Changes in urine | Urine – All about the topic!

Changes in urine

The following describes findings where changes in urine occur. Bacteria in the urine do not necessarily indicate a disease. The urine that accumulates in the bladder is not completely germ-free.

When urinating, the urine comes into contact with the mucous membrane of the urethra and thus also with bacteria. These bacteria belong to the normal flora of the urogenital tract, so they normally have no disease value. They are among them: Staphylococcus epidermidis, enterococci and in some cases also Escherichia coli, proteins and non-pathological neisseria.

These bacteria usually do not cause any symptoms unless they are found in too high concentrations. Up to 10,000 bacteria per mL of urine are normal, unless it can be seen that one species is particularly pronounced or dominant. An increase in the amount of bacteria above 10,000 per mL indicates a bacterial infection or a urinary tract infection.

Common pathogens of urinary tract infections are for example Escherichia coli, Klebsiellen and Proteus mirabilis. Staphylococci (especially Staphylococcus saprophyticus) can also lead to urinary tract infections. In order to detect bacteria, various types of urine diagnostics can be performed.

However, it is important to avoid contamination through the genital skin or by prolonged standing of the sample. Basically, a distinction is made between microhaematuria, when blood cells in the urine can only be seen with a microscope, and macrohaematuria, when blood is visible to the naked eye. However, blood in urine can have various causes.

It can end up in the urine in different ways. If blood is detected in the urine (except menstrual blood), a doctor should be consulted to determine the exact cause of the bleeding and to be able to fight it. If additional pain occurs during urination, a doctor should be consulted as soon as possible.

  • If the ureters are injured, for example in the case of a ureteral stone (but also in the case of kidney stones, bladder stones, etc.) or trauma, there may be blood in the urine.
  • Another cause is tumors of the bladder, ureter or kidney.
  • Infections or inflammations of the urinary tract often lead to microhaematuria, and in severe cases to macrohaematuria.
  • Some parasites, such as the couple’s fluke, can also cause blood admixture in the urine.
  • In women, blood in the urine can also occur due to menstrual bleeding. In the context of endometriosis, for example, the mucous membrane of the uterus can appear in the urinary tract and thus lead to additional bleeding.
  • Furthermore, some drugs such as cytostatics or anticoagulants can lead to bleeding.

The excretion of protein (or proteins) with the urine is normal in small amounts.

As a rule, the daily protein excretion should be about 60 to 150 mg. If the protein excretion is higher than 150 mg, this is called proteinuria. Proteinuria can be detected in various ways, for example by a screening test for protein excretion or by urine tests.

If the amount of protein is increased but the concentration in the morning urine is below 300 mg/l, this is called benign proteinuria. This form of proteinuria occurs more often after exertion such as sport or stress or during pregnancy. Pathological proteinuria occurs in the context of several diseases.

Infarcts, dissolution of muscle fibers or blood cells, as well as infections and bleeding of the urinary tract can lead to an increase in the amount of protein in the urine. Renal diseases and insufficiencies can also cause this. Proteinuria can also be a sign of a malignant disease such as plasmocytoma.

The mild form of proteinuria is microalbuminuria (albumin excretion). Microalbuminuria is an early sign of kidney disease in the context of diabetes mellitus. White, cloud-like admixtures in the urine, which sink to the bottom, are colloquially called “flakes in the urine”.

In reality, these are proteins. These formations can also occur in the urine of healthy people, e.g. as a result of diet, stress, fever or sport. A reduced fluid intake can also lead to “flakes” in the urine.

So there does not necessarily have to be a disease behind it. However, it is important that the urine picture normalizes as soon as possible. If you often have protein admixtures, i.e. flakes in your urine, this can indicate illness.The kidney is in the first place.

The kidney normally ensures through its filter function that proteins do not pass into the urine. The following is a list of diseases that affect the kidneys and urination. They can therefore cause a fluffy appearance of the urine.

  • Kidney disease, cystitis
  • Inflammation of the prostate gland
  • Diabetes Mellitus
  • Elevated blood pressure
  • Pregnancy with complications, e.g. pre-eclampsia

Very often a foaming urine indicates protein, which is in it. This condition is called “proteinuria”. Particularly in men, the urine can foam up because it comes up with a solid stream or encounters residues of foaming cleaning agents.

If this is not the case, the foaming urine should be examined by a doctor. The kidney usually does not filter the proteins, so they cannot pass from the blood into the urine. If this happens anyway, there may be various underlying diseases.

A particularly protein-rich diet, such as that found among athletes in muscle building, sometimes leads to proteins in the urine. Under certain circumstances, the diet should be adjusted, as it overtaxes the metabolism and can lead to kidney weakness. The kidney itself is often the cause of the protein in the urine.

If its filtration function is restricted, it becomes permeable to the large proteins. This can be the case with cysts in the kidney, kidney stones, inflammation of the kidneys, but also with kidney hypofunction, up to and including renal insufficiency. The cause of renal insufficiency is in most cases severe diabetes, vascular diseases such as high blood pressure, cancer of the blood or the intake of certain drugs.