Urine

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Urine (from Latin Urina, ae, f.) is a liquid by-product of the body secreted by the kidneys through a process called urination and excreted through the urethra.

Cellular metabolism generates numerous by-products, many rich in nitrogen, that require clearance from the bloodstream. These by-products are eventually expelled from the body during urination, the primary method for excreting water-soluble chemicals from the body. These chemicals can be detected and analyzed by urinalysis.

Sample of human urine
Urea structure
Image of two facing pages of the illuminated manuscript of "Isagoge", fols. 42b and 43a. On the top of the left hand page is an illuminated letter "D" - initial of "De urinarum differencia negocium" (The matter of the differences of urines). Inside the letter is a picture of a master on bench pointing at a raised flask while lecturing on the "Book on urines" of Theophilus. The right hand page is only shown in part. On its very bottom is an illuminated letter "U" - initial of "Urina ergo est colamentum sanguinis" (Urine is the filtrate of the blood). Inside the letter is a picture of a master holding up a flask while explaining the diagnostic significance of urine to a student or a patient. HMD Collection, MS E 78.

Physiology

Main article: Renal physiology

Most animals have excretory systems for elimination of soluble toxic wastes. In humans, soluble wastes are excreted primarily by the urinary system and, to a lesser extent in terms of urea removed, by perspiration.[1] The urinary system consists of the kidneys, ureters, urinary bladder, and urethra. The system produces urine by a process of filtration, reabsorption, and tubular secretion. The kidneys extract the soluble wastes from the bloodstream, as well as excess water, sugars, and a variety of other compounds. The resulting urine contains high concentrations of urea and other substances, including toxins. Urine flows from the kidney through the ureter, bladder, and finally the urethra before passing from the body.

Composition

Exhaustive detailed description of the composition of human urine can be found in NASA Contractor Report No. NASA CR-1802, D. F. Putnam, July 1971.[2] That report provided detailed chemical analyses for inorganic and organic constituents, methods of analysis, chemical and physical properties and its behavior during concentrative processes such as evaporation, distillation and other physiochemical operations. Urine is an aqueous solution of greater than 95% water, with the remaining constituents, in order of decreasing concentration urea 9.3 g/L, chloride 1.87 g/L, sodium 1.17 g/L, potassium 0.750 g/L, creatinine 0.670 g/L and other dissolved ions, inorganic and organic compounds.

Urine is sterile until it reaches the urethra, where epithelial cells lining the urethra are colonized by facultatively anaerobic Gram negative rods and cocci.[3] Current research suggests urine is not even sterile in the bladder.[4] Regardless, subsequent to elimination from the body, urine can acquire strong odors due to bacterial action,[citation needed] and in particular the release of ammonia from the breakdown of urea.

Some diseases alter the quantity and consistency of urine, such as diabetes introducing sugar. Consuming beets can result in beeturia (pink/red urine containing betanin) for some 10–14% of the population.[5]

Hazards

Healthy urine is not toxic.[6] However, it contains compounds eliminated by the body as undesirable, and can be irritating to skin and eyes. After suitable processing it is possible to extract potable water from urine.

Characteristics

Chemical analysis

Main article: Urinalysis

Urine is principally water. It also contains an assortment of inorganic salts and organic compounds, including proteins, hormones, and a wide range of metabolites, varying by what is introduced into the body.

Green urine during long term infusion of the sedative propofol

Color

Urine varies in appearance, depending principally upon a body's level of hydration, as well as other factors. Normal urine is a transparent solution ranging from colorless to amber but is usually a pale yellow. In the urine of a healthy individual the color comes primarily from the presence of urobilin. Urobilin in turn is a final waste product resulting from the breakdown of heme from hemoglobin during the destruction of aging blood cells.

Colorless urine indicates over-hydration, generally preferable to dehydration (though it can remove essential salts from the body). Colorless urine in drug tests can suggest an attempt to avoid detection of illicit drugs in the bloodstream through over-hydration.

  • Dark yellow urine is often indicative of dehydration.
  • Yellowing/light orange may be caused by removal of excess B vitamins from the bloodstream.
  • Certain medications such as rifampin and phenazopyridine can cause orange urine.
  • Bloody urine is termed hematuria, a symptom of a wide variety of medical conditions.
  • Dark orange to brown urine can be a symptom of jaundice, rhabdomyolysis, or Gilbert's syndrome.
  • Black or dark-colored urine is referred to as melanuria and may be caused by a melanoma.
  • Pinkish urine can result from the consumption of beets.
  • Greenish urine can result from the consumption of asparagus.
  • Reddish or brown urine may be caused by porphyria (not to be confused with the harmless, temporary pink or reddish tint caused by beeturia).
  • Blue urine can be caused by the ingestion of methylene blue (e.g., in medications).
  • Blue urine stains can be caused by blue diaper syndrome.
  • Purple urine may be due to purple urine bag syndrome.

Odor

The odor of normal human urine can reflect what has been consumed or specific diseases. For example, an individual with diabetes mellitus may present a sweetened urine odor. This can be due to kidney diseases as well, such as kidney stones.

Eating asparagus can cause a strong odor reminiscent of the vegetable caused by the body's breakdown of asparagusic acid.[7] Likewise consumption of saffron, alcohol, coffee, tuna fish, and onion can result in telltale scents.[citation needed] Particularly spicy foods can have a similar effect, as their compounds pass through the kidneys without being fully broken down before exiting the body.[8][9]

Turbidity

Turbid (cloudy) urine may be a symptom of a bacterial infection, but can also be caused by crystallization of salts such as calcium phosphate.[citation needed]

pH

The pH of urine can vary between 4.6 and 8, with neutral (7) being norm. In persons with hyperuricosuria, acidic urine can contribute to the formation of stones of uric acid in the kidneys, ureters, or bladder.[10] Urine pH can be monitored by a physician[11] or at home.

A diet high in citrus, vegetables, or dairy can increase urine pH (more basic).[12] Some drugs also can increase urine pH, including acetazolamide, potassium citrate, and sodium bicarbonate.[citation needed]

A diet high in meat can decrease urine pH (more acidic).[citation needed] Cranberries, popularly thought to decrease the pH of urine, have actually been shown not to acidify urine.[13] Drugs that can decrease urine pH include ammonium chloride, chlorothiazide diuretics, and methenamine mandelate.[14][15]

Volume

Average urine production in adult humans is about 1 – 2 L per day, depending on state of hydration, activity level, environmental factors, weight, and the individual's health. Producing too much or too little urine needs medical attention. Polyuria is a condition of excessive production of urine (> 2.5 L/day), oliguria when < 400 mL are produced, and anuria one of < 100 mL per day.

Density or specific gravity

Normal urine density or specific gravity values vary between 1.003–1.035 (g·cm−3), and any deviations may be associated with urinary disorders.

Urine in medicine

A Doctor Examining Urine. Trophime Bigot.

Examination

Many physicians in ancient history have resorted to the inspection and examination of the urine of their patients. Hermogenes wrote about the color and other attributes of urine as indicators of certain diseases. Abdul Malik Ibn Habib of Andalusia d.862 AD, mentions numerous reports of urine examination throughout the Umayyad empire.[16] Diabetes mellitus got its name because the urine is plentiful and sweet. A urinalysis is a medical examination of the urine and part of routine examinations. A culture of the urine is performed when a urinary tract infection is suspected. A microscopic examination of the urine may be helpful to identify organic or inorganic substrates and help in the diagnosis.

The color and volume of urine can be reliable indicators of hydration level. Clear and copious urine is generally a sign of adequate hydration. Dark urine is a sign of dehydration. The exception occurs when diuretics or excessive amounts of alcohol[citation needed] or caffeine[citation needed] are consumed, in which case urine can be clear and copious and the person still be dehydrated.

Source of Medications

Urine contains proteins and other substances that are useful for medical therapy and are ingredients in many prescription drugs (e.g., Ureacin, Urecholine, Urowave).[citation needed] Urine from postmenopausal women is rich in gonadotropins that can yield follicle stimulating hormone and luteinizing hormone for fertility therapy.[17] One such commercial product is Pergonal.[18] Urine from pregnant women contains enough human chorionic gonadotropins for commercial extraction and purification to produce hCG medication. Pregnant mare urine is the source of estrogens, namely Premarin.[17] Urine also contains antibodies, which can be used in diagnostic antibody tests for a range of pathogens, including HIV-1.[19]

Other uses

Agriculture

Main article: Fertilizer

Urine contains large quantities of nitrogen (mostly as urea), as well as significant quantities of dissolved phosphates and potassium, the main macronutrients required by plants, with urine having plant macronutrient percentages (i.e. NPK) of approximately 11-1-2 by one study[20] or 15-1-2 by another report,[21] illustrating that exact composition varies with diet. Undiluted, it can chemically burn the roots of some plants, but it can be used safely as a source of complementary nitrogen in carbon-rich compost.[22]

When diluted with water (at a 1:5 ratio for container-grown annual crops with fresh growing medium each season,[23] or a 1:8 ratio for more general use[22]), it can be applied directly to soil as a fertilizer. The fertilization effect of urine has been found to be comparable to that of commercial fertilizers with an equivalent NPK rating.[24] Urine contains most (94% according to Wolgast[20]) of the NPK nutrients excreted by the human body. Conversely, concentrations of heavy metals such as lead, mercury, and cadmium, commonly found in solid human waste, are much lower in urine (though not low enough to qualify for use in organic agriculture under current EU rules).[25] The more general limitations to using urine as fertilizer then depend mainly on the potential for buildup of excess nitrogen (due to the high ratio of that macronutrient),[23] and inorganic salts such as sodium chloride, which are also part of the wastes excreted by the renal system. The degree to which these factors impact the effectiveness depends on the term of use, salinity tolerance of the plant, soil composition, addition of other fertilizing compounds, and quantity of rainfall or other irrigation.

Urine typically contains 70% of the nitrogen and more than half the phosphorus and potassium found in urban waste water flows, while making up less than 1% of the overall volume. Thus far, source separation, or urine diversion and on-site treatment has been implemented in South Africa, China, and Sweden among other countries (with the Bill and Melinda Gates Foundation providing some of the funding for the implementations).[26]

"Urine management" is a relatively new way of closing the cycle of agricultural nutrient flows (also called ecosan) and - possibly - reducing sewage treatment costs and ecological consequences such as eutrophication resulting from the influx of nutrient rich effluent into aquatic or marine ecosystems.[21] Proponents of urine as a natural source of agricultural fertilizer claim the risks to be negligible or acceptable. Their views seem to be backed by research showing there are more environmental problems when it is treated and disposed of compared with when it is used as a resource.[27]

It is unclear whether source separation, urine diversion, and on-site urine treatment can be made cost effective; nor whether required behavioral changes would be regarded as socially acceptable, as the largely successful trials performed in Sweden may not readily generalize to other industrialized societies.[24] In developing countries the use of whole raw sewage (night soil) has been common throughout history, yet the application of pure urine to crops is rare. Increasingly there are calls for urine's use as a fertilizer, such as a Scientific American article "Human urine is an effective fertilizer".[28]

If urine is to be collected for use as a fertiliser in agriculture, then the easiest method of doing so is (in increasing order of costs) by using waterless urinals, urine-diverting dry toilets (UDDTs) or urine diversion flush toilets.[29]

Cleaning

Due to the fact that urea in urine breaks down into ammonia, urine has been used for the cleaning properties of the ammonia therein. In pre-industrial times urine was used – in the form of lant or aged urine – as a cleaning fluid.[30] Urine was also used for whitening teeth in Ancient Rome.

Gunpowder

Main article: Potassium nitrate

Urine was used before the development of a chemical industry in the manufacture of gunpowder. Urine, a nitrogen source, was used to moisten straw or other organic material, which was kept moist and allowed to rot for several months to over a year. The resulting salts were washed from the heap with water, which was evaporated to allow collection of crude saltpeter crystals, that were usually refined before being used in making gunpowder.[31]

Survival uses

See also: Urophagia

The US Army Field Manual,[32] advises against drinking urine for survival. These guides explain that drinking urine tends to worsen, rather than relieve dehydration due to the salts in it, and that urine should not be consumed in a survival situation, even when there is no other fluid available. In hot weather survival situations where other sources of water are not available, soaking cloth (a shirt for example) in urine and putting it on the head can help cool the body.

During World War I the Germans experimented with numerous poisonous gases for use during war. After the first German chlorine gas attacks, Allied troops were supplied with masks of cotton pads that had been soaked in urine. It was believed that the ammonia in the pad neutralized the chlorine. These pads were held over the face until the soldiers could escape from the poisonous fumes, although it is now known that chlorine gas reacts with urine to produce toxic fumes (see chlorine and use of poison gas in World War I).[citation needed] The Vickers machine gun, used by the British Army during World War 1, required water for cooling when fired so soldiers would resort to urine if water was unavailable.[33]

Urban myth states that urine works well against jellyfish stings, and this scenario was demonstrated on a Season 4 episode of the NBC-TV show Friends called "The One With the Jellyfish"; an early episode of the CBS-TV show Survivor; The Paperboy (2012) wherein Nicole Kidman pees on Zac Efron's face; and the 2003 reality film The Real Cancun. However, at best it is ineffective, and in some cases this treatment may make the injury worse.[34][35][36]

Tanning

Main article: Tanning

Tanners soaked animal skins in urine to remove hair fibers—a necessary step in the preparation of leather.[citation needed]

Textiles

Urine has often been used as a mordant to help prepare textiles, especially wool, for dyeing. In the Scottish Highlands and Hebrides, the process of "waulking" (fulling) woven wool is preceded by soaking in urine, preferably infantile.[37]

History and language

Prior to the acquisition of soap from the Germanic peoples during the first century AD, Ancient Romans used fermented human urine (in the form of lant) to cleanse grease stains from clothing.[38] The emperor Nero instituted a tax (Latin: vectigal urinae) on the urine industry, continued by his successor, Vespasian. It is Vespasian to whom the Latin saying Pecunia non olet (money doesn't smell) is attributed – said to have been the emperor's reply to a complaint from his son about the unpleasant nature of the tax. Vespasian's name is still attached to public urinals in France (vespasiennes), Italy (vespasiani), and Romania (vespasiene).

Alchemists spent much time trying to extract gold from urine, which led to discoveries such as white phosphorus by German alchemist Hennig Brand when distilling fermented urine in 1669. In 1773 the French chemist Hilaire Rouelle discovered the organic compound urea by boiling urine dry.

The onomatopoetic term "piss" was the usual word for urination prior to the 14th century. "Urinate" was at first used mostly in medical contexts. "Piss" continues to be used, but is considered vulgar; it is also used in such colloquialisms as "to piss off" and "piss poor". Euphemisms and expressions used between parents and children such as "wee", "pee", and many others, arose.

See also

References

Notes

  1. ^ Arthur C. Guyton; John Edward Hall (2006). "25". Textbook of medical physiology (11 ed.). Elsevier Saunders. ISBN 978-0-8089-2317-6. Retrieved 26 September 2011. 
  2. ^ David F. Putnam Composition and Concentrative Properties of Human Urine. NASA Contractor Report. July 1971
  3. ^ Michael T. Madigan; Thomas D. Brock (2009). Brock biology of microorganisms. Pearson/Benjamin Cummings. ISBN 978-0-13-232460-1. Retrieved 10 September 2011. 
  4. ^ Hilt, Evann E.; Kathleen McKinley, Meghan M. Pearce, Amy B. Rosenfeld, Michael J. Zilliox, Elizabeth R. Mueller, Linda Brubaker, Xiaowu Gai, Alan J. Wolfe and Paul C. Schreckenberger (26 December 2013). "Urine Is Not Sterile: Use of Enhanced Urine Culture Techniques To Detect Resident Bacterial Flora in the Adult Female Bladder". Journal of Clinical Microbiology 52 (3): 871–876. doi:10.1128/JCM.02876-13. Retrieved 18 May 2014. 
  5. ^ Watts AR, Lennard MS, Mason SL, Tucker GT, Woods HF (December 1993). "Beeturia and the biological fate of beetroot pigments". Pharmacogenetics 3 (6): 302–11. doi:10.1097/00008571-199312000-00004. PMID 8148871. 
  6. ^ Urine therapy. Vanderbilt.edu (1992-10-16). Retrieved on 2011-04-27.
  7. ^ Lison M, Blondheim SH, Melmed RN (1980). "A polymorphism of the ability to smell urinary metabolites of asparagus". Br Med J 281 (6256): 1676–8. doi:10.1136/bmj.281.6256.1676. PMC 1715705. PMID 7448566. 
  8. ^ Stefan Gates; Max La Riviere-Hedrick (15 March 2006). Gastronaut: adventures in food for the romantic, the foolhardy, and the brave. Houghton Mifflin Harcourt. pp. 87–. ISBN 978-0-15-603097-7. Retrieved 27 April 2011. 
  9. ^ Foods that Affect the Odor of Urine. livestrong.com. December 27, 2010.
  10. ^ Martín Hernández E, Aparicio López C, Alvarez Calatayud G, García Herrera MA (2001). "[Vesical uric acid lithiasis in a child with renal hypouricemia]". An. Esp. Pediatr. (in Spanish; Castilian) 55 (3): 273–6. PMID 11676906. 
  11. ^ "Urine pH". MedlinePlus Medical Encyclopedia. Retrieved December 26, 2008. 
  12. ^ Welch AA, Mulligan A, Bingham SA, Khaw KT (2007). "Urine pH is an indicator of dietary acid–base load, fruit and vegetables and meat intakes: Results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk population study". British Journal of Nutrition 99 (6): 1335–1343. doi:10.1017/S0007114507862350. PMID 18042305. 
  13. ^ Avorn J, Monane M, Gurwitz JH, Glynn RJ, Choodnovskiy I, Lipsitz LA (1994). "Reduction of bacteriuria and pyuria after ingestion of cranberry juice". JAMA: the Journal of the American Medical Association 271 (10): 751–4. doi:10.1001/jama.1994.03510340041031. PMID 8093138. We did not find evidence that urinary acidification was responsible for the observed effect, since the median pH of urine samples in the cranberry group (6.0) was actually higher than that in the experimental group (5.5). While cranberry juice has been advocated as a urinary acidifier to prevent urinary tract infections, not all studies have shown a reduction in urine pH with cranberry juice ingestion, even with consumption of 2000 mL per day. 
  14. ^ Urine pH: MedlinePlus Medical Encyclopedia. Nlm.nih.gov (2011-03-28). Retrieved on 2011-04-27.
  15. ^ Discovery Health "Urine PH – Medical Dictionary". Healthguide.howstuffworks.com (2007-05-16). Retrieved on 2011-04-27.
  16. ^ Ibn Habib, Abdul Malik d.862CE/283AH "Kitaab Tib Al'Arab" (The Book of Arabian Medicine), Published by Dar Ibn Hazm, Beirut, Lebanon 2007(Arabic)
  17. ^ a b Carrell, D.T., & Peterson, C. M. eds. (2010). Chapter 31, Artificial insemination: intrauterine insemination. 31.3.1.2 Gonadotrophins, Reproductive endocrinology and infertility.(Excerpt, p. 489), New York, New York: Springer. DOI 10.1007/978-1-4419-1436-1. Retrieved on 2013-03-26.
  18. ^ [Adelson, Andrea. Wall Street; A Fertility Drug Grows Scarce. http://www.nytimes.com/1995/02/26/business/wall-street-a-fertility-drug-grows-scarce.html New York Times 1995-02-26 Retrieved 2013-03-27.].
  19. ^ Urine Antibody Tests: New Insights into the Dynamics of HIV-1 Infection – Urnovitz et al. 45 (9): 1602 – Clinical Chemistry. Clinchem.org. Retrieved on 2011-04-27.
  20. ^ a b Wolgast, M (1993). "Rena vatten. Om tankar i kretslopp.". Uppsala: Creamon HB. 
  21. ^ a b Ganrot, Zsofia (2005). Ph.D. Thesis: Urine processing for efficient nutrient recovery and reuse in agriculture. Goteborg, Sweden: Goteborg University. p. 170. 
  22. ^ a b Steinfeld, Carol (2004). Liquid Gold: The Lore and Logic of Using Urine to Grow Plants. Ecowaters Books. ISBN 978-0-9666783-1-4. 
  23. ^ a b Morgan, Peter (2004). "10. The Usefulness of urine". An Ecological Approach to Sanitation in Africa: A Compilation of Experiences (CD release ed.). Aquamor, Harare, Zimbabwe. Retrieved 6 December 2011. 
  24. ^ a b M. Johansson; Jönsson, H.; Höglund, C.; Richert Stintzing, A.; Rodhe, L. (2001). "Urine Separation – Closing the Nitrogen Cycle" (PDF). Stockholm Water Company. 
  25. ^ Håkan Jönsson (2001-10-01). "Urine Separation — Swedish Experiences". EcoEng Newsletter 1. 
  26. ^ South African city looks to turn urine into fertilizer, UN Office for the Coordination of Humanitarian Affairs, November 2010. Sanitationfinance.org (2010-11-13). Retrieved on 2011-12-07.
  27. ^ UDD-Toilets and urine management. (PDF). ecosanservices.org. Retrieved on 2011-12-07.
  28. ^ Mara Grunbaum Human urine is shown to be an effective agricultural fertilizer, Scientific American, July 2010. Retrieved on 2011-12-07.
  29. ^ von Münch, E., Winker, M. (2011). Technology review of urine diversion components - Overview on urine diversion components such as waterless urinals, urine diversion toilets, urine storage and reuse systems. Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH
  30. ^ Sueton, Vespasian 23 English, Latin. Cf. Dio Cassius, Roman History, Book 65, chapter 14,5 English, Greek/French (66, 14)
  31. ^ Joseph LeConte (1862). Instructions for the Manufacture of Saltpeter. Columbia, S.C.: South Carolina Military Department; printer: Charles P. Pelham. p. 14. Retrieved 2007-10-19. 
  32. ^ Water Procurement, US Army Field Manual
  33. ^ "Vickers Mk.I machine gun". Royal Armouries. Retrieved September 26, 2012. 
  34. ^ Old Wives' Tale? Urine as Jellyfish Sting Remedy. ABC News (2006-08-08). Retrieved on 2011-04-27.
  35. ^ Fact or Fiction?: Urinating on a Jellyfish Sting is an Effective Treatment. Scientific American. 4 January 2007. Retrieved on 2011-04-27.
  36. ^ Jellyfish Sting Treatment – How to Treat a Jellyfish Sting. Firstaid.about.com. 22 August 2010. Retrieved on 2011-04-27.
  37. ^ Mentioned by an interviewee in Lomax the Songhunter, a 2004 documentary film.
  38. ^ "Hygiene in Ancient Rome". Retrieved 2010-02-09. 

Further reading

External links

Look up Lant in Wiktionary, the free dictionary.
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