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• Urilyzer 100 Pro automates the urine testing process, improving efficiency and accuracy compared to manual methods
• Reagent strip use

  1. Well-mixed specimen; Less than 1 second in the dip

  2. Leaching happens when prolonged dipping

  3. "Run-over" effect happens when urine reagent strip is not blotted

  4. Timing and good light source
• Types of Proteinuria
• Cranberry contains Quinic acid and Hippuric acid (antibacterial)
• Renal proteinuria - true renal disease includes Glomerular proteinuria, Orthostatic/cadet/postural proteinuria, Pre-eclampsia, hypertension, dehydration, and exercise
• Albumin is excreted at 100 mg/24 hours
• Pre-renal/overflow proteinuria can be caused by intravascular hemolysis, hemoglobin, muscle injury, myoglobin, infection & inflammation, acute phase reactants, multiple myeloma, and Bence-Jones protein
• Principle of pH Testing

  • Double indicator system: methyl red and bromothymol blue and measures between 5 to 9
  • No known substance interferes with urinary pH performed by reagent strip
• Diarrhea causes

  Loss of Bicarbonate (making it acidic)
• Reagent strip handling, storage and QC

  1. Protected from heat, light, chemicals, and moisture

  2. Expiration date

  3. Checked against + and - controls once every 24 hours, with newly opened bottle

  4. Stored below 30°C (but never refrigerated), 9 to 29°C
• There is no normal value for pH
• Bence Jones Protein is associated with multiple myeloma, chronic leukemia, and bone tumor
• Physiological increase in proteinuria can be due to fever, increased physical activity, and posture
• Microalbuminuria is a term used to designate the protein that cannot be detected
• Albumin is the major serum protein found in the urine
• Chemical testing of urine

  1. Quantitative: Numbers as results

  2. Semi-quantitative: "Trace amounts", Words with numbers as results

  3. Qualitative: Description as results
• Tamm-Horsfall protein (Uromodulin) is produced by Renal Tubular Epithelial Cells and seen in cases with acute kidney injury and chronic kidney disease
• pH values

  • Random Urine: 4.5 to 8.0
  • First morning Urine: 5 to 6
  • Unpreserved Urine: Greater than or equal to a pH of 9
• Urilyzer 100 Pro analyses urine and gives a result after 2 minutes
• pH Sources of Error
• Vomiting causes

  Loss of Gastric acid (making it basic)
• Bence Jones Protein screening involves Bradshaw, Toluene sulfonic acid, and heating; confirmatory test is Electrophoresis for Kappa or Lambda Chains
• Causes of proteinuria include fever, increased physical activity, and posture
• Non-glucose sugars in urine include galactose, pentose, fructose, and lactose with their respective conditions
• Tests for fructose include Seliwanoff’s, Berchardt’s, and Ba
• Protein testing: Reagent strip has a protein error of indicators
• Post-renal proteinuria

  1. UTI, injury, and trauma

  2. Menstrual contamination

  3. Vaginal/prostatic secretions
• Presence of microalbuminuria indicates increased risk of cardiovascular disease
• False negative causes in protein testing: dilute urine, proteins other than albumin, microalbuminuria
• Sugar testing: Glycosuria without elevated blood glucose can be due to renal tubular dysfunction, Fanconi’s syndrome, or pregnancy
• Diabetic nephropathy is a kidney disease indicated by microalbuminuria
• Renal proteinuria - True renal disease

  1. Glomerular proteinuria

  2. Orthostatic/cadet/postural proteinuria

  3. Pre-eclampsia, hypertension

  4. Dehydration, exercise
• Sulfosalicylic acid (SSA) precipitation test is a cold precipitation test that reacts equally with all forms of protein
• Micral Test principle: Enzyme immunoassay, Result: 60 sec / Reagent pad color Red, Positive result
• Tests for glucose include Glucose oxidase method, Benedict’s test, Clinitest, and other methods like Somogyi Quantitative Method, Folin-Wu Method, Trinder’s Reaction, Hagedorn-Jensen Method, Neocuproine Method
• Sugar testing: Glycosuria with high blood sugar includes glycosuria, glucosuria, diabetes mellitus, pancreatic diseases, and other endocrine disorders
• Microalbuminuria is a term used to designate the protein that cannot be detected by a regular reagent strip
• False positive causes in protein testing: vaginal discharge, semen, heavy mucus, pus and blood, alkaline urine, quaternary ammonium compounds, high SG
• Beta-hydroxybutyric acid is the major ketone but not detected in urine reagent strip
• Hematuria presents with cloudy and red urine (presence of RBC)