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Urinalysis Diagnosis

Presence Disease Advantages/Disadvantages

Leukocytes Rule out Urinary Tract Normally Negative
 associated with acute
interstitial nephritis,
severe pyelonephritis
Nitrite suggestive of bacteria Normally Negative
in urine presence of nitrate
urinary tract infection indicates nitrate reducing
bacteria such as
Veillonellae, Haemophilus,
Corynebacteria, Lactobacilli,
Flavobacteria and
Urobilinogen possible liver disease Urine test:
(hepatitis) lower limit: 0.2
elevated levels may upper limit:1.0
indicate hemolytic
anemia (excessive RBC increase in urobilinogen
breakdown), levels are indication of
overburdening of the impaired intrahepatic
liver, increased urobilinogen cycle (liver
urobilinogen production, damage)
re-absorption-a large Urobilinogen is converted
hematoma, restricted to yellow pigmented Urobilin
liver function, hepatic apparent in urine
infection, poisoning or Urobilinogen remaining in
liver cirrhosis the intestine
(stercobilinogen) is oxidized
to brown stercobilin. This
gives feces its characteristic
Protein Globular proteinuria Normally absent
Tubular proteinuria presence of albumin
detectable protein rules Albustix test-since protein
out kidney damage, are macromolecules, they
increased glomerular are not normally present in
permeability (from fever urine.
cardiac disease, CNS detection indicates
disease, shock, muscular permeability of the
exertion), blood in urine, glumerulus is abnormally
inflammation, cancers, increased. This can be
infection. caused by renal infections,
diabetes mellitus, jaundice
or hyperparathyroidism
high concentration of very
small proteins can also
show up in the urine such as
Bence Jones protein,
hemoglobin monomers and
up to 10% of children can
have protein in their urine.
Sometimes this is due to
colostral antibodies.
pH too high: normally 5 to 7
Alkaline-rule out diets measure of hydrogen ion
high in vegetables and concentration (acidity or
urinary tract infections alkalinity)
(bacteria converts urine if results conclude
to ammonia) alkalinity, it is suggested to
too low: increase intake of protein
Acid-rule out diets high in and junk foods for 2-3 days
protein and refined
carbohydrates, anorexia
and starvation.
Blood Hematuria-associated Reference range for urine
with kidney stones, test:
infections, tumors and Lower Upper
other conditions limit limit
Pyuria-associated with Red 0 2 -3
urinary infections blood
Eosinophiluria- cells
associated with allergic RBC n/a 0/negative
interstitial nephritis, casts
atheroembolic disease White 0 2
RBC casts-associated blood
with glumerulonephritis, cells
vasculitis, malignant rule out infections, kidney
hypertension stones, trauma and bleeding
WBC casts-associated from bladder or kidney
with acute interstitial tumors
nephritis, exudative
severe pyelonephritis
Specific Gravity Increased: normal SpG is 1.005 –
• Dehydration 1.030
• Fever  Falsely decreased
• Vomiting specific gravity may be
• Diarrhea caused by Alkaline urine
• Diabetes Mellitus Falsely increased specific
and other causes gravity may be caused by
of Glycosuria Intravenous dextran or
• Congestive Heart raiopague dye and
Failure proteinuria
• Synrome Specific Gravity is an
Inappropriate ADH important indication if you’re
Secretion (SIADH) hydrated or dehydrated
• Adrenal if urine is under 1.007,
insufficiency you are hydrated. If urine is
Decreased: above 1.010, you are
• Diabetes Insipius dehydrated.
• Excessive
• Glomerulonephritis
• Pyelonephritis
• Diuretics
• Adrenal
• Aldosteronism

Ketone Diabetes Mellitus Normally Absent

Diabetic Ketoaciosis accumulation in blood is
due to excess of fatty acid
(collectively known as
ketone bodies) that was
unable to metabolize in the
body, and is excreted in the
urine (ketonuria)
also present if patient is
Bilirubin possible liver disease Normally Absent. Liver
and RBC breakdown clear up this pigment
Hepatitis abnormally high level of
Cirrhosis blood bilirubin may result
obstruction of the from an increased rate of
common bile duct as with red blood cell destruction
gallstones the presence of
jaundice conjugated bilirubin in
intravascular hemolysis detectable amounts does
not enable one to
Hemoglobinuria confidently between
tubular cell conjugation hepatocellular and
of free bilirubin obstructive jaundice, but
does not commonly occur
when hyperbilirubinemia is
consequent to hemolysis
Ascorbic acid in urine
gives false negative reaction
in reagent strips and tablets.
Phenothiazines may
cause false positive reaction
in both cases.
Glucose Diabetes Mellitus Normally Absent
Renal Glycosuria Glucose is usually not
rules out kidney detectable because
disease (decreased ketones, ascorbic acid or
tubular reabsorption), other substances found in
acromegaly, urine may cause false
hyperpituitarism, bovine negative results by reagent
milk fever, bovine strips even when urinary
neurologic disease, glucose approaches clearly
excessive insulin dosage, abnormal values
fear or exertional when a hexokinase
catecholamine release, reagent strip is used,
Fanconi-like syndrome, glucose concentrations
moribund animals, sheep below 2 mg/dl in morning
endotoxemia, and drugs urine from a fasting person
such as ACTH, correlate well with urinary
glucocorticoids, fluids, tract infection.
ketamine, morphine,
phenothiazine and