Urinalysis
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Urinalysis is a urine test in which a urine sample is examined using dipstick, microscopic and sometimes chemical analysis to assess its physical and chemical properties. It is used to help detect urinary tract infections, kidney disease and metabolic conditions, as well as to monitor overall health.
Why get tested?
To look for metabolic and kidney disorders and for urinary tract infections
When to get tested?
On admission to a hospital; preparation for surgery; as part of a medical examination; or when evaluating a new pregnancy. It may be done if you have tummy or back pain, frequent or painful urination, or blood in the urine
Sample required?
Sample of urine (20–50 mls) in a sterile container; the first urine passed in the morning is preferred.
Urine for urinalysis however can be collected at any time. The first morning sample is the most valuable because it is more concentrated and more likely to demonstrate abnormal results if there is an underlying problem e.g. blood from bleeding in the urinary tract.
Because of the potential (particularly in women) to contaminate urine with bacteria and cells from the surrounding skin, it is important to first clean the genitalia. Men should wipe the tip of the penis; women should spread the labia of the vagina and clean from front to back. As you start to urinate, let some urine fall into the toilet, then collect a sample of urine in the container provided.
Test preparation needed?
No test preparation is needed
What is being tested?
This test identifies and measures some of the by-products of normal and abnormal metabolism, cells, cell fragments, and bacteria in urine. Urine is produced by the kidneys, which filter wastes out of the blood, help regulate the amount of water in the body, and conserve proteins, electrolytes, and other compounds that the body can reuse. Anything that is not needed is excreted in the urine.
Several diseases can be diagnosed in their early stages by detecting abnormalities in the urine. Abnormally high levels of glucose, protein, bilirubin, red blood cells, white blood cells, crystals, and bacteria can indicate disease. They may be present because:
1) There are elevated concentrations in the blood which spill over into urine
2) Kidney disease has made the kidneys less effective at filtering or
3) An infection has put bacteria and white blood cells into the urine .
A complete urinalysis consists of three distinct testing phases:
- Visual examination, which evaluates the urine’s colour, clarity, and concentration;
- Chemical examination, which tests chemically for a number of substances that provide valuable information about health and disease; and
- Microscopic examination, which identifies and counts the type of cells, casts, crystals, and other components (bacteria, mucous ) that can be present in urine.
See below for details of these examinations.
Today, a routine urinalysis consists of the visual and the chemical examinations. Your urine may be examined under a microscope if there is an abnormal finding in one of the first two phases listed above or if your doctor specifically requests it.
Common questions
Urinalysis is used as a screening and/or diagnostic tool because it can detect different metabolic and kidney disorders. Often, substances such as protein or glucose will begin to appear in the urine before patients are aware that they may have a problem. It is used to detect urinary tract infections (UTI) and other disorders of the urinary tract. In some conditions, urinalysis also provides an easy, economical, and relatively fast test to follow patient progress, for example, if you want to know whether a condition is getting better or worse. However, a urinalysis cannot detect all disorders.
A routine urinalysis may be done when you visit your doctor, when you attend the outpatient clinic or when you are admitted to the hospital. It may also be part of a routine medical examination, a new pregnancy evaluation, or preparation for planned surgery. A urinalysis will most likely be performed if you see your doctor complaining of tummy pain, back pain, painful or frequent urination, or blood in the urine. This test can also be useful in monitoring whether a condition is getting better or worse.
Urinalysis results can have many interpretations. Abnormal findings are a warning that something may be wrong and should be looked at further. Normal urinalysis results do not mean there is no illness. Urinalysis is only one screening test that can provide a general overview of a person’s health. Your doctor must look at the urinalysis results alongside your health complaints and other information available.
No prior preparation is needed for a spot urine test, unless specified by your doctor.
Urinalysis testing is frequently carried out by dip-stick testing in the clinic and results are available immediately. This is called near-patient testing or point of care testing (POCT). If there is an abnormal finding, such as excessive protein or the presence of blood, it may be necessary to send the sample on to the laboratory for further analysis. This will take several days and depending on the tests that need to be carried out.
Because this is a general screening test, this is usually not important and most of the time it is a random urine collection. However, if your doctor is looking for a specific finding, you may be asked to collect a sample at a specific time. For example, the presence of glucose is better looked for in a specimen collected after a meal, low levels of protein are better detected in a concentrated specimen collected first thing in the morning.
Some commercial testing strips can be purchased at a pharmacy to perform part of the chemical examination, such as urine pH, urine glucose, and urine ketones but the tests are best performed by someone who is used to reading and interpreting them.