BIOMEDIC 2

BIOCHEMISTRY OF URINE
dr.Syahrijuita,M.Kes, Sp.THT

BIOCHEMISTRY DEPARTMENT Faculty of Medicine Hasanuddin University 2011

Biochemistry of Urine
Sub Topic Function of Kidney and Biochemistry of Urine Acid-Base Status and Buffer System Metabolic Acidosis and Metabolic Alkalosis Kidney Compensation Metabolism of amino acid, and biosynthesis of urea,uric acid, creatinine Biochemistry of Urolithiasis

Learning Objectives
Describe function of kidney and biochemistry of urine Describe acid-base status and buffer system Describe metabolic acidosis and metabolic alkalosis Describe kidney compensation Describe metabolism of amino acid and biosynthesis of urea, uric acid, creatinine Describe biochemistry of urolithiasis

An organic Component

ACID-BASE STATUS
Acids : substances that can donate hidrogen ions (proton) Bases: compounds that accept protons Examples: HCl H + Cl NH3 NH4 + OH Acid-base reactions always involve conjugate acid-base pairs.

pH VALUE
pH: the H+ concentration in an aqueous solution :the negative logarithm of the H+ : - log (0,00000004) : 7,4 pH of urine: 5,8 ( 4,8 7,5) because kidney can excrete both acids or bases.

BUFFER SYSTEMS
Such systems are mixtures of a weak acid (HB) with its conjugate base (B-) or A weak base with its conjugate acid Short-term changes in living organisms are counteracted. The main buffer system in the urine involves ammonium ions (NH4+) and ammonia (NH3)

METABOLIC ACIDOSIS AND ALKALOSIS

ASIDOSIS & ALKALOSIS METABOLIK

ACID- BASE BALANCE

There are 3 main system to manage (H+)in body fluid and to prevent acidosis and alkalosis:
1. Buffer Systems, to prevent (H+) over 2. Respiratoric System, to excrete CO2 3. Kidney, to excrete acid/base

Buffer system of the plasma

KIDNEY COMPENSATION
There are 3 mekanism to manage ion Hidrogen concentration at extracellular fluid: 1.Secretion of Hidrogen ions 2.Reabsorption of bikarbonat ions 3.Production of new bikarbonat ions Kidney control acid-base balance with excrete both acid or base in urine.

Respiratoric Acidosis: hipoventilation and increase of P CO2 Respiratoric alkalosis: hiperventilation and decrease of P CO2 Kidney compensation: Acidosis: increase of ion hydrogen excretion increase Bicarbonat extracelular fluid Alkalosis: decrease of ion hydrogen secreation at tubulus. decrease of bicarbonat extraceluler fluid.

DIAGNOSTIK ASAM BASA

GANGGUAN ASAM BASA KOMPLEKS & PENGGUNAAN NOMOGRAM ASAM BASA UNTUK DIAGNOSTIK

ALIRAN NITROGEN

BIOCHEMISTRY OF UROLITHIASIS
Calculus >>> Kidney Analysis of calculus: 75% Calsium Oxalat/ + Calsium Phosphat 15% Magnesium Ammonium Phosphat 10% Uric acid/ Cysteine 2,5% organic material:mucoprotein

PREDISPOSITION FACTOR
1. FAMILIAL 2. SEX, >> MAN 3. CONCENTRATION OF CALCULUS MATERIAL 4. INFECTION 5. CRONIC DISEASES 6. ACID/BASE OF URINE,ETC

Calsium calculus of kidney: 70% hipercalsiuria 25% abnormalitas of kidney Hipertiroidism : hipercalsemia+hipercalsiuria Recurrence of infectionbase urinemagnesium ammonium phosphat calculus Gout, Leukemia:>>uric acid calculus Acid urineuric/ cysteine calculus Cysteine calculus.>> genetic anomali of amino acid transport at kidney Mucoprotein is the basic organic material of calculus