Urine pH |
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The pH of a urine sample is affected by a variety of factors including:
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- renal H+ excretion and HCO3- resorption
- pathologic abnormalities of systemic acid/base balance.
- pathologic abnormalities of tubular function: with failure to excrete an acid load or failure to absorb bicarbonate.
- dietary factors - due to differences in dietary "acid load", herbivores usually have alkaline urine, carnivores tend to have acidic urine. Urine in carnivores does become slightly less acidic after eating, associated with a post-prandial alkaline tide (due to increased secretion of HCl into the stomach).
- age of specimen (loss of CO2 from the sample to the air raises the pH)
- presence of contaminant or pathogenic bacteria (some convert urea to ammonia, raising pH)
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Knowledge of the urine pH is important in interpreting urine sediment findings. Erythrocytes, leukocytes, and casts tend to disintegrate in alkaline urine (pH > 8.0). In addition, precipitation of urine crystals in supersaturated urine is highly dependent on urine pH (e.g. struvite will precipitate in alkaline not acidic urine).
Note that although the kidneys play a central role in the control of acid/base metabolism, the pH of a random urine sample is not a reliable indicator of total body acid/base status. In addition, studies have shown that the dipstick measurement of urine pH can be quite inaccurate (e.g. a pH value of 7.5 can be anywhere from 7 to 8). In some conditions, impaired renal tubular function in fact causes or perpetuates the underlying acid/base derangement. Meaningful evaluation of acid-base status generally requires blood gas analysis and consideration of clinical signs.
Source : © Cornell University |
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