Urinalysis

Prepared by :
NOR FATIN AINA BINTI AZMI
(Lablink, KPJ Selangor Specalist Hospital)
INTRODUCTION
• Urinalysis is a laboratory test. It is to help the doctor to detect problems
that may be shown by urine.
What is urine ?
• Urine is a waste product that is produced by the kidneys in their process of
cleaning the blood and is made up of water and dissolved waste products.
The waste products are substances that unnecessary for the body and that
can be harmful to our organs if accumulated in the body.
• Urine is produced by urinary system consists of the kidneys, ureters,
urinary bladder, and urethra.
 Kidney filters metabolic wastes, excess
ions, and chemicals and produce urine

Ureter carry urine from the kidney to the

urinary bladder

The urinary bladder is used for the

storage of urine

The urethra is the tube through which urine passes from the
bladder to the exterior of the body.
List of urinalysis tests
 Profile  Single Test
• Urine FEME • Albumin
• Urine Microalbumin • Amylase

• Urine Albumin/Creatinine Ratio (ACR) • Calcium

• Glucose
• Phosphate
 Screening test
• Total protein
• Urine pregnancy test
• Urea
• Urine drugs
• Creatinine
• Urine Strep. Pneumonia
• Na
• K
• Cl
• Uric acid
Urine FEME
• Consist of macroscopic, dipstick and o WBC
microscopic examination.
o RBC
• Parameter :
o Epithelial cells
o Appearance
o Cast Microscopic
o Specific gravity
o Crystals
o pH
o Bacteria
o Protein
o Yeast
o Glucose
o Ketone
o Leukocyte
o Nitrite
o Urobilinogen
o Bilirubin
o Blood
• pH - The pH level indicates the amount of acid in • White blood cells (leukocytes) - may be a sign of
urine. Abnormal pH levels may indicate a kidney or an infection.
urinary tract disorder.
• Concentration - A measure of concentration, or • Red blood cells (erythrocytes) - may be a sign of
specific gravity, shows how concentrated particles kidney disease, a blood disorder or another
are in your urine. A higher than normal concentration underlying medical condition, such as bladder
often is a result of not drinking enough fluids.
cancer.
• Protein. Low levels of protein in urine are normal but
higher levels may indicate a kidney problem. • Bacteria or yeasts - may indicate an infection.
• Sugar. Any detection of sugar on this test usually • Casts - tube-shaped proteins — may form as a
related with diabetes patient. result of kidney disorders.
• Ketones. As with sugar, any amount of ketones
detected in your urine could be a sign of diabetes • Crystals that form from chemicals in urine may be a
sign of kidney stones.
• Bilirubin - Normally, bilirubin is carried in the blood
and passes into liver, where it's removed and
becomes part of bile. Bilirubin in urine may indicate
liver damage or disease.
• Evidence of infection - If either nitrites or leukocyte
is detected in urine, it may be a sign of a urinary
tract infection.
• Blood - Blood in your urine may be a sign of kidney
damage, infection, kidney or bladder stones, kidney
or bladder cancer, or blood disorders.
Urine Microalbumin
 A urine microalbumin test is a test to detect very small levels of a blood
protein (albumin) in your urine. A microalbumin test is used to detect early
signs of kidney damage in people who are at risk of developing kidney
disease.
 Microalbumin tests are recommended for people with an increased risk of
kidney disease, such as those with type 1 diabetes, type 2 diabetes or high
blood pressure.
Normal Range
• <20 mg/L

• Moderately increased albumin levels found in both initial and repeat urine
tests indicate that a person is likely to have early kidney disease. Very high
levels are an indication that kidney disease is present in a more severe form.
Undetectable levels are an indication that kidney function is normal.
Urine Albumin, Creatinine Ratio
• Microalbumin is a small amount of a protein called albumin. It is normally found in the
blood. Creatinine is a normal waste product found in urine. A microalbumin creatinine
ratio compares the amount of albumin to the amount of creatinine in urine.
• The urine albumin test or albumin/creatinine ratio (ACR) is used to screen people with
chronic conditions, such as diabetes and high blood pressure (hypertension) that put
them at an increased risk of developing kidney disease.
• ACR is calculated by dividing albumin concentration in milligrams by creatinine
concentration in mmol per litre.
• Normal range :
o Albumin : < 20 mg/L
o Creatinine : 2.0 – 20.0 mmol/L
o Albumin/Creatinine Retio : < 3.5 mg/mmol

• If the results show the present of albumin in urine, it may indicate early-stage kidney
disease. If the test results show high levels of albumin, it may related to kidney failure.
• If small amounts of albumin are found in urine, it doesn't necessarily mean to have kidney
disease. Urinary tract infections and other factors can cause albumin to show up in urine.
LIST OF URINE DRUGS

• Morphine
• Marijuana
• Amphetamine
• Benzodiapines
• Methamphetamine
Urine Streptococcus Pneumoniae
• Streptococcus pneumoniae (pneumococcus) is the most common bacterial etiology of
community-acquired pneumonia (CAP) in adults.
• The pneumocococcal urine antigen test (UAT) is an assay commonly used to identify
pneumococcal antigens excreted into the urine.
Conclusion
• We must take a good care of our kidney because kidney is the main organ that filter
toxins out of the body, as well as other substances that our body doesn’t need and been
removed from our body through urine.
• We must drink plain water in optimum amount and a good diet to ensure our kidney is
working properly.
 References
 https://medlineplus.gov/lab-tests/microalbumin-creatinine-ratio/
 https://labtestsonline.org/tests/urine-albumin-and-
albumincreatinine-ratio
 https://www.webmd.com/diabetes/urine-test-microalbumin
 https://www.kidney.org/kidneydisease/siemens_hcp_acr
 https://www.mayoclinic.org/tests-
procedures/microalbumin/about/pac-20384640
 https://www.innerbody.com/image/urinov.html