Urinalysis

What is a urinalysis? Urinalysis (UA) simply means analysis of urine. This is a very commonly ordered test which is performed in many clinical settings such as hospitals, clinics, emergency departments, and outpatient laboratories. Urinalysis is a simple test that can provide important clinical information, has a quick turn-around time, and is also cost effective.

How can we use a UA? Results of a urinalysis may be helpful in: diagnosing urinary tract infections (UTIs), diagnosing kidney stones, screening for and evaluating many types of kidney diseases, and diagnosing and monitoring the progression of diseases such as diabetes mellitus and high blood pressure (hypertension). 

Midstream Clean Catch urine sample Procedure can differ for men and women For men, the opening of the urethra (tip of the penis) should be wiped clean with a cleansing wipe before collection is begun. In women, the area around the urethra also needs to be wiped clean with a cleansing wipe. The woman then spreads the labia of the external genitalia and wipes from front to back. After the urethra is properly cleaned, the collection may begin by discarding the initial stream of urine into the toilet. Then, 10-15 milliliters (ml) of urine may be collected in the provided sterile specimen cup by directly urinating into the cup. Once an adequate amount is collected, then the remaining urine should be voided in the toilet.

Obtaining a ua Have the patient use the mid-stream clean catch method Immediately use the UA test strip and dip into the urine for 1-2 seconds. Ensure each test pad is covered in urine. Dry off excess urine Results should be read within 1 minute

What do the Results look like?

Visual inspection 1st step in analysis Assess color, clarity, and odor A normal urine sample may be reported as clear and yellow without any cloudiness. Obvious abnormalities in color, clarity, and cloudiness may suggest conditions such as: dehydration, infection, Liver disease, or muscle breakdown.

What does the Standard Dipstick UA analyze? In class we will analyze: Glucose Protein Nitrite pH Blood Leucocytes

Glucose A urine glucose test measures the level of glucose, or sugar, in your urine. High levels of glucose in the urine could indicate diabetes Less reliable than blood analysis Used more often when blood glucose kits weren’t readily available In some cases, a high amount of glucose in urine can be due to pregnancy. Pregnant women tend to have higher urine glucose levels than women who aren’t pregnant. Elevated levels of glucose in urine may also be a result of renal glycosuria. This is a rare condition in which the kidneys release glucose into the urine. Renal glycosuria can cause urine glucose levels to be high even if blood glucose levels are normal.

Protein Protein normally isn't found in the urine. Fever, hard exercise, pregnancy, and some diseases, especially kidney disease, may cause protein to be in the urine. Healthy kidneys remove extra fluid and waste from your blood, but let proteins and other important nutrients pass through and return to your blood stream. When your kidneys are not working as well as they should, they can let some protein (albumin) escape through their filters, into your urine. When you have protein in your urine, it is called proteinuria (or albuminuria). Having protein in your urine can be an early sign of kidney disease.

Nitrites in urine show a UTI is present. Bacteria that cause a urinary tract infection (UTI) make an enzyme that changes urinary nitrates to nitrites. Nitrites in urine show a UTI is present.

pH The pH is a measure of how acidic or alkaline (basic) the urine is. A urine pH of 4 is strongly acidic, 7 is neutral (neither acidic nor alkaline), and 9 is strongly alkaline. Sometimes the pH of urine is affected by certain treatments. For example, your doctor may instruct you how to keep your urine either acidic or alkaline to prevent some types of kidney stones from forming.

Blood Blood cells aren't found in urine normally. Inflammation, disease, or injury to the kidneys, ureters, bladder, or urethra can cause blood in urine. Strenuous exercise, such as running a marathon, can also cause blood in the urine.

Leukocytes WBCs in the urine most likely indicate infection.

Questions?

Calcium oxalate

Calcium Oxalate

Triple Phosphate

Cystine crystals

Tyrosine crystals

Uric acid crystals

Starch crystals

Wbc’s

RBC’s

Budding yeast

hyphae

trichomonas

trichomonas