Module 5:-

Analysis of constituents of blood and urine-

The analysis of blood and urine is essential for diagnosing and monitoring various health
conditions. Each sample type provides different insights into the body’s function, with
both being commonly analyzed using semi-auto analyzers in clinical and experimental
settings. Here’s a breakdown of the key constituents analyzed in blood and urine:

•Blood Constituents Analysis:

Blood tests are often used to assess overall health and detect a wide range of
conditions. Some key constituents analyzed include:

1. Electrolytes: Sodium, potassium, chloride, and bicarbonate, which are crucial

for maintaining fluid balance and nerve function.

2. Glucose: Measures blood sugar levels, essential for diagnosing diabetes and
monitoring blood sugar control.

3. Liver Enzymes: ALT, AST, ALP, and bilirubin are used to assess liver function and
detect liver diseases.

4. Lipids: Cholesterol, triglycerides, LDL, and HDL to evaluate cardiovascular

health.

5. Kidney Markers: Creatinine and blood urea nitrogen (BUN) to assess kidney
function.

6. Proteins: Total protein and albumin levels help assess nutritional status, liver
function, and chronic diseases.

7. Complete Blood Count (CBC): Measures red and white blood cells, hemoglobin,
hematocrit, and platelets to evaluate blood cell health, detect anemia,
infections, and clotting disorders.
 8. Enzymes: Such as amylase and lipase, used to detect pancreas-related
disorders.

9. Hormones: Insulin, thyroid hormones (T3, T4), and cortisol, important for
endocrine and metabolic assessments.

•Urine Constituents Analysis:

Urine tests provide insights into kidney function, metabolic disorders, and urinary tract
health. Key constituents include:

1. pH: Indicates the acidity or alkalinity of urine, helping to diagnose kidney or

metabolic disorders.

2. Protein: High levels of protein (proteinuria) may indicate kidney damage or

disease.

3. Glucose: High levels in urine (glucosuria) suggest uncontrolled diabetes or

metabolic dysfunction.

4. Ketones: Indicates the breakdown of fats, often seen in diabetes, fasting, or

ketogenic diets.

5. Nitrites and Leukocyte Esterase: Signs of bacterial infection in the urinary tract.

6. Creatinine: Used to evaluate kidney function and assess how well the kidneys
are filtering waste.
 7. Electrolytes: Sodium, potassium, and calcium levels are measured to check for
imbalances that may signal kidney or endocrine issues.

8. Bilirubin and Urobilinogen: Abnormal levels may indicate liver disease or

hemolytic disorders.

9. Red and White Blood Cells: Presence in urine indicates infection, inflammation,
or injury in the urinary tract.

10. Crystals: Presence of crystals like calcium oxalate can indicate kidney stones or
other metabolic conditions.

Both blood and urine analyses provide valuable diagnostic information, offering insights
into the body’s metabolic, kidney, liver, and overall systemic health.

•Analysis of normal and abnormal constituents of blood and urine:-

The analysis of normal and abnormal constituents of blood and urine is crucial in
diagnosing and monitoring diseases, assessing organ function, and identifying
metabolic disorders. Below is a comparison of normal and abnormal constituents in
both blood and urine:

°Blood Analysis

Normal Constituents of Blood

1. Glucose: 70–100 mg/dL (fasting)

*Function:

1) Main energy source for cells.

2)Normal range indicates balanced blood sugar.

 2. Electrolytes:

Sodium (Na+): 135–145 mEq/L

Potassium (K+): 3.5–5.0 mEq/L

Chloride (Cl-): 96–106 mEq/L

*Function: Maintain fluid balance, nerve impulses, and muscle function.

3. Hemoglobin (Hb):

Male: 13.8–17.2 g/dL

Female: 12.1–15.1 g/dL

*Function: Oxygen transport in red blood cells.

4. White Blood Cells (WBCs): 4,000–11,000 cells/µL

*Function: Immune defense.

5. Platelets: 150,000–450,000 cells/µL

*Function: Blood clotting.

6. Liver Enzymes:

ALT (Alanine Transaminase): 7–56 U/L

AST (Aspartate Transaminase): 10–40 U/L

*Function: Involved in amino acid metabolism, indicate liver function.

 7. Cholesterol:

Total Cholesterol: Less than 200 mg/dL

HDL (Good Cholesterol): Greater than 40 mg/dL

LDL (Bad Cholesterol): Less than 100 mg/dL

*Function: Essential for cell membrane integrity, hormone production.

°Abnormal Constituents of Blood

1. High Glucose (Hyperglycemia): >126 mg/dL (fasting)

Indicates diabetes or glucose intolerance.

2. Low Glucose (Hypoglycemia): <70 mg/dL

Can lead to dizziness, confusion, and unconsciousness.

3. High Potassium (Hyperkalemia): >5.0 mEq/L

Can cause arrhythmia, kidney failure, or tissue damage.

4. High Urea or Creatinine:

Urea (Blood Urea Nitrogen): >20 mg/dL

Creatinine: >1.2 mg/dL

Indicates impaired kidney function.

5. Anemia: Hemoglobin levels below normal.

May result from nutritional deficiencies, chronic disease, or bone marrow disorders.
 6. High Liver Enzymes (ALT, AST):

Suggests liver damage from hepatitis, fatty liver disease, or alcohol use.

7. High Cholesterol (Hypercholesterolemia):

Increases risk of cardiovascular diseases like atherosclerosis or heart attacks.

°Urine Analysis

Normal Constituents of Urine

1. Water: 95% of urine is water.

*Function: Eliminates waste and maintains hydration.

2. Electrolytes:

Sodium, potassium, chloride, and calcium are normally present in small amounts.

3. Urea: 20–35 g/24 hours

*Function: Waste product of protein metabolism.

4. Creatinine: 1–2 g/24 hours

*Function: Waste product of muscle metabolism.

5. Uric Acid: 250–750 mg/24 hours

*Function: Waste product from purine metabolism.

 6. Minimal Proteins: Less than 150 mg/24 hours.

Normally, only small amounts of protein pass through urine.

°Abnormal Constituents of Urine

1. Glucose (Glycosuria):

Normal: Absent

Presence indicates diabetes or kidney disorders (glucose should not be filtered into
urine).

2. Proteins (Proteinuria):

Normal: <150 mg/24 hours

Elevated protein suggests kidney damage, infection, or hypertension.

3. Ketones (Ketonuria):

Normal: Absent

Presence suggests uncontrolled diabetes, starvation, or ketogenic diets.

4. Blood (Hematuria):

Normal: Absent

Indicates urinary tract infections (UTI), kidney stones, or trauma.

5. Nitrites:

Normal: Absent

Indicates bacterial infection, often in UTIs.

6. Leukocytes (Leukocyturia):
Normal: Absent

Suggests infection or inflammation of the urinary tract.

7. Bilirubin (Bilirubinuria):

Normal: Absent

Indicates liver disease, bile duct obstruction, or hemolytic disorders.

8. Crystals:

Normal: Minimal

Excessive crystal formation (e.g., calcium oxalate) suggests kidney stones or metabolic
abnormalities.

9. Urobilinogen:

Normal: 0.5–4.0 mg/24 hours

High levels may indicate liver disease or hemolytic anemia.

°Summary

Normal constituents in blood and urine reflect the body’s balanced metabolic and
organ functions, such as glucose regulation, electrolyte balance, protein metabolism,
and waste excretion.

Abnormal constituents signal potential diseases or dysfunctions, such as diabetes,

kidney disease, liver disorders, infections, and metabolic imbalances. Regular analysis
of these constituents is critical for early detection, diagnosis, and management of
health conditions.
°Here is a summary of the normal reference ranges and clinical significance for the
hematologic and biochemical tests. These tests help assess various aspects of body
functions, including blood health, metabolism, Liver, kidney and pancreatic functions:--

1. Hematologic Values (Complete Blood Count – CBC)

WBC (White Blood Cells): 4,000-11,000 cells/µL

Elevated levels can indicate infection or inflammation; decreased levels may suggest
bone marrow disorders or immune system issues.

RBC (Red Blood Cells): Men: 4.5-5.9 million cells/µL, Women: 4.1-5.1 million cells/µL

Low RBC count may indicate anemia; high levels can suggest polycythemia.

Hemoglobin (Hb): Men: 13.5-17.5 g/dL, Women: 12.0-15.5 g/dL

Low Hb is often a sign of anemia.

Hematocrit (Hct): Men: 41-53%, Women: 36-46%

Reflects the percentage of RBCs in blood.

Platelets: 150,000-450,000 cells/µL

Low levels can indicate bleeding disorders; high levels may suggest thrombocytosis.

2. Thyroid Function Tests

TSH (Thyroid Stimulating Hormone): 0.4-4.0 mIU/L

High TSH indicates hypothyroidism; low TSH suggests hyperthyroidism.

Free T4 (Thyroxine): 0.8-2.3 ng/dL

Reflects thyroid hormone production; low levels can indicate hypothyroidism.

Free T3 (Triiodothyronine): 2.3-4.2 pg/mL

Measures the active thyroid hormone in the blood.

 3. Glucose

Fasting Blood Glucose: 70-99 mg/dL (normal); 100-125 mg/dL (prediabetes); ≥126
mg/dL (diabetes)

Random Blood Glucose: Should be <140 mg/dL for non-diabetics.

HbA1c: <5.7% (normal); 5.7-6.4% (prediabetes); ≥6.5% (diabetes)

Provides an average blood glucose level over the past 2-3 months.

4.Urea

1. Blood Urea Nitrogen (BUN)

Normal range: 7–20 mg/dL

Clinical significance: High levels indicate kidney dysfunction or dehydration; low levels
may suggest liver disease or malnutrition.

5.Creatinine

1. Serum Creatinine

Male: 0.74–1.35 mg/dL

Female: 0.59–1.04 mg/dL

Clinical significance: High levels indicate kidney dysfunction or reduced renal

clearance.

6.Cholesterol

1. Total Cholesterol

Normal range: Less than 200 mg/dL

Clinical significance: Elevated levels (hypercholesterolemia) increase the risk of

cardiovascular diseases.
 2. Low-Density Lipoprotein (LDL)

Normal range: Less than 100 mg/dL

Clinical significance: High LDL is associated with atherosclerosis and heart disease.

3. High-Density Lipoprotein (HDL)

Normal range: Greater than 40 mg/dL

Clinical significance: Higher HDL is protective against cardiovascular disease.

4. Triglycerides

Normal range: Less than 150 mg/dL

Clinical significance: Elevated levels increase the risk of heart disease and pancreatitis.

7.Alkaline Phosphatase (ALP)

1. Normal range: 44–147 IU/L

Clinical significance: Elevated levels suggest liver disease, bile duct obstruction, or
bone disorders. Lower levels can indicate malnutrition or genetic disorders.

8.Acid Phosphatase

1. Normal range: 0–0.8 U/L

Clinical significance: Elevated levels may indicate prostate cancer, Paget’s disease, or
other bone diseases.

9.Bilirubin

1. Total Bilirubin

Normal range: 0.1–1.2 mg/dL

Clinical significance: Elevated levels indicate liver disease, bile duct obstruction, or
hemolytic anemia (jaundice).

2. Direct Bilirubin

Normal range: 0.1–0.3 mg/dL

Clinical significance: Increased levels may indicate liver dysfunction or biliary

obstruction.

10.SGOT (Serum Glutamic-Oxaloacetic Transaminase) or AST (Aspartate

Aminotransferase)

1. Normal range: 10–40 IU/L

Clinical significance: High levels indicate liver damage, myocardial infarction, or muscle
injury.

11.SGPT (Serum Glutamic-Pyruvic Transaminase) or ALT (Alanine

Aminotransferase)

1. Normal range: 7–56 IU/L

Clinical significance: Elevated levels are primarily associated with liver damage,
hepatitis, or alcohol-related liver disease.

12.Amylase (Diastase)

1. Normal range: 30–110 U/L

Clinical significance: Elevated levels indicate pancreatitis or blockage of the pancreatic

duct, while low levels may suggest chronic pancreatitis or liver damage.

13.Lipase

1. Normal range: 0–160 U/L

Clinical significance: High levels indicate acute pancreatitis, pancreatic cancer, or
gallbladder inflammation. Low levels may suggest pancreatic insufficiency.

°Summary

These hematologic and biochemical values are critical in diagnosing and monitoring a
wide range of conditions:

*Liver Function: SGOT/SGPT, Bilirubin, ALP

*Kidney Function: Creatinine, Urea

*Pancreatic Function: Amylase (Diastase), Lipase

*Thyroid Function: TSH, T3, T4

*Metabolic and Cardiovascular Health: Glucose, Cholesterol, Lipids