The mean pH value of the urine in healthy subjects with normal nutrition is abount 5,0-7,0.

The value of pH is affected by the use of medicinal preparations and chraracter of nutrition.

A diet high in meats, eggs, cheese, whole grains, plums, prunes, and cranberries (including prune juice and cranberry juice) may decrease the pH, producing an acid urine.

A diet high in vegetables, citrus fruits, and milk may increase the pH, producing an alkaline urine.

Also the urine pH may be intentionally altered to inhibit bacterial growth or urinary stone development or to facilitate the therapeutic activity of certain medications. An acid urine shoud be maintained in the treatment of urinary tract infections and persistent becteriuria and in the management of urinary calculi.

Conversely, an alkaline urine should be maintained when streptomycin, neomycin, and kanamycin are used in the treatment of urinary tract infections.

Acidity of urine can increase in diabetes mellitus, renal insufficiency, tuberculosis of the kidneys, metabolic or respiratory acidosis, pyrexia, starvation.

Alkaline pH occurs with diarrhoea and vomiting, chronic urinary tracts infections due to bacterial-ammoniacal fermentation, metabolic or respiratory alkalosis.

Protein. Testing the urine for protein is based on its coagulation in the presence of acid. Normal urine does not practically contain protein. The small quantity of plasma proteins that is present in the urine, cannot be determined by qualitative tests used in practical medicine. The appearance of protein in the urine is called proteinuria. It can be of renal and extra renal origin.

Functional renal proteinuria is connected with the permeability of membranes in the renal filter in the presence of strong stimulation, slowing of the blood flow in the glomeruli, in intoxications. The urine will contain albumin after a cold bath, excessive exercise (effort), a high-protein diet or a lordotic posture in children (orthostatic), emotional stress.

In cases with extrarenal proteinuria proteins enter the urine from the urinary and sex ducts. Extrarenal proteinuria is not exceed 1 g/L usually.

Organic renal proteinuria occurs in kidney affections due to increased permeability of glomeruli which is underlined by vascular inflammation or structural disorganization of the basal membrane. Glomerular permeability is upset by the "molecular sieve" mechanism, low-molecular proteins are lost in the first instance (selective proteinuria), as the process progresses, high-molecular proteins are also lost (non-selective proteinuria).

Renal proteinuria occurs with glomerulonephritis, preeclampsia in pregnant woman, or multiple myeloma, amyloidosis, renal abscesses, urinary tract stones.

Congestive proteinuria may be indicative of decompensative heart failure, abdomen cavity tumors.

Toxic proteinuria may be after overdosage some medications (aspirin, analgetic).

Neurogenic proteinuria occurs with cranium trauma, and hemorrhage of the brain, myocardial infarction, renal colic.

Proteinuria can be moderate, when protein loss is not exceed 1 g/twenty-four hours, everage, when protein loss is from 1 to 3 g/twenty-four hours, and considerable, when protein loss more than 3 g/twenty-four hours.

Glucose. Testing the urine for glucose can be done by using reagent strips. The urine of a healthy person contains very small quantity of glucose, which cannot be detected by common qualitative tests. Glucose in the urine (glycosuria) can be both physiological and pathological. In the presence of normal renal function, glycosuria occurs only in increased concentration of sugar in the blood exceed 9.9 mmol/L.

Physiological glycosuria can be observed in persons whose diet is rich in carbohydrates (alimentary glucosuria), following emotional stress, and administration of some medicines (caffeine, corticosteroids). Less frequent is renal glycosuria associated with disturbed resorption of glucose in the tubules in normal amount of sugar in the blood (in renal diabetes, chronic nephritis, nephrotic syndrome).

Pathological glycosuria occurs most frequently in diabetes mellitus, less frequently in thyrotoxicosis, in Itsenko-Cushing syndrome, in liver cirrhosis.

Ketones. The presence of ketone bodies in the urine is called ketonuria. The urine of a healthy person contains very small quantity of ketone bodies, which cannot be detected by common qualitative tests.

Ketonuria can be detected due to abnormal fat metabolism. Ketones may be indicative of poorly controlled diabetes, dehydration, starvation, long-standing gastro-intestinal disorders, postoperatively, or excessive ingestion of aspirin.

Bilirubin. Normal urine is practically free from bilirubin. Bilirubinuria occurs in hepatic and subhepatic jaundice at which the concentration of bound bilirubin in the blood increases (more than 34 mmol/L).

Urobilin. Urobilinoids are urobilin and stercobilin. Excretion of large amount of urobilinoids in the urine is called urobilinuria which occurs in diseases of the liver, hemolytic anemia and enteritis, extensive myocardial infarction, congestive failure, pyrexia.

Microscopic examination of urine sediment is made for qualitative and quantitative appraisal of the main urine elements.

Epithelium Cells. Cells of squamous, transitional and renal epithelium can be revealed.

Squamous epithelium enters the urine from the external genitalia and the urethra, their diagnostic importance is low.

Large amount of squamous epithelium in female can be indicative of bad clearing of the external genitalia or some gynecological diseases.

Large amount of squalors epithelium in male occurs with inflammation of the urethra.

Cells of transitional epithelium line the mucosa of the urinary tract. The presence of large amount of transitional epithelium in the urine indicates inflammatory process in the pelves or the bladder.

The presence of renal epithelium in the urine is a specific sign of acute and chronic affections of the kidneys, and also of fever, toxicosis, and infectious diseases.

Leucocytes in the urine of a healthy person are usually neutrophilis and their amount is insignificant to 6-8 in the microscope's vision field.

Increased quantity of leucocytes in the urine (leycocyturia) indicates inflammation in the kidneys or urinary tract (urethritis, prostatitis, cystitis, pyelonephritis).

Erythrocytes can be altered and unaltered. The urine of a healthy person is free from erythrocytes or can have single erythrocytes in preparation.

The presence of erythrocytes in the urine is called hematuria. Hematuria that can be established only by microscopy is called microhematuria, while hematuria revealed by macroscopy is called macrohematuria.

Physiological microhematuria can be found in physical overstrain of the sportsman.

 Erythrocytes may be liberated either from the kidneys (glomerulonephritis, tumor of the kidney) or from the urinary tract (stones in the pelves, urinary bladder or; tuberculosis or malignant new growths of the urinary bladder or ureters;).

In the presence of glomerular hematuria the urine usually contains much protein. Proteinerythrocytic dissociation (hematuria with insignificant proteinuria) usually suggests hematuria associated with pathology of the urinary tract. Non-glomerular hematuria can have intermittent character.

Casts are proteinous or cells formation of tubular origin, they have cylindrical configuration and variable size. In normal urine the casts are absent.

Hyaline casts are found in acute and chronic glomerulonephritis, nephrotic syndrome and also in physiological transient albuminuria. They can be found in the urine of practically healthy people when the pH of the urine decreases sharply along with increasing specific gravity of the urine, which is characteristic of dehydration.

Presence of granular casts indicates dystrophic processes in the tubules. 

Waxy casts are characteristic of chronic diseases of the kidneys.

"Non-organized sediment" of the urine consists of salts that precipitate as crystals and amorphous substances. Their character depends on the colloidal composition of the urine, its pH and other properties.

 Acid urine contains uric acid, urates, oxalates.

Alkaline urine contains ammonium urate, calcium carbonate, phosphates. The sediment is diagnostically insignificant.

Phosphate and calcium oxalate crystals occur with hyperparathyroidism or malabsorption.

Urate crystals occur with serum acid levels (gout).