Urine Test Strip Parameters And Possible Pathologies 1 2 3 4 5 6 7 8 9 10 System Parameter Genitourinary Hepatobiliary Renal Dysfunction Hyponatremia in hepatic cirrhosis • Renal failure 1 Specific Gravity • Tubulointerstitial disease (edema, infiltrate, fibrosis) except when nephrogenic diabetes insipidus is present (e.g., in sickle cell disease, toxic nephritis, pyelonephritis, nephrosclerosis) Gastrointestinal Nausea and vomiting-induced dehydration may alter urine concentration Cardiovascular Hyponatremia in congestive heart failure Hypertension Hormonal, Metabolic, and Other Systems Environmental (Diet, Drugs, Stress) Clinical disorders of water and sodium metabolism (e.g. hypernatremia, dehydration, nephrogenic diabetes insipidus, hyponatremia, water excess, syndrome of inappropriate ADH secretion, toxemia/eclampsia of pregnancy) Diabetes mellitus Protein malnutrition Collagen disease Diuretic-induced functional tubular impairment Radiographic dye injection Up in: • Alkalosis (metabolic, respiratory) Up in: • Diet high in vegetables, citrus fruits • Alkalizing drug use (sodium bicarbonate, acetazolamide) • Functional tubular impairment (e.g. in nephrogenic diabetes insipidus, Fanconi’s Syndrome, osmotic diuresis, diureticinduced potassium deficiency, hypercalcemia) 2 3 4 5 6 7 8 9 10 Urine pH Up in: • Pyloric obstruction • Vomiting Up (<pH 6) in: • Renal failure • Bacterial infection (e.g., Proteus bacteriuria) • Renal tubular acidosis Down in: • Acidosis (metabolic, respiratory, diabetic) • Pulmonary emphysema • Dehydration Down in: • Diarrhea • Malapsorption Down in: • Diet high in meats or other protein, cranberries • Starvation • Acidifying drug use (ammonium chlo ride, methanamine mandelate therapy) Leukocytes Renal infection/inflammation • Acute/chornic pyelonephritis • Glomerulonephiritis • Urolithiasis • Tumors • Lower urinary tract infection (cystitis, urethritis, prostatitis) Phenacetin-induced nephritis Nitrite Bacteriuria • Urinary tract infection (cystitis, urethritis, prostatitis, pyelonephritis) Congestive heart failure Gout Hypokalemia Pre-eclampsia Severe febrile infection Nephrotoxic drugs Protein Renal/glomerular/tubular disease • Glomerulonephritis • Glomerulosclerosis (e.g. in diabetes) • Nephrotic Syndrome • Pyelonephritis • Renal tuberculosis Myocardial infarction Diabetes mellitus Hemochromatosis Hyperthyroidism Cushing Syndrome Pheochromocytomas Sudden shock or pain Steriod therapy Glucose Renal glycosuria (e.g., during pregnancy) Renal tubular disease (e.g., in Fanconi’s Syndrome) Decreased renal glucose threshold (e.g., in old age) Vomiting Diarrhea Diabetic ketosis Glycogen-storage disease Eclampsia Acute fever Weight-reducing diet Ketogenic diet (e.g., anticonvulsant therapy) Starvation Note: May be negative with inhibition of intestinal flora by antimicrobial agents. Sickle cell anemia Hemolytic disease • Pernicious anemia Leptospirosis Ketones Liver cell damage Chronic liver stasis Cirrhosis Dubin-Johnson Syndrome Note: May be zero or down in biliary dysfunction Uribilinogen • • • • Bilirubin Blood Erythrocytes (Hematuria) Hemoglobin Renal infection/inflammation/injury • Renal tuberculosis • Renal infarction • Calculi (urethral, renal) • Polycystic kidneys • Tumors (bladder, renal, pelvis, prostrate) • Salpingitis • Cystitis Renal intravascular hemolysis Acute glomerulonephritis Color Compensation Pad Biliary dysfunction Gallstones Obstructive jaundice Hepatitis (viral toxic) Dubin-Johnson Syndrome Cirrhosis Hemolytic disease Leptospirosis Colon tumor Diverticulitis Bacterial endocarditis Blood dyscrasias • Hemophilia • Thrombocytopenia Sickle cell anemia Disseminated Lupus Erythematosus Malignant hypertension Hemolytic disease Plasmodium (malaria) Clostridia (tetanus) infection Hemorrhagenic drugs (e.g., enticoagulant, salicylates) Nephrotoxic agents Internal injury or foreign body Vitamin C or K deficiency Overexertion Exposure to cold Incompatible blood transfusion Drug-induced hemolysis System “subtracts” background color, enhancing accuracy by reducing false positives. For more information or a distributor near you, call 1-800-428-2336. Technical Support: 1-800-428-4674. © 2002, Roche Diagnostics Corporation. All rights reserved. 311-15613-0502 *Reagent strip detection of an abnormal urine constituent or concentration characteristic of disease, e.g., glycosuria in diabetes mellitus, may provide a useful screen or monitor but requires confirmation by other laboratory and clinical evidence. This construction is representative of all strip types. Some strip types do not include all the pads shown here. Adapted from: 1. Conn, HF and Conn, RB (eds): Current Diagnosis 5, WB Saunders Co., Philadelphia, 1977. 2. Davidson, I and Henry, JB (eds): Todd-Sanford Clinical Diagnosis by Laboratory Methods. Ed 16, WB Saunders Co., Philadelphia, 1974. 3. Raphael, SS, et al” Lynch’s Medical Laboratory Technology, ed. 3, WB Saunders Co., Philadelphia, 1976. 4. Wallach, J: Interpretation of Diagnostics Tests, ed. 2, Little, Brown & Co., Boston, 1974. 5. Widmann, FK: Goodales Clinical Interpretation of Laboratory Tests, ed. 7, FA Davix Co., Philadelphia, 197. 6. Merck Manual of Diagnosis and Therapy, Volume I, General Medicine, Fifteenth Edition, 1987, Ch. 146, Clinical Evaluation of Genitourinary Disorders. Pg. 738-9, 741, 1025. Information compiled by John Wilson, PhD, Department of Clinical Pathology, William Beaumont Hosptial, Royal Oak, MI.