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Urine Complete

Kidney
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Report in 4Hrs

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At Home

nofastingrequire

No Fasting Required

Details

Microscopic and chemical analysis of urine including pH, protein, glucose, RBCs, WBCs, and crystals.

145300

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Urine Complete - Comprehensive Medical Test Guide

  • Why is it done?
    • Screens for urinary tract infections (UTIs) by detecting bacteria, white blood cells, and nitrites in urine
    • Evaluates kidney and bladder function by assessing protein, glucose, and blood in urine
    • Detects systemic diseases such as diabetes, hypertension, and kidney disease
    • Identifies metabolic disorders including diabetes mellitus and liver disease
    • Part of routine health screening during physical examinations and pre-operative assessments
    • Monitors treatment effectiveness in patients with chronic kidney disease or diabetes
    • Performed when patients present with dysuria, frequency, urgency, or other urinary symptoms
  • Normal Range
    • Appearance: Colorless to pale yellow; clear without cloudiness
    • Color: Pale to deep yellow (depends on hydration status)
    • Odor: Slightly aromatic or characteristic urine odor
    • pH: 4.5 to 8.0 (normal is slightly acidic)
    • Specific Gravity: 1.005 to 1.030 (indicates hydration and kidney concentrating ability)
    • Protein: Negative or <150 mg/day (trace amounts may be normal)
    • Glucose: Negative or <5 mg/dL (not normally filtered by kidneys)
    • Ketones: Negative (absent in normal urine)
    • Bilirubin: Negative (should not be present)
    • Urobilinogen: 0.1-1.0 mg/dL (trace to 1 mg/dL is normal)
    • Nitrites: Negative (indicates absence of gram-negative bacteria)
    • Leukocyte Esterase: Negative (absence of white blood cells)
    • Blood/Hemoglobin: Negative (should not be present)
    • Red Blood Cells (RBCs): 0-3 per high-power field (hpf); <5 RBCs/μL
    • White Blood Cells (WBCs): 0-5 per high-power field (hpf); <5 WBCs/μL
    • Epithelial Cells: 0-5 per low-power field (squamous cells; few are normal)
    • Casts: 0-2 hyaline casts per low-power field (may be absent or trace)
    • Crystals: Negative or occasional (presence may indicate kidney stones or metabolic disorders)
    • Bacteria: Absent or none (presence indicates possible infection)
  • Interpretation
    • Appearance and Color Abnormalities:
      • Cloudy urine may indicate UTI, kidney disease, or presence of bacteria and WBCs
      • Red or dark urine suggests hematuria (blood), rhabdomyolysis, or certain medications
      • Brown urine may indicate bilirubinuria or myoglobinuria
      • Very pale or clear urine suggests over-hydration or dilute urine
    • pH Abnormalities:
      • High pH (>8): May indicate UTI with urease-producing bacteria, alkaline diet, or renal tubular acidosis
      • Low pH (<4.5): Suggests acidic urine from high protein diet, diabetes, or metabolic acidosis
    • Specific Gravity Abnormalities:
      • High (>1.030): Indicates dehydration, diabetes mellitus, or acute glomerulonephritis
      • Low (<1.005): Suggests excessive hydration, diabetes insipidus, or chronic kidney disease
    • Protein Positivity:
      • Trace to 1+: May indicate early kidney disease, fever, or intense exercise
      • 2+ or greater: Suggests glomerulonephritis, nephrotic syndrome, or diabetic nephropathy
    • Glucose Positivity:
      • Any positive result: Indicates diabetes mellitus (when fasting), uncontrolled hyperglycemia, or renal threshold dysfunction
    • Ketones Positivity:
      • Positive result: Suggests diabetic ketoacidosis, starvation, severe dehydration, or high-fat diet
    • Bilirubin Positivity:
      • Positive result: Indicates liver disease (cirrhosis, hepatitis), biliary obstruction, or hemolytic anemia
    • Elevated Urobilinogen:
      • Elevated levels: Suggest hemolytic anemia, liver disease, or Crigler-Najjar syndrome
    • Nitrites Positivity:
      • Positive result: Indicates UTI with gram-negative bacteria (E. coli, Klebsiella); 90% specific for bacterial infection
    • Leukocyte Esterase Positivity:
      • Positive result: Suggests white blood cells in urine indicating UTI, pyelonephritis, or glomerulonephritis
    • Blood/Hemoglobin Positivity:
      • Positive result: Indicates hematuria (kidney stones, UTI, glomerulonephritis, prostate disease) or myoglobinuria from rhabdomyolysis
    • Elevated RBCs (>3 hpf):
      • Suggests kidney stones, glomerulonephritis, pyelonephritis, polycystic kidney disease, renal infarction, or bleeding disorders
    • Elevated WBCs (>5 hpf):
      • Indicates UTI, pyelonephritis, glomerulonephritis, interstitial nephritis, or contamination during collection
    • Cellular Casts:
      • WBC casts suggest pyelonephritis or interstitial nephritis
      • RBC casts indicate glomerulonephritis or pyelonephritis
      • Granular casts suggest acute kidney injury, chronic kidney disease, or pyelonephritis
    • Crystals:
      • Calcium oxalate crystals: Suggest hyperoxaluria or kidney stone risk
      • Uric acid crystals: Indicate gout, leukemia, or tumor lysis syndrome
      • Phosphate crystals: Suggest high pH urine or urinary tract infections
    • Bacteria:
      • Moderate to many bacteria: Indicate bacterial UTI (confirmed with culture)
      • Few bacteria with WBCs: Suggest contamination vs. true infection (culture confirmation needed)
  • Associated Organs
    • Primary Organ Systems:
      • Kidneys (primary filtration organ)
      • Urinary bladder and urethra (storage and elimination)
      • Ureteral system (transport)
    • Secondary Systems Affected:
      • Liver (bilirubin metabolism)
      • Pancreas (glucose regulation and metabolism)
      • Immune system (response to infection)
      • Prostate gland (in males; prostatitis can cause pyuria)
    • Common Diseases Associated with Abnormal Results:
      • Urinary Tract Infections (cystitis, pyelonephritis): Positive nitrites, WBC, bacteria
      • Diabetes Mellitus: Glucose and possibly ketones positive
      • Chronic Kidney Disease: Proteinuria, casts, abnormal cellular elements
      • Glomerulonephritis: RBC casts, proteinuria, hematuria
      • Nephrotic Syndrome: Heavy proteinuria (>3.5 g/day), lipiduria
      • Kidney Stones (Nephrolithiasis): Hematuria, crystals, pain
      • Liver Disease: Bilirubinuria, elevated urobilinogen
      • Diabetic Ketoacidosis: Glucose, ketones, and reduced pH
      • Acute Kidney Injury: Variable findings depending on etiology
      • Hemolytic Anemia: Hemoglobinuria, increased urobilinogen
      • Rhabdomyolysis: Myoglobinuria (positive blood but no RBCs)
      • Prostate Inflammation: WBCs, bacteria, pain on urination
      • Gout: Uric acid crystals
    • Potential Complications of Abnormal Results:
      • Untreated UTI may progress to sepsis and organ failure
      • Persistent proteinuria may lead to progressive kidney failure
      • Uncontrolled diabetes can cause diabetic nephropathy
      • Kidney stones can obstruct urine flow and cause kidney damage
      • Untreated glomerulonephritis can rapidly progress to end-stage renal disease
  • Follow-up Tests
    • If Proteinuria is Present:
      • 24-hour urine protein collection for quantification
      • Serum creatinine and BUN (kidney function)
      • Estimated glomerular filtration rate (eGFR)
      • Kidney ultrasound or CT imaging
    • If Hematuria is Present:
      • Cystoscopy (direct bladder visualization)
      • CT or ultrasound imaging of kidneys and urinary tract
      • Coagulation studies (if bleeding disorder suspected)
    • If UTI/Bacteriuria is Suspected:
      • Urine culture and sensitivity (gold standard for diagnosis)
      • Repeat urinalysis after treatment
    • If Glucose is Present:
      • Fasting blood glucose
      • Hemoglobin A1C (diabetes screening)
      • Oral glucose tolerance test (OGTT)
    • If Ketones are Present:
      • Serum or blood beta-hydroxybutyrate (emergency if DKA suspected)
      • Venous or arterial blood gas analysis
      • Serum glucose and electrolytes
    • If Bilirubin/Urobilinogen is Elevated:
      • Serum bilirubin (total and direct)
      • Liver function tests (AST, ALT, ALP, GGT)
      • Abdominal ultrasound or CT imaging
    • If Casts are Present:
      • Serum creatinine and BUN
      • Kidney biopsy (if indicated by clinical findings)
      • Immunological tests (anti-GBM, ANCA, ANA)
    • Monitoring Frequency:
      • Chronic kidney disease: Every 3-6 months or as directed by nephrologist
      • Diabetes patients: Annually or more frequently if changes noted
      • Recurrent UTI patients: After each infection and periodically
      • Routine screening: As part of annual physical examination
  • Fasting Required?
    • Fasting Status: NO - Fasting is not required for urinalysis
    • Specimen Collection Timing: First morning urine is preferred as it is more concentrated and provides better results for detecting abnormalities
    • Collection Method: Clean-catch midstream urine sample (most common) - patient must clean external genitalia with provided wipe, begin urination into toilet, then collect mid-stream into sterile container
    • Special Handling Instructions: Specimen should be delivered to laboratory within 1-2 hours; if delay unavoidable, refrigerate at 2-8°C (not freezing)
    • Medications to Avoid: Generally no medications need to be discontinued; however, some may affect results (inform healthcare provider of all medications): Pyridium (azo dye - colors urine), B vitamins (color urine), rifampicin (orange-colored urine), beets (red urine), phenolphthalein
    • Pre-Test Preparations: Adequate hydration is acceptable and does not affect test validity; avoid excessive fluid intake immediately before testing; women should avoid collecting specimen during menstrual period if possible (may contaminate sample with RBCs); for men with suspected prostatitis, collect after prostate massage if directed
    • Catheterized Specimens: For patients with indwelling catheters, clean-catheterized specimen or suprapubic aspiration may be required for accurate culture results
    • Children and Infants: Special collection bags may be used for infants; suprapubic aspiration may be necessary for suspected UTI in neonates

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