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| Urine Metabolism Tests |
Urine Metabolism
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URINALYSIS + URINE VITAMIN C
◒ Urinalysis (UA) dipstick, with or without a microscopic examination of centrifuged urine sediment.
The urinalysis consists of three components: the physical (color, appearance, pH, specific gravity); the chemical (leukocyte esterase-LE-, nitrite, pH (a physical component measured chemically), protein, glucose, ketones, urobilinogen, bilirubin, blood (intact RBCs), and hemoglobin (lysed RBCs). Confirmatory tests are performed if protein, ketones, or bilirubin are abnormal on the dipstick. Any abnormal result on the dipstick (except pH) will be followed up with a microscopic analysis of urine sediment. A fresh, first morning urine is preferred. For a midstream-catch specimen, the patient should urinate a small amount of urine into the toilet, then collect urine into the container without stopping the urine stream. Female patients: if specimen may be contaminated with vaginal discharge or menstrual blood, the vaginal area should be thoroughly cleansed by wiping from front to back with moistened towelettes prior to collecting the urine specimen. Note on requisition if patient is currently menstruating. The recommended volume is 20 mL (protected from light), minimum volume required is 15 mL. DO NOT freeze. Refrigerate within 10 minutes of collection. A properly performed urine dipstick analysis will allow screening for urinary tract infections (LE and nitrite), kidney conditions (protein , blood, specific gravity), diabetic problems (glucose and ketones), liver problems (bilirubin and urobilinogen), hemolytic problems (urobilinogen and blood), and acid/base problems (pH). Depending on the test, the result may be reported as negative or positive, 1+ to 4+, mg/dL, EU/dL, trace to large, or in case of pH and specific gravity, a plain number. A microscopic examination of the urine sediment will help confirm some of the dipstick findings and add additional information on the status and location of the Urinary Tract Infection (UTI) problem. Various casts and cells may indicate renal from non-renal conditions. Types of epithelial cells, RBCs and WBCs may also help indicate the state of an infection. In certain cases, yeast and T. vaginalis may be detected in fresh urine ◒ Urine vitamin C, Ascorbic acid
This is a screening test for measuring the amount of vitamin C or ascorbic acid being excreted in the urine. The urine is collected fresh and transported (protected from light) as described for the urinalysis specimen. This test may also be ordered along with the urinalysis as urinalysis + C. The amount of vitamin C excreted in the urine varies with the intake and stress level of the patient. In a 24-hour period, a person on an adequate diet and tissue saturation levels will excrete 20-30 mg/day. People under severe physiological or psychological stress may show a negative, or ZERO urine vitamin C. Since some of the tests on the urine dipstick are inhibited by high levels of vitamin C (glucose, bilirubin, blood), some laboratories use the vitamin C results as a technical help in interpreting these results. Depending on the manufacturer of the strip, the chemical reaction may differ. It is usually some form or modification of the Tillman's reagent. The presence of vitamin C (ascorbic acid) causes a decolorization of the chemical in the test field from a gray-blue to orange. The sensitivity of most strips is 10 mg/dL. |
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