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Urinalysis Test

Last updated Jan. 9, 2019

Approved by: Krish Tangella MD, MBA, FCAP

Urinalysis Test is a group of tests that helps assess several characteristics of urine.

What are the other Names for this Test? (Equivalent Terms)

  • UA Test
  • Urine Analysis (UA) Test

What is Urinalysis Test? (Background Information)

  • Urine is a waste product produced by the kidneys and excreted through the urethra. It contains salts and other chemical byproducts of bodily functioning
  • The kidneys are located on either side of the spine in the middle back. They filter blood and maintain blood pressure. Urine is essential to this role, as it is the means by which the kidneys excrete unwanted byproducts and wastes
  • Filtration occurs in the kidneys at millions of microscopic sieve-like structures called glomeruli. These sieves are very fine and normally restrict all but the smallest molecules, from passing into urine
  • Urine is normally made up of salts and certain byproducts of metabolism. Additionally, therapeutic (and recreational) drugs are usually broken down and discarded through urine
  • Abnormalities in the make-up of urine can be due to several factors. These include kidney disease, urinary tract infections, and accumulations of substances in blood, to name a few

A Urinalysis Test is a group of tests that helps assess several characteristics of urine. These characteristics include:

  • Appearance: Made by visual observation, this includes factors such as color, cloudiness, and concentration of urine. This is performed by a qualified laboratory personnel
  • Chemical composition: Performed by inserting a dipstick containing indicators for pH, protein, glucose, ketones, hemoglobin, bilirubin, urobilinogen, nitrite, and leukocyte esterase
  • Microscopic composition: Performed by observing the urine sample under a microscope; this includes red and white blood cells, epithelial cells, crystals, bacteria, yeast, and parasites

What are the Clinical Indications for performing the Urinalysis Test?

Following are the clinical indications for performing the Urinalysis Test:

  • Routine screening, as part of a general physical examination
  • Monitoring the effects of physical or emotional stress
  • Monitoring fluid imbalances or the treatment for fluid imbalances
  • Monitoring response to drug therapy for undesired reactions; some drugs may impair kidney function
  • Abdominal pain
  • Back pain
  • Discolored or bloody urine
  • Painful urination; frequent urination
  • Urgency to urinate with little or no urine produced

How is the Specimen Collected for Urinalysis Test?

Following is the specimen collection process for the Urinalysis Test:

Sample required: Urine

Process: Collection of mid-stream urine into a sterile container, usually done first thing in the morning.

Preparation required: To avoid contamination, the genitals must be cleaned properly prior to collection of the urine sample. Proper cleaning involves wiping the tip of the penis or cleaning the vagina from front to back (to avoid introducing fecal matter into the sample inadvertently).

What is the Significance of the Urinalysis Test Result?

The significance of the Urinalysis Test result is explained:

The following are interpretations of discolored urine (the color may indicate the presence of):

  • Deep yellow: Riboflavin
  • Orange: Bilirubin, chrysophanic acid, pyridium, santonin
  • Pink or red: Hemoglobin, myoglobin, porphyrin, rhubarb, uroerythrin
  • Green: Oxidized bilirubin, breath mint
  • Blue: Diagnex, indican, methylene blue
  • Brown: Bilirubin, hematin, methemoglobin, metronidazole, nitrofurantoin, rhubarb, senna
  • Black: Homogentisic acid, melanin
  • Smokey: Red blood cells

The following are interpretations of abnormal chemical composition of urine:

  • High pH (basic): Metabolic and respiratory alkalosis
  • Low pH (acidic): Metabolic or respiratory acidosis
  • Protein: Diabetic nephropathy, glomerulonephritis, nephrosis, toxemia of pregnancy
  • Glucose: Diabetes
  • Ketones: Diabetes, isopropanol intoxication
  • Hemoglobin: Glomerulonephritis, hemolytic anemia, cancer, pyelonephritis, insect bites, tuberculosis, urinary tract infection
  • Urobilinogen: Cirrhosis, heart failure, hepatitis, infectious mononucleosis, malaria
  • Bilirubin: Cirrhosis, hepatic tumor, hepatitis
  • Nitrites: Bacterial infection
  • Leukocyte esterase: Bacterial infection, tumor

The following are interpretations of microscopic abnormalities in urine:

  • Red blood cells: Glomerulonephritis, lupus nephritis, infarction, tuberculosis, urinary tract infection, gout, scurvy, heart failure
  • White blood cells: Acute urinary tract infection, lupus nephritis, pyelonephritis
  • Crystals: Kidney stone

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario.

Additional and Relevant Useful Information:

Certain factors may interfere with the results of the Urinalysis Test. These include:

  • Pregnancy
  • Diet
  • Stress

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider, the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: June 2, 2015
Last updated: Jan. 9, 2019