By Penelope A. Domogo, MD
This week, we continue the discussion on our urinary system as it is still June, the National Kidney Month. Since our kidneys are not visible to us like our hands, how can we know if we are taking care of these properly? If we are taking care of our two built-in waste disposal machines, then they should be functioning well, right? Right? Praise God, he gave us simple ways to check the state of our urinary system, particularly our kidneys. The most common is through urinalysis – an examination of our urine. We can look at it closely with our own eyes and then though the microscope to see those invisible to our naked eye. This is not to say that you interpret you be your own doctor. No, you still have to consult your doctor or nurse or midwife. But, as non-medical people, you also have the right and responsibility to your own health and health care. You need to understand technical terms and what they mean so that when you consult your doctor or health worker then you have a meaningful discussion with him or her. This way, you will be empowered to take care of your own health. For example, if the doctor says there are pus cells or “nana” in your urine, you will not go into panic mode because pus cells are not really “nana”, they are white blood cells. You see, technical terms may seem intimidating but as I said, they are just technical terms.
Last week, we discussed the urinary system. In brief review, the parts of the urinary system are 2 kidneys, 2 ureters, I urinary bladder and 1 urethra. The kidneys are the body’s filtering machine or built-in liquid waste disposal system. Imagine it containing millions of curled ultra-fine mesh tubes screening your blood 24/7 at the rate of 125ml per minute. Small particles like water, sugar (glucose), salt, amino acids and nitrogenous wastes (urea) pass through easily through these tiny holes while large particles like cells, platelets and large proteins don’t. Further down, the system then reabsorbs what is needed by your body like water, sugar and amino acids then excretes waste and excess water to the environment in the form of urine.
What we refer here as “waste” are 1) byproducts of the metabolism of food like urea and medicines/chemicals that are poisonous if they accumulate and 2) excess water and excess electrolytes like salt.
Urine then can provide information on what is going on in our bodies, especially our kidneys. So you will notice that urinalysis is a favorite of us doctors. Urinalysis simply means an examination of the urine. Urine can be examined in a lot of ways- basic, drug test, etc. We will focus on the basic or routine urinalysis. This examines the color, specific gravity, pH, presence of protein (measured as albumin) and sugar (measured as glucose), presence of cells or crystals and other big particles.
Normal urine is straw yellow and is clear to slightly hazy. pH is 5-8. There should be no sugar or protein in it. Big particles such as red and white blood cells and other cells are not supposed to be there or if they are there, are, they should be minimal. Crystals should be from normal metabolic processes. Yes, sir, there could be beautiful crystals also but these could damage the urinary system as they are sharp like shattered glass.
So if your urinalysis shows red and white blood cells and other cells that are not supposed to be there, it could mean that there’s a leak in the filtering machine. These red and pus cells can also come from infection or inflammation of your urinary bladder, though.
Protein is also too big to pass through the fine filters so presence of protein in the urine again means the filtration holes have widened or are damaged.
What causes these leaks? What can damage or widen these holes? As with any pliable mesh, too much pressure will do it. Even steel pipes burst with too much pressure. Thus kidney damage is common in hypertension and diabetes. In these two diseases, the blood is thick and heavy and blood vessels are damaged.
Sugar (alias glucose) in the urine means an excess of sugar in the blood. Glucose can pass freely through the mesh but it is supposed to be reabsorbed back to the bloodstream. For glucose to be reabsorbed, they need carriers. If all the carriers are used up, the excess glucose is set free in the urine. Thus urine test is an easy way to assess your sugar level.
Our urine is certainly interesting. You yourself should monitor its color and odor and clarity. For the laboratory to give more accurate results, you should collect urine properly – early morning urine is best, wash penis or vagina with water (not soap or anything) and catch the midstream urine. Midstream urine means you urinate a little, fill up the specimen bottle and urinate the rest to the toilet bowl. This sample should be in the laboratory in an hour. And we doctors would be very glad to discuss with you the results of the laboratory test. Please feel free and not be ashamed to ask if there is anything you don’t understand. ***
“Let the words of my mouth and the meditation of my heart be acceptable in your sight, O Lord, my strength and my redeemer.” Psalm 19:14
