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What Is Urine Routine Test?

A urine routine test, which is also called urinalysis, involves a battery of microscopic, chemical and physical tests to detect and/or measure the presence of cells and cellular fragments, microorganisms like bacteria, and the by-products of normal and abnormal metabolism in urine.

Under normal conditions, kidneys filter waste from blood, aid in the regulation of water in the body. They also help in the conservation of vital components like electrolytes, and proteins in blood.  thus, preventing their elimination along with waste products. Presence of a component that is not usually found in urine, e.g., proteins, may indicate a health condition and warrants further investigation.

  1. Why is Urine Routine Test performed?
  2. How do you prepare for Urine Routine Test?
  3. How is a Urine Routine Test performed?
  4. What do Urine Routine Test results mean?

A urine routine test may be performed for routine health check-ups, to assess fitness for surgery, on suspicion of a disease or to check pregnancy status. It is generally performed when the individual exhibits the following symptoms:

A urine routine test is typically performed to assess the components of urine. It helps detect the presence of any abnormal components or abnormal level of normal components.

Some components that are typically not found in the urine sample of a healthy individual include:

  • Glucose
  • Protein
  • Bilirubin
  • White blood cells
  • Red blood cells
  • Bacteria
  • Crystals

. Many diseases can be diagnosed in early stages with a  urine routine test. These include:

A urine routine test may also be ordered at regular intervals to monitor certain diseases over time.

Except for cleaning the genitals before sample collection, no other special preparations are needed for this test.

Ensure that your doctor is informed about any over-the-counter or prescription medications like antibiotics and supplements that you are taking as it may interfere with the results of urine routine test. E.g., consumption of multivitamins can make the urine bright yellow and interfere with visual analysis. Women should inform the doctor if they are menstruating when they give the sample for urine routine.

About 5-10 mL of urine is collected in a clean container for a urine routine test. It can be collected at any time of the day. However, sometimes, the doctor may recommend collecting the urine sample at a particular time, e.g., first urine of the day because of its high concentration that makes the detection of abnormalities more likely. A doctor may ask you to "clean-catch", i.e., clean the genital area before urine collection. This is because cells and bacteria from the surrounding skin can contaminate urine sample, leading to incorrect results. Women are suggested to spread the labia of vagina and clean the area, whereas men are advised to clean the tip of penis before collecting urine sample. The first few drops are discarded, and then 5-10 mL is collected in a sterile container.

No risk is involved when giving a sample for a urine routine test. Though a temporary discomfort may be experienced in case the sample is to be collected using a catheter.

Urine is analysed by microscopic, chemical and visual examination. These examinations can indicate various things. Visual examination: Although sometimes a change in the colour and appearance of urine is normal, it generally indicates the following:

  • Haziness of urine indicates the presence of white blood cells or bacteria due to an underlying infection.
  • Red-coloured urine or blood in urine may indicate a damage in the urinary tract. A greenish-brown or yellow-brown urine suggests the presence of bilirubin in urine.

Microscopic examination: It may reveal the presence of:

  • Red blood cells: These may be present in the urine due to a urinary tract infection or injury to the urinary tract. Blood in urine may also indicate some critical or chronic condition and warrants further investigations.
  • White blood cells (WBCs): Presence of WBCs  generally indicates an infection or inflammation of the urinary tract.
  • Microorganisms: Presence of bacteria, yeast or a parasites indicates urinary tract infection.
  • Epithelial cells: These can be seen due to an infection, inflammation or malignancy in body.
  • Crystals: Crystals indicate the presence of stones in kidney or urinary tract.

Chemical examination: An excess of any of the following chemical constituents in urine indicates the presence of an underlying condition as given below:

  • Bilirubin: Jaundice and hepatitis
  • Proteins, e.g., albumin: Proteinuria
  • Glucose: Hormonal disorders, pregnancy or liver disease
  • Ketones: Diabetic ketoacidosis
  • Blood or myoglobin: Haemoglobinuria or muscle injury
  • Urobilinogen: Viral hepatitis, liver cirrhosis or liver damage due to certain drugs or toxic substance

Abnormal findings in urine analysis test have many interpretations that should be correlated with the symptoms, e.g., presence of glucose, red blood cells or proteins in urine indicates an underlying condition that needs to be diagnosed and treated. However, a urine routine does not indicate the exact underlying cause of any condition and other tests such as complete blood count, comprehensive metabolic panel, renal panel, liver panel and urine culture should be performed to identify the cause.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. This information is purely from an educational point of view and is in no way a substitute for medical advice by a qualified doctor.

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References

  1. Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. McPherson R, Pincus M, eds. Philadelphia, PA: Saunders Elsevier: 2011, Chapter 28.
  2. Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL eds. (2005) Harrison's Principles of Internal Medicine, 16th Edition, McGraw Hill. Pp 249-251, 1647-1649, 1718-1720.
  3. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Burtis CA, Ashwood ER, Bruns DE, eds. 4th edition, St. Louis: Elsevier Saunders; 2006, 808-812.
  4. the Women's: The Royal Women's Hospital, Victoria, Australia; Your first pregnancy check-up
  5. Australian prescriber: an independent peer review journal; Testing for sexually transmitted infections
  6. Clarke, W. and Dufour, D. R., Editors (2011). Contemporary Practice in Clinical Chemistry , AACC Press, Washington, DC, Pp 397-408.