LEC 1: URINALYSIS

• Urinalysis Testing of urine with procedures commonly performed in an expeditious, reliable, safe and cost effective manner.
• Average Daily output is 1200mL – 1500mL
• Normal Daily Output 


  1200-1500mL (600-2000mL also

  considered normal)
• Oliguria 


  Decreased Urine Output:

  400mL/day (Adults)
• Oliguria


  Occurs at excessive water

  loss
• Anuria


  cessation of urine flow; suggests

  severe kidney damage
• Nocturia


  increased excretion of urine during the night
• Polyuria


  increased Urine Output : >2.5L / day (Adults)
• Urine is normally 95% water and 5% Solutes (Organic and Inorganic)
• Urea


  amount: 25.0-35.0g
• Creatinine


  amount: 1.5g
• Uric acid


  amount: 0.4-1.0g
• Hippuric acid


  amount: 0.7g
• OTHERS

  2.9g
• Urea


  60-90% Nitrogenous material

  (protein metabolism)
• Creatinine


  Derived from creatine

  (muscle metabolism)
• Uric acid


  Common component of

  Kidney Stones
• Hippuric acid


  Derived from Benzoic Acid
• NaCl


  amount: 15.0g
• Potassium


  amount: 3.3g
• Sulfate


  amount: 2.5g
• Phosphate 2.5g Serves as buffers in blood
• Ammonium 


  0.7g Derived from protein and

  glutamine metabolism
• Magnesium


  0.1g Occurs as chloride, sulfate,

  phosphate salts
• Calcium


  0.3g Occurs as chloride, sulfate,

  phosphate salts
• Chain of Custody


  Documentation of Sample Handling
• In urine drug samples, how much urine need to be collected?

  30-45 ml
• Ideal Temp of urine drug sample(32.5-37.7 C)
• Urine pH of greater than 9 suggests adulteration
• Specific Gravity less than 1.005 suggests dilution
• Bluing dye is placed on toilets to prevent patients to use toilet water to dilute specimen
• Specimen should be delivered and tested within 2 hours.
• First Morning


  ● Pregnancy tests

  ● Orthostatic protein

  ● Most preferred because

  it is more concentrated
• Fasting


  Diabetic screening/

  monitoring
• 24-hour Specimen


  ● Quantitative chemical tests

  ● For Quantitative measurements

  ● Patients are given a larger container with

  preservative

  ● Container is stored at 2 – 8 degree
• Catheterized


  ● Bacterial culture

  ● Collect under sterile conditions by passing a sterile hollow tube

  through the urethra into the bladder.
• Midstream Clean-Catch


  ● Routine screening

  ● Bacterial culture

  ● Alternative to

  catheterized specimens

  ● Less traumatic

  ● Less contaminated by Epithelial Cells and Bacteria
• Random Urine


  ● Routine screening

  ● Most common
• Suprapubic Aspiration


  ● Bladder urine for

  bacterial culture

  ● Cytology
• What is are normal urine: Pale yellow, Dark yellow and Amber