Urinalysis Principle ,Procedure Result interpretation Including Microscope

Urinalysis Dipstick

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Urinalysis test strips are easy to use, cost-effective medical tool that allow for the specific diagnosis and effective treatment of various disease states. The test strips are designed to detect small pathological changes in urine, and provide the result via a colour-change test field.

Urine Dipstick (Combi11) provides  up to 11 parameters in a single strip
These parameters include:

• Ascorbic Acid
• Glucose
• Bilirubin
• Ketones
• Specific Gravity
• Blood
• pH
• Protein
• Urobilinogen
• Nitrites
• Leukocytes

SPECIMEN: Freshly voided, clean-catch, midstream: first morning or random. 
Causes for rejection: unlabelled specimen, specimen at room temperature for longer than one hour; Containers and instructions are located in each restroom. 
If specimen cannot be examined within one hour, it may be refrigerated up to eight hours and brought to room temperature before examination.



PRINCIPLE: Through chemical and microscopic analysis of the urine specimen, information about the body’s metabolic functions may be obtained. This aids in the evaluation of renal, urinary, and metabolic disorders.

Urine SAMPLE

PROCEDURE : A strip is dipped in to a urine sample, then using the provided colour chart, the results are matched to ascertain concertation levels of substances within the urine. Test result may provide information regarding the status of carbohydrate metabolism, kidney and liver function, acid-base balance, and urinary tract infection.

READING TIME

Urinalysis dipstick reading time

SIGNIFICANCE AND CLINICAL CONDITION 

clinical significance or Urinalysis

Any irregular results should be confirmed with additional laboratory testing of the urine sample like Protein with SSA,Bile with Hay test and others.

Leukocytes: The detection of white blood cells in the urine suggests a possible UTI.

• Expected result : Negative

Nitrite: Screening for possible asymptomatic infections caused by nitrate-reducing bacteria – Suggesting a possible UTI. Note: These two parameters (Leukocytes and Nitrite) are commonly used to screen for possible Urinary Tract Infection (UTI)

• Expected result : Negative

Urobilinogen: the presence of excreted urobilinogen suggests a possible deterioration of liver functions. Urobilinogen is the breakdown product of bilirubin

• Expected result: less than 17 µmol/l (< 1mg/dl)

Protein: This test is usually run to screen for kidney disease.  Protein in the urine is called Proteinuria.

• Expected result: Negative

pH: Measures the acidity in your urine which may be a sign of kidney stones. Your pH varies during the day going from more acid in the am to more alkaline in the pm.

• Expected result : Low

Blood: Blood in the urine is called hematuria. A number of things can cause hematuria including UTI, Kidney infection, medication, menstruation, strenuous exercise

• Expected result: Negative

Specific Gravity: Evaluates the body’s water balance (hydration) and urine concentration and helps evaluate kidney functions and possible kidney diseases

• Expected Results: low at 1,000 but normal ranges from 1.020 to 1.030

Ketone: The control of urinary ketone is useful in managing and monitoring type 1diabetes.

• Expected Results: Negative

Bilirubin: The detection of Bilirubin in the urine is an early indication of liver disease. Bilirubin is the breakdown product of hemoglobin. Note: These two parameters (Urobilinogen and Bilirubin) are commonly used to screen for possible liver disease.

• Expected Result: negative

Glucose: Glucose in the urine could indicate diabetes or renal glycosuria.

• Expected Results: Negative

Note: These two parameters are commonly used to screen for possible metabolic disorders

Ascorbic Acid: People taking vitamin C may have large amounts of ascorbic acid in their urine. Ascorbic acid is known to interfere with the accuracy of some chemical test strips, causing them to be falsely low or falsely negative. Examples of tests that may be affected include the urine dipstick tests for glucose, blood, bilirubin, nitrite, and glucose

 MICROSCOPIC EXAMINATION

urine microscopical examination

Examination of urine sediment may reveal the presence of different types of cells such as epithelial cells, leukocytes, erythrocytes, or renal cells. Different types of crystals, yeast, bacteria, or casts may also be present. Casts are cylindrical structures created by protein precipitation in the renal tubules.

          Procedure:

• Transfer urine sample to a conical centrifuge tube.
• Centrifuge your sample at a moderate speed for 5 minutes. 

BE SURE TO BALANCE CENTRIFUGE.

•  Discard the supernatant (fluid off the top) by quickly pouring off fluid.
• Tap tube with index finger to mix sediment with remaining fluid.
•  Make a wet mount of sample by transferring 1 drop of material to a slide and covering with a coverslip.
• Examine the sample under the microscope under low and high power.
• Identify what you see .

You can also identify various crystals found in urine,Bacteria,yeast,epithelial cells etc

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