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The kidneys are two bean-shaped organs located on either side of the vertebral column, just below the rib cage. Each kidney is about the size of a fist and weighs roughly 150 grams. Together, they filter approximately 180 liters of blood per day, though only about 1–2 liters become urine. The kidneys perform several vital functions: they remove metabolic waste products such as urea and creatinine, regulate water and electrolyte balance, maintain blood pH, and produce hormones that regulate blood pressure and red blood cell production.
Step 1 — Filtration: Blood enters the glomerulus under high pressure. The glomerular membrane is selectively permeable, allowing water, ions, glucose, urea, and creatinine to pass into the Bowman's capsule. Larger molecules like proteins and red blood cells are normally too large to pass through and remain in the blood.
Step 2 — Reabsorption: As the filtrate travels through the proximal tubule and loop of Henle, useful substances are returned to the bloodstream. Glucose, amino acids, and most water are reabsorbed. This is why healthy urine does not normally contain glucose or protein.
Step 3 — Secretion: The distal tubule and collecting duct actively secrete additional waste products — such as hydrogen ions, potassium, and certain drugs — from the surrounding capillaries into the filtrate. This fine-tunes urine composition and helps regulate blood pH.
A urinalysis (UA) is one of the most common diagnostic tests in clinical medicine. It can detect urinary tract infections, kidney disease, diabetes mellitus, dehydration, and more — often before symptoms appear. A complete UA involves three components: physical assessment (color, clarity, odor), chemical assessment (dipstick test), and microscopic examination (cells, casts, crystals).
| Test Parameter | Normal Result | Abnormal Finding | Possible Cause |
|---|---|---|---|
| Color | Pale to dark yellow | Red / brown | Hematuria, medication |
| Clarity | Clear | Cloudy / turbid | Bacteria, WBCs, mucus |
| pH | 4.5 – 8.0 | <4.5 or >8.5 | Diet, infection, kidney disease |
| Specific Gravity | 1.005 – 1.030 | >1.030 | Dehydration, SIADH |
| Protein | Negative | Trace – 3+ | Kidney damage, infection |
| Glucose | Negative | 1+ – 4+ | Diabetes mellitus |
| Blood | Negative | 1+ – 3+ | UTI, kidney stones, trauma |
| Nitrite | Negative | Positive | Bacterial infection (UTI) |
| Ketones | Negative | 1+ – 3+ | Fasting, DKA, starvation |
Glycosuria (glucose in the urine) occurs when blood glucose levels exceed the kidney's reabsorption capacity, called the renal threshold. This is a hallmark finding in uncontrolled diabetes mellitus. Proteinuria suggests damage to the glomerular membrane, which normally prevents large proteins from passing into the filtrate. The presence of nitrites indicates bacterial activity, as many urinary pathogens convert urinary nitrates to nitrites — a key indicator of a urinary tract infection (UTI). A high specific gravity (above 1.030) indicates the kidney is producing highly concentrated urine, which may signal dehydration.
Complete all activities below. Use the reading passage and vocabulary section for support.
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Study each patient's urine sample and dipstick test strip. Use the Color Reference Chart below to read each pad, then record your findings in the data table.
Maria presents with increased thirst, frequent urination, and fatigue for the past 3 weeks. She has a family history of diabetes. Her fasting blood glucose was 265 mg/dL. The physician ordered a urinalysis to check for glucose and other abnormalities.
James reports burning urination, lower back pain, and a fever of 38.9°C for 5 days. His urine has a foul odor and appears cloudy. He had a kidney infection 2 years ago. His physician suspects a urinary tract infection and orders a urinalysis.
Sofia is a cross-country runner who trained intensely on a hot afternoon and has not had much water since morning. She reports dizziness, muscle cramps, and very dark urine. Her blood pressure is slightly low. The physician suspects dehydration.
Record your findings for each patient based on the dipstick results above. Do not skip any cell.
| Test Parameter | Normal Range | Patient A — Maria | Patient B — James | Patient C — Sofia |
|---|---|---|---|---|
| Color | Pale to dark yellow | |||
| Clarity | Clear | |||
| pH | 4.5 – 8.0 | |||
| Specific Gravity | 1.005 – 1.030 | |||
| Protein | Negative | |||
| Glucose | Negative | |||
| Blood | Negative | |||
| Nitrite | Negative | |||
| Ketones | Negative |
Use the urinalysis results and your knowledge to answer each case study question.
Maria has been feeling extremely thirsty and urinating frequently for the past three weeks. Her fasting blood glucose is 265 mg/dL (normal: 70–99 mg/dL). Her urinalysis dipstick showed a strongly positive result for glucose (3+) and trace ketones. All other values were within normal limits. Her physician suspects a hormonal condition that affects how cells absorb glucose.
James arrives at the urgent care clinic with a fever of 38.9°C, severe burning during urination, lower back pain, and cloudy, foul-smelling urine for five days. His medical history reveals a kidney infection two years prior. The urinalysis shows cloudy amber urine with positive nitrites, 2+ blood, and 1+ protein.
Sofia is a competitive cross-country runner who trained for four hours on a hot day with minimal water intake. She is dizzy, has a mild headache, and notices her urine is very dark amber but otherwise clear with no odor. Her blood pressure is slightly low at 95/60 mmHg. Her urinalysis is otherwise unremarkable except for a specific gravity of 1.030.
Analyze the graphs below and answer each question using the dropdown menus.
Test your knowledge before the quiz! This section is for practice only and does not affect your grade.
Can you diagnose like a clinician? Answer 5 questions to prove it!
Answer all 5 questions. You must score 60% or higher to pass. A new set of questions appears on each retry.
Review your complete lab performance below, then print to PDF.
| Test | Normal Range | Patient A | Patient B | Patient C |
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| Activity | Your Response / Result | Points |
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| Question | Your Answer | Result |
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| Question | Your Answer | Result |
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