Synonym

• Routine urinalysis
• UA

Tubes

• 10-20 mL urine in a disposable sterile plastic container or plain tube
• Midstream random urine sample to be collected

Additional information

• Use a freshly voided specimen
• Send specimen to lab immediately
• If delay of >1hr is expected, refrigerate the specimen
• Attention should be given to avoid having skin epithelium, secretions, hair, lint, etc from contaminating the sample
• Avoid preservatives or any other contamination
• Instructions for clean catch midstream urine collection:
• For male
• Wash hands thoroughly
• Cleanse the meatus
• Void a small amount into the toilet
• Then, void directly into the specimen container
• For female
• Wash hands thoroughly
• Cleanse the labia from front to back
• While keeping the labia separated, void a small amount into the toilet
• Without interrupting the urine stream, void directly into the specimen container

Info

• Urine is the waste product formed by the kidneys through ultrafiltration of plasma
• Testing of urine can give information on metabolism, endocrine and renal function
• Factors such as diet, fluid intake, exercise, and kidney function often affect the urine
• Urinalysis is a battery of qualitative and semi-quantitative tests to evaluate the kidney's ability to selectively excrete and reabsorb substances while maintaining proper water balance and fulfilling specific body needs
• The urinalysis is the most widely and routinely performed urine test; it is simple, and results are rapidly available
• A complete UA consists of three distinct testing processes:
• Physical examination for
• Appearance
• Color
• Odor
• Specific gravity
• pH
• Chemical examination for
• Glucose
• Ketones
• Protein
• Blood
• Bilirubin
• Urobilinogen
• Leukocyte esterase
• Nitrite
• Microscopic examination of urine sediment for formed elements
• Cells
• Bacteria
• Casts
• Crystals
• Other components

The Urine dipstick test typically looks like the image below:

Glucose

Bilirubin

Ketones

Specific Gravity

Blood

pH

Protein

Urobilinogen

Nitrite

Leukocyte Esterase

Clinical

The conditions where routine urine analysis is indicated includes:

• As a basic screening test performed for
• Routine physical examination
• Pregnancy workup
• Admission to a health care facility
• Preoperative evaluation
• Evaluation of kidney function
• As a screening test for urinary tract disorders
• To detect genitourinary infection or abnormality
• For evaluation of metabolic or systemic disease related to renal disorders
• To monitor or treat fluid imbalances
• To monitor the effects of physical or emotional stress
• To monitor and evaluate the therapeutic efficacy of a drug or adverse reactions on the renal function
• For detection of drugs and substances (urine toxicology testing)

The factors interfering with the test results include:

• Aged sample kept at room temperature
• Refrigeration of urine sample
• Urine dipsticks exposed to air
• Contamination of the collection container or specimen with chlorine, sodium hypochlorite, peroxide, or formalin residue
• Contamination of urine sample by skin epithelium, bacteria, hair, lint, menstrual or vaginal discharge, mucus, or semen
• Food coloring or Azo dye metabolites
• Radiographic contrast agents
• Strongly acidic urine or alkaline urine
• Ascorbic acid
• Drugs
• Captopril
• Cephalexin
• Cephalothin
• Finasteride
• Gentamicin
• Lamotrigine
• Nitrofurantoin
• Phenazopyridine
• Tetracycline

Nl Result

Consult your laboratory for their normal ranges as these may vary somewhat from the ones listed below.

1. Physical examination
• Appearance/Tubidity: Clear or minimal haziness
• Color: Pale yellow, straw, amber
• Odor: Slightly aromatic
• Specific gravity: 1.005-1.030
• pH: 4.5-8.0 (usually 5-6)
2. Chemical examination (Dipstick)
• Glucose: Negative
• Ketones: Negative
• Protein: Negative
• Blood: Negative
• Bilirubin: Negative
• Urobilinogen: Normal (Present)
• Leukocyte esterase: Negative
• Nitrite: Negative
3. Microscopic examination
• Cells
• WBC's: 0-5/hpf
• RBC's: 0-2/hpf
• Bacteria: Negative or rare
• Casts: Negative or occasional hyaline casts
• Crystals: Negative or few
• Other components
• Epithelial cells: Negative or rare
• Trichomonas: Negative
• Clue cells: Negative
• Yeast: Negative

High Result

Please see the specific sections for interpretation of high (abnormal) results on each of these items:

• Urine Dipstick Glucose and Ketones
• Urine Dipstick Protein
• Urine Dipstick Blood
• Urine Microscopic Bacteria & Cells

Low Result

Please see the specific sections for interpretation of low results on each of these items:

• Urine Dipstick Glucose and Ketones
• Urine Dipstick Protein
• Urine Dipstick Blood
• Urine Microscopic Bacteria & Cells

References

• Laboratory Corporation of America®. Urinalysis, Complete With Microscopic Examination. [Homepage on the internet]©2003. Last updated on September 15, 2003. Last accessed on November 25, 2006. Available at URL: http://www.labcorp.com/datasets/labcorp/html/chapter/mono/ur002700.htm
• LabTestsOnline®. Urinalysis. [Homepage on the Internet] ©2001-2006. Last reviewed on May 9, 2005. Last accessed on November 25, 2006. Available at URL: http://www.labtestsonline.org/understanding/analytes/urinalysis/sample.html
• MedlinePlus Medical Encyclopedia®. Urinalysis.[Homepage on the Internet]©2005. Last updated on May 17, 2005. Last accessed on November 25, 2006. Available at URL: http://www.nlm.nih.gov/medlineplus/ency/article/003579.htm
• Simerville JA et al. Urinalysis: A Comprehensive Review. Am Fam Physician. 2005 Mar 15;71(6):1153-62.
• UTMB Laboratory Survival Guide®. URINALYSIS (Chemistry and Microscopic). [Homepage on the Internet]©2006. Last reviewed in February 2006. Last accessed on November 23, 2006. Available at URL: http://www.utmb.edu/lsg/LabSurvivalGuide/chem/URINALYSIS.html