URINALYSIS

• URINALYSIS

  • Testing of urine with procedures commonly performed in an expeditious, reliable, safe and cost-effective manner
• Reasons for Urinalysis

  • Diagnosis of Disease
  • Screening asymptomatic populations for undetected disorders
  • Monitoring progress of disease and effectiveness of therapy
• Urine Formation

  • Ultrafiltrate of Plasma
  • Formed at Kidneys
  • Average Daily output is 1200mL – 1500mL
• Normal Daily Output

  • 1200-1500mL (600-2000mL also considered normal)
• Oliguria

  • Occurs at excessive water loss
• Oliguria

  • Decreased Urine Output: 400mL/day (Adults)
• 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)
• Solute: Urea, Amount: 25.0-35.0g, Remark: 60-90% Nitrogenous material (protein metabolism)
• Solute: Creatinine, Amount: 1.5g, Remark: Derived from creatine (muscle metabolism)
• Solute: Uric Acid, Amount: 0.4-1.0g, Remark: Common component of Kidney Stones
• Solute: Hippuric Acid, Amount: 0.7g, Remark: Derived from Benzoic Acid
• Solute: Others, Amount: 2.9g
• Solute: NaCl, Amount: 15.0g, Remark: Principal Salt
• Solute: Potassium, Amount: 3.3g, Remark: Occurs as chloride, sulfate, phosphate salts
• Solute: Sulfate, Amount: 2.5g, Remark: Derived from amino acids
• Solute: Phosphate, Amount: 2.5g, Remark: Serves as buffers in blood
• Solute: Ammonium, Amount: 0.7g, Remark: Derived from protein and glutamine metabolism
• Solute: Magnesium, Amount: 0.1g, Remark: Occurs as chloride, sulfate, phosphate salts
• Solute: Calcium, Amount: 0.3g, Remarks: Occurs as chloride, sulfate, phosphate salts
• URINE COLLECTION

  • Remember that Urine is classified as a BIOHAZARD
  • Observe Standard Precautions
  • Requisition Forms are required
• URINE COLLECTION: Containers for routine urinalysis

  • Clean and Dry (Sterile)
  • Leak Proof
  • Screw top lids
  • Should have a wide mouth
  • Made of clear material
  • Recommended capacity: 50mL
  • Labelled. (Attached to CONTAINER, not the lid)
• Most Common

  • Random Urine
• Most Preferred

  • First Morning (Because it is more concentrated)
• 24 Hour Specimen

  • For Quantitative Measurements
  • Patients are given large container with preservative
  • Container is stored at 2-8ᵒ C
• Suprapubic Aspiration

  • Commonly done on pediatrics
  • Needle is introduced through abdomen into bladder
• Type of specimen: Random, Purpose: Routine screening
• Type of specimen: First Morning, Purpose: Routine screening
• Type of specimen: First Morning, Purpose: Pregnancy Test
• Type of specimen: Random, Purpose: Orthostatic protein
• Type of specimen: Fasting, Purpose: Diabetic screening/monitoring
• Type of specimen: 24 hour (or timed), Purpose: Quantitative chemical tests
• Type of specimen: Catheterized, Purpose: Bacterial culture
• Type of specimen: Midstream clean-catch, Purpose: Routine screening
• Type of specimen: Midstream clean-catch, Purpose: Bacterial Culture
• Type of specimen: Suprapubic aspiration, Purpose: Bladder urine for bacterial culture
• Type of specimen: Suprapubic aspiration, Purpose: Cytology
• Catheterized

  • Collected under sterile conditions by passing a sterile hollow tube through the urethra into the bladder.