to normalize an indicator

To reduce the acidity of urine, it is necessary to reduce the intake of protein foods and increase the intake of foods with a neutral or acidic alkaline load.If alkalization of urine is associated with pathological processes in the body, then this is a cause for concern.

In this case, further diagnostics will be needed to determine the cause of the deviation from the norm.Daily tests with test strips will help you choose the right diet.

The diet should contain foods with zero acid formation. These products are:

Oil
Ice cream
Milk
Cucumber
Vegetable oil

Products with negative acid formation: fruits, fruit juices, vegetables, mushrooms, herbs, mineral water, coffee, red and white wine. The division of products by "acidity" is very conditional. Every body digests and metabolizes food differently.It is necessary to make changes in the diet: exclude or add products.

If urolithiasis is detected and long-term treatment is prescribed, then patients should independently monitor urine pH using test strips.

You should not follow a certain diet and eat foods with a low level of acid formation. It is recommended to use all products, but within reasonable limits.

To cleanse the body and kidneys, it is necessary to consume a sufficient amount of fluid. In people leading a healthy lifestyle, the acidity of urine is always normal.

During pregnancy, every woman gives up. Since the kidneys work with a double load, a urine test is simply necessary. In addition, the immune system is weakened, the hormonal background changes, as a result of which the function of the ureters is impaired. This can provoke an infectious process or lead to an exacerbation of chronic diseases of the urinary system.

The acidity of urine in a pregnant woman varies and depends on the food consumed. With excessive consumption of meat food, the reaction of urine will be acidic, and if you follow a vegetarian diet, then the reaction will be alkaline.Normally, for a pregnant woman, the normal value is pH 4-8.This is provided that the material for research is fresh and handed over on time.

A low pH level during pregnancy is observed with toxicosis, vomiting, and diarrhea.

In addition, a decrease can be observed with a deficiency of potassium in the body. Changes in the urine of a pregnant woman are considered by doctors in a complex, but not separately.If the pH level is elevated, then this may indicate a malfunction of the parathyroid gland.

Together with the acidity of urine, gynecologists and urologists examine the color, transparency, presence, of cylinders.If the urinalysis is bad, then this is a reason for re-examination of urine but in a different way.