Urinalysis Lab Simulation

The Macroscopic Exam

Table of Contents ►

Exam Background Information

Introduction
Urine Volume
Urine Color
Urine Clarity
Urine Odor

Exam Procedures

24-Hour Collection
Fresh Sample Collection

Macroscopic Exam Results
Terms of Use
References and Attributions

Exam Background Information

Introduction

The macroscopic exam determines the physical properties of urine, such as volume, color, clarity, and odor. The process is performed without instruments, using only the unaided eyes and nose.

Although simple, the macroscopic exam is an important step in urinalysis. Because urine is formed from filtered blood plasma, its physical properties provide a quick, noninvasive look at hydration status, kidney function, and overall health.

Abnormal findings, such as unusual color, cloudiness, or odor, can provide early clues to conditions such as dehydration, urinary tract infections, liver disease, or diabetes. These observations also help guide the chemical (dipstick) and microscopic exams.

Urinalysis simulation image, macroscopic examination of urine

Urine Volume

Urine volume is the urine produced over 24 hours, which usually ranges from 0.8 Liters (800 mL) to 2 Liters (2000 mL). Low urine volume, or oliguria (less than 400 mL), can indicate possible chronic kidney disease. High urine volume or polyuria (more than 3000 mL) can indicate diabetes, increased fluid intake, or possible kidney disease.

24-Hour Urine Volume Chart

Urine Color

Usually, the color of urine is pale yellow. However, color changes can result from particular foods, dehydration, infections, organ dysfunction, and medications.

Pale Yellow

Normal Color

Amber

Due to concentrated urine resulting from dehydration.

Pink

Due to blood in the urine (hematuria) resulting from urinary tract infection (UTI), kidney stones, or certain foods.

Orange

Due to medications, carotene (carrots), B vitamins, or bilirubin (resulting from liver or bile duct disease).

Blue

Due to food coloring, medications, or urinary tract infections.

Brown

Due to fava beans, medications, kidney disease, or muscle breakdown.

Urine Clarity

Urine clarity refers to its turbidity or transparency. Urine is usually translucent (clear) but can become increasingly opaque or cloudy as the number of solid particles increases. A high concentration of crystals (related to dehydration, certain foods, or urine pH), white blood cells (related to urinary tract infections), or elevated glucose (related to diabetes) can cause the urine to become cloudy.

Clear

Cloudy

Urine Odor

Normal urine has a slight odor due to the chemical compounds it typically contains. Urine odor, however, can vary significantly with dehydration, diabetes, medications, infections, and particular foods. A sweet or fruity odor in the urine can result from elevated glucose or ketones due to diabetes. An ammonia (NH₃) smell can result from dehydration, which increases urine concentration. A pungent or foul odor can result from urinary tract infections, medications, or certain foods.

Normal (Slight)

Sweet or Fruity

Ammonia

Pungent or Foul

Exam Procedures

Collect the Subject's Urine
for 24 Hours

Before visiting your clinic, have the subject collect her urine for 24 hours.

To hold the urine, provide a 3-liter plastic container labeled with volume increments on the outer surface. Instruct the subject to urinate in an ordinary glass jar and transfer the contents to the plastic container.

On her arrival at the clinic, have the plastic container delivered to your team for evaluation.