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Consistency of Urine
بقول ابن سینا: قوام البول
According to the Modern Medicine
In contemporary medicine, the term viscosity is more known as specific gravity although few physicians claim that these two are different things but I believe in the broad context these two terms share common grounds.”Specific gravity measures the kidney’s ability to concentrate or dilute urine in relation to plasma by comparing the weight of urine (particles) to the weight of distilled water (1.000). Because urine contains various substances, such as minerals and salts, the specific gravity is normally higher than that of water, usually ranging from 1.005 to 1.025, but the specific gravity may increase with an increase of other substance, such as protein, in the urine or if the fluid content falls, such as with dehydration.”
Diluted urine (Hyposthenuria): “Very diluted urine represents the narrowing of blood vessels in the kidneys, dysfunction of the tubular reabsorption of water or diabetes insipidus, or drinking excessive water (initial polydipsia).”
Dense urine (Hypersthenuria): “It may be due to decreased fluid intake; dehydration owing to fever, sweating, vomiting, diarrhea, diabetes mellitus and inappropriate secretion of antidiuretic hormone (ADH). The specific gravity can be useful in differentiating between diabetes insipidus and diabetes mellitus. Both diseases produce a high urinary volume, but in diabetes insipidus, the specific gravity is very low and in diabetes mellitus, there is a deficiency of insulin and thus an excess of glucose, which exceeds the renal threshold and is excreted in the urine.”
Dehydration is the most common cause of Dense urine: “Increased secretion of the antidiuretic hormone increases tubular water reabsorption, resulting in a decreased volume of the urine. Various factors, such as trauma, stress, surgery, and medications, can result in an increased ADH secretion. On the other hand, as the ADH concentrates the urine, so in the absence of ADH the kidneys produce a large amount of urine (15 to 20 liter/day) with a decreased specific gravity. ACSM (American College of Sports Medicine) guidelines, the recommendation is to consume 14-32 ounces of water per hour. 1L is the maximum which is about 34 ounces, but during exercise, the body just cannot process that. So, there is no way to consume 34 ounces of liquid in an hour. Research suggests a good way to check your hydration levels can be using a urine color chart. The less color, the more hydrated you are. The darker the color, the more dehydrated you are.” Totally clear and no transparent urine may mean you are overhydrated. Not very complicated!
Note: it is estimated that the increase of urine specific gravity by 0.001 will lead to an increase of urine osmolality by 30-40 mOsm/kg. Hence it can be predicted that the value of urine osmolality by following formula. Predicted urine osmolality = (Specific Gravity-1) x (30,000-40,000).
Suggested Readings
- Shamsi, M., Haghverdi, F., & Ashtiyani, S. C. (2014). A brief review of Rhazes, Avicenna, and Jorjani’s views on diagnosis of diseases through urine examination. Iranian journal of kidney diseases, 8(4), 278.
- White WI. A new look at the role of urinalysis in the history of diagnostic medicine. Clin Chem. 1991;37:119-25.
- Noor, H., Ansari, M. A., Ali, F., & Qadeer, A. (2018). Bawl (Urine) and its credibility in unani system of medicine.
- Avicenna’s Canon of medicine by O. C. Gruner.
Tag:Urology in Canon