Analyzed Factor in Urine

Clinical Significance

Principle involved
Double indicator

Reagent Strip Reaction

-Reagent strip measures urine pH between pH 5 to 9 (0.5-1-unit increments) *methyl red pH range of 4-6 (red to yellow) *bromthymol blue- pH range of 6-9 (yellow to blue) -uses the principle of protein error of indicators -more sensitive to albumin

Reagent

Sensitivity

Reaction Interference
- no known substance interferes with pH measurement * just prevent runover: this may produce falsely acidic reading in alkaline pH

pH

-Respiratory/ metabolic acidosis/alkalosis

Methyl red Bromthymol blue

5-9

Protein

-indicative of renal disease -Clinical proteinuria is indicates at 30 mg/dL(300 mg/L) *Prerenal Proteinuria - Bence Jones Protein *Renal Proteinuria - Glomerular Proteinuria > amyloidosis, Pre-eclampsia - Tubular Proteinuria >Fanconi Syndrome -Orthostatic Proteinuria - Microalbuminuria *Postrenal Proteinuria

Protein error of indicators

Multistix: Tetrabromphenol blue Chemstrip: 3,3,5,5 tetrachlorophenol 3,4,5,6tetrabromosulfophthalein

Multistix: 15-30 mg/ dL albumin Chemstrip: 6 mg/dL albumin

-technical error of allowing the reagent pad to remain in contact with the urine for a prolonged period of time *False positive: -Highly buffered alkaline -Pigmented specimens -Quaternary ammonium compounds -antiseptics *False-negative -Proteins other than albumin -microalbuminuria

Glucose

-hyperglycemia -glycosuria -Diabetes mellitus -Gestational diabetes

2 diff. test 1. Glucose oxidase test -specific

-glucose oxidase -peroxidase -chromogen -potassium iodide

Multistix: 75-125 mg/dL Chemstrip: 40 mg/dL

False Positive: - container contaminated with peroxide of strong oxidizing detergents False Negative: -Presence of ascorbic acid -High levels of ketones -High Specific gravity -Reducing sugars such as galactose, lactose, fructose, maltose, pentose -very hygroscopic, therefore should be stored in closed package False pisotive: -Phthalein dyes -pigmented red urine -Levodopa -Medication containing sulfhyfryl groups False negative: -improperly preserved specimen

2.

Copper Reduction test (CuSo4 to Cu2O)

*Clinitest tablet( employ Benedict solution contains -copper sulfate -sodium carbonate -sodium citrate -sodium hydroxide -sodium nitroprusside *in case of ketosis, Acetest tablet is used: -sodium nitroprusside -glycine -disodium phosphate -lactose

200 mg/dL

Ketones

-Ketonuria -Starvation -Malabsorption -Diabetic acidosis

- Sodium nitroprusside reacts with acetoacetic acid gibing purple color

Multistix: 5-10 mg/dL acetoacetic acid Chemstrip: 9 mg/dL acetoacetic acid

Blood