Urinalysis

A urinalysis is a laboratory test of a person's urine. It detects and managesvarious disorders, including urinary tract infections, kidney disease, and diabetes. A urinalysis may screen for and diagnose medical conditions, monitor treatment, and help guide further testing.

A typical urinalysis includes several different tests:

1. Physical examination: This includes the urine's appearance, color, and clarity.

2. Chemical examination: This includes tests for specific substances in the urine, such as glucose (a type of sugar), protein, and ketones (substances produced during the breakdown of fats).

3. The microscopic examination involves looking at a urine sample under a microscope to check for abnormal cells, bacteria, and other substances.

The results of a urinalysis can help diagnose and manage various conditions, including infections, kidney disease, and diabetes. It can also be used to monitor the effectiveness of treatment for these conditions.

The Urinalysis test screens for various conditions, including urinary tract infection (UTI), urinary bladder disease, kidney disease, and diabetes. Many systemic illnesses can affect results, and significant deviations from the normal range may require further evaluation by your physician.

Tests Included

• Urinalysis, Complete With Microscopic Examination
• Color
• Appearance
• Specific gravity
• pH
• Protein
• Glucose
• Occult blood
• Ketones
• Leukocyte esterase
• Nitrite
• Bilirubin
• Urobilinogen
• Microscopic examination of urine sediment

Limitations: There needs to be more volume to limit the extent of procedures performed. High vitamin C intake may cause an underestimate of glucosuria or a false-negative nitrite test. Metabolites of Pyridium® may interfere with the dipstick reactions by producing color interference.

Urinalysis - Everything You Want to Know

One of the most efficient analyses with zero medical intrusion is urinalysis, also called urine test. It is used to examine substances from the urine at a chemical, microscopic or visual level.

Usually, healthcare providers request a urinalysis because of its complex assessment. Depending on the symptoms you may encounter, the doctor will decide what indicators to be examined.

Usually, this test is performed when the patient presents symptoms associated with a urinary infection, the urinary system, or liver disorders.

What is the Urinary System Function?

The urinary system has multiple functions besides removing waste produced by kidneys in the form of urine. It also balances the body's fluids and electrolytes and releases hormones that control blood pressure and red blood cell production. Another less-known function is maintaining calcium and phosphorus levels that translate into healthy bones. 

As the renal system (urinary system) is vulnerable in the face of multiple infections, some leading to kidney blockage, it is essential to remove waste when the body feels like it. Do not hold pee for too long, stay hydrated, have a meticulous hygiene routine, and take a urine test at least once a year.

What are the Symptoms that Indicate You Need a Urinalysis?

It is recommended to follow a urine test when you have one or many of these symptoms:

• Abdominal pain
• Back pain (in the kidney area)
• Pain/burning while urinating
• Frequent urination
• Blood in the urine (the urine turns pink-red)
• Dark urine for prolonged periods, even if hydrated
• Urinary incontinence

Other situations when the urinalysis is requested:

• Routine medical examination
• When monitoring the progress of a treatment
• At the admission to a hospital
• Before the surgery takes place

What are the Tests Included in Urinalysis?

Urinalysis comprises a large number of tests, each one being valuable for the identification of certain disorders. Generally, your doctor will want to check three aspects of your urine, color and appearance, chemical, and microscopic findings.

Chemical tests are performed under the dipsticks procedure using test strips introduced in the urine sample and color according to the substances encountered.

Protein - in the urine test, proteins such as albumin are examined to determine disorders such as kidney disorders, dehydration, or heart failure. Lower protein values in the urine are not a concern, while higher values may indicate a kidney disorder.

PH - The PH indicates the levels of acidity in the urine. High PH levels can be a sign of kidney disorders or tract infections. Conversely, low PH levels signify diabetes, diabetic ketoacidosis, or diarrhea.

Ketones - ketone is a product of your body when breaking down fatty acids and fats for energy. This process happens when you need to consume more carbohydrates or glucose. Ketones are also checked when there is a suspicion of diabetes-related ketoacidosis.

Glucose - Glucose is often examined in the blood. If glucose is found in the urine, this may be a sign of diabetes.

Bilirubin is a yellow pigment produced by the liver, found in the bile. Abnormal values for this indicator may indicate a liver disorder.

Nitrite - a positive test for nitrite indicates a urinary tract infection. Nitrite should not be confused with nitrate, a product from bacteria found in urine. There are cases when the nitrite test turns negative while having a urinary infection. This is why it is best to have other indicators examined simultaneously.

Leukocyte esterase urine - an enzyme found in the white blood cells. If the test turns positive, then this is an indication of inflammation in the urinary system.

Urine specific gravity - this test will evaluate the concentration of all the chemical elements from the urine. Abnormal values are associated with many health disorders, and doctors should consider this alongside other tests.

Microscopic examination

Urinalysis-microscopic examination: This exam can identify substances that cannot be seen with a bare eye. The elements looked for at the microscope are:

Red blood cells (erythrocytes) - Elevated levels of RBC may indicate kidney disorders, blood problems, or urinary system cancer.

White blood cells (leukocytes) - a high number of these cells indicate an active infection

Bacteria/ Parasites - indicates infection of the urinary tract.

Crystals - an indication of kidney stones

Epithelial cells may indicate tumors in abnormal values, but the sample may also be contaminated, and the test should be redone.

Tube-shaped proteins - this may appear in case of kidney disorder/modification.

Occult blood - blood found in urine may indicate more issues; it may be a sign of kidney disorder, infections, cancers, or coagulation problems. For this indicator, various analyses are needed to identify the problem.

Urobilinogen - urobilinogen or urine is a product of erythrocytes processing. This indicator has higher levels in case of hemolytic jaundice or other intestinal disorders.

Microscopic examination of urine sediment - Your healthcare provider may ask you to perform a test for the urine sediment as well to determine whether small, undetected elements may be present in the urine, such as:

• Casts
• Cells
• Cell fragments
• Mucus
• Crystals
• Bacteria/germs

Color & Appearance

Many aspects can affecturine color, either due to food, medication, or a particular disorder. Colors are significant indicators, especially before taking a blood/urine test.

Transparent - If the urine is clear, this may mean that you consume enough water. If cloudy, it may indicate the presence of compounds or cells.

Light yellow - Your urine is normal, your body is adequately hydrated, and your kidneys are functioning well.

Dark yellow - Still normal. It would help if you stayed more hydrated, so make sure that you drink more water whenever you can

Honey yellow - You don't drink enough water for the body to work correctly.

Orange - When the urine turns orange, it is still possible that dehydration may be the cause. If the color persists, further should be done to evaluate whether a hepatic disorder or urinary bladder issues may be present.

Brown - This may be an indication of hepatic disease or severe dehydration.

Pink or Red - Usually, when urine turns pink or red, this may mean that blood is present. The red color may also appear after eating certain foods with intense red pigment. If a doctor confirms this, further tests should be performed to evaluate possibilities for hepatic disorders, infections, tumors, or sometimes mercury intoxication.

Blue/Green urine - This is not a common situation. This color may signify a rare genetic disease, or in milder cases, you've ingested a food coloring product or a result of medicine.

Whenever you see abnormal color in your urine, you must note how frequently this happens to identify whether you were consuming products with coloring. Some highly pigmented foods like beet, blueberries, turmeric, and certain medicines and supplements may change the color of your urine. 

In terms of appearance, acidity and foaming could be present in the urine. If any of those appear, this may signify a protein excess or kidney disorders.

How to Prepare for the Urinalysis Test?

The first thing to do is to have a clinical evaluation by a doctor. You should follow the doctor's instructions before collectingthem, but the results may be different than expected. After this, your healthcare provider will issue a referral for the analysis to perform.

Menstrual discharge may affect the values of the test. Your healthcare provider may indicate you give up on specific medication before collecting or collecting first thing in the morning or later in the day. Also, if you are a woman, it is essential to specify whether you are menstruating before the test.

How Can You Interpret the Results of Your Urinalysis Test?

The urinalysis results may provide different interpretations because of the high number of tests. Most times, values out of the standard limit indicate a medical problem. Your healthcare provider may ask you to repeat the tests alongside other blood tests for higher diagnostic accuracy.

Since neither disorder can be fully diagnosed using a urinalysis, this test is often used to show the healthcare provider's direction. The doctors need to get as much information as possible from the patient about symptoms, diet, and medication to follow the correct route.