Despite the implied disgusting nature (especially smell) of urine, it is one of the most important types of “samples” used in medicine for diagnostic purposes. Like blood, urine can tell a lot about a person’s health and whether they have a certain disease or not.
One of the earliest recorded uses of urine as a medical test was for the detection of diabetes mellitus. People noticed that the urine of a diabetic would often smell quite sweet, and also taste sweet (it is uncertain how they came to test urine this way). This is because a diabetic has too much glucose (sugar) in their blood, causing it to spill over into the urine as the kidneys become saturated. In fact, the words diabetes mellitus stand for “passing through” (referring to the symptom of frequent urination) and “honey-sweet”. A completely unrelated disease called diabetes insipidus also causes frequent urination, but the urine does not taste sweet, hence “insipidus” (tasteless). This type of etymology is also seen in countries like Korea, China and Japan, where the word 당뇨(糖尿) literally stands for “sugar urine”. Although we no longer taste urine, it is still used to gauge the severity of diabetes by measuring the amount of protein in the urine (due to kidney damage).
There are many other tests one can do with urine to check for certain diseases. The chemical composition of urine tells us about the hydration status of a person, while giving away clues to diseases that cause electrolyte imbalance. It also gives some indication of how well the kidneys can do their job of concentrating urine. Certain markers such as white blood cells and bacteria in the urine can indicate a urinary tract infection. Antibodies in the urine can point towards a certain type of bacteria as the cause of a patient’s pneumonia, or whether a woman is pregnant (βhCG). Looking for proteins or sediments in the urine can be diagnostic of certain kidney diseases such as glomerulonephritis. Even rare diseases such as phaeochromocytomas can be diagnosed from the level of catecholamines in the urine (this is slightly too complex for our scopes).
A more interesting part of urinalysis is looking at the colour of the urine. Urine is usually a yellow colour, ranging in darkness depending on the concentration of urine. But when there are other things in the urine, the colour changes. Reddish urine suggests blood (which is not an indicator of kidney failure as TV shows say), which can be caused by trauma, UTIs, kidney stones or some other disease. Brown urine could be due to muscle breakdown somewhere in the body. Urine can appear very dark if the person has an illness called obstructive jaundice. Eating beetroots can cause your urine to turn bright red, while medications can change your urine colour from anywhere from red to orange to green. Murky or cloudy urine (with an offensive smell) may suggest a UTI.
Perhaps the most interesting urine colour known in medicine is purple. This unique colour is produced in a rare genetic disease called acute intermittent porphyria. If urine is collected from a patient suffering an attack of AIP (causes crippling abdominal pain) then left in the sun or under a UV light, it will turn purple due to certain proteins. Because of this, urine collected to test for AIP is wrapped in tinfoil before sending to the lab (where the chemicals are measured) to limit light exposure.
(Also read the article on how different colours of skin can be of diagnostic importance: http://jinavie.tumblr.com/post/32313894252/skin-colour)
