Urinalysis DiagnosisPresence Disease Advantages/DisadvantagesLeukocytes Rule out Urinary Tract

Infection associated with acute interstitial nephritis, exudative glumerulonephritis, severe pyelonephritis

Normally Negative

Nitrite suggestive of bacteria in urineurinary tract infection

Normally Negativepresence of nitrate indicates nitrate reducing bacteria such as Veillonellae, Haemophilus, Staphylococci, Corynebacteria, Lactobacilli, Flavobacteria and Fusobacteria

Urobilinogen possible liver disease (hepatitis)elevated levels may indicate hemolytic anemia (excessive RBC breakdown), overburdening of the liver, increased urobilinogen production, re-absorption-a large hematoma, restricted liver function, hepatic infection, poisoning or liver cirrhosis

Urine test:lower limit: 0.2upper limit:1.0

increase in urobilinogen levels are indication of impaired intrahepatic urobilinogen cycle (liver damage)Urobilinogen is converted to yellow pigmented Urobilin apparent in urineUrobilinogen remaining in the intestine (stercobilinogen) is oxidized to brown stercobilin. This gives feces its characteristic color

Protein Globular proteinuriaTubular proteinuriadetectable protein rules out kidney damage, increased glomerular permeability (from fever cardiac disease, CNS disease, shock, muscular exertion), blood in urine, inflammation, cancers,

Normally absentpresence of albuminAlbustix test-since protein are macromolecules, they are not normally present in urine. detection indicates permeability of the glumerulus is abnormally increased. This can be

infection. caused by renal infections, diabetes mellitus, jaundice or hyperparathyroidismhigh concentration of very small proteins can also show up in the urine such as Bence Jones protein, hemoglobin monomers and myoglobin,up to 10% of children can have protein in their urine. Sometimes this is due to colostral antibodies.

pH too high: Alkaline-rule out diets high in vegetables and urinary tract infections (bacteria converts urine to ammonia)too low: Acid-rule out diets high in protein and refined carbohydrates, anorexia and starvation.

normally 5 to 7measure of hydrogen ion concentration (acidity or alkalinity)if results conclude alkalinity, it is suggested to increase intake of protein and junk foods for 2-3 days

Blood Hematuria-associated with kidney stones, infections, tumors and other conditionsPyuria-associated with urinary infectionsEosinophiluria-associated with allergic interstitial nephritis, atheroembolic diseaseRBC casts-associated with glumerulonephritis, vasculitis, malignant hypertensionWBC casts-associated with acute interstitial nephritis, exudative glumerulonephritis, severe pyelonephritis

Reference range for urine test:

Lower limit

Upper limit

Red blood cells

0 2 -3

RBC casts

n/a 0/negative

White blood cells

0 2

rule out infections, kidney stones, trauma and bleeding from bladder or kidney tumors

Specific Gravity Increased: Dehydration Fever

normal SpG is 1.005 – 1.030 Falsely decreased

Vomiting Diarrhea Diabetes Mellitus

and other causes of Glycosuria

Congestive Heart Failure

Synrome Inappropriate ADH Secretion (SIADH)

Adrenal insufficiency

Decreased: Diabetes Insipius Excessive

hydration Glomerulonephritis Pyelonephritis Diuretics Adrenal

insufficiency Aldosteronism

specific gravity may be caused by Alkaline urineFalsely increased specific gravity may be caused by Intravenous dextran or raiopague dye and proteinuriaSpecific Gravity is an important indication if you’re hydrated or dehydratedif urine is under 1.007, you are hydrated. If urine is above 1.010, you are dehydrated.

Ketone Diabetes MellitusDiabetic Ketoaciosis

Normally Absentaccumulation in blood is due to excess of fatty acid (collectively known as ketone bodies) that was unable to metabolize in the body, and is excreted in the urine (ketonuria)also present if patient is fasting

Bilirubin possible liver disease and RBC breakdownHepatitisCirrhosisobstruction of the common bile duct as with gallstonesjaundiceintravascular hemolysisHemoglobinuriatubular cell conjugation of free bilirubin

Normally Absent. Liver clear up this pigmentabnormally high level of blood bilirubin may result from an increased rate of red blood cell destructionthe presence of conjugated bilirubin in detectable amounts does not enable one to confidently between hepatocellular and obstructive jaundice, but

does not commonly occur when hyperbilirubinemia is consequent to hemolysisAscorbic acid in urine gives false negative reaction in reagent strips and tablets.Phenothiazines may cause false positive reaction in both cases.

Glucose Diabetes MellitusRenal Glycosuriarules out kidney disease (decreased tubular reabsorption), acromegaly, hyperpituitarism, bovine milk fever, bovine neurologic disease, excessive insulin dosage, fear or exertional catecholamine release, Fanconi-like syndrome, moribund animals, sheep endotoxemia, and drugs such as ACTH, glucocorticoids, fluids, ketamine, morphine, phenothiazine and xylazine.

Normally AbsentGlucose is usually not detectable because ketones, ascorbic acid or other substances found in urine may cause false negative results by reagent strips even when urinary glucose approaches clearly abnormal valueswhen a hexokinase reagent strip is used, glucose concentrations below 2 mg/dl in morning urine from a fasting person correlate well with urinary tract infection.