Reagent strip
pH, Protein, Glucose, Ketones, Blood, Bilirubin, Urobilinogen, Nitrite, Leukocytes (WBCs), SG
When is QC preformed
minimun 24hrs (some hospitals run 8)
Sensitivity
the smallest concentration of a substance that can be reliably measured by a particular analytical method
Specificity
a test’s ability to detect only the substance being tested; Negativity in the absence of disease
pH
1st morning specimen is highly acidic, pH = 5 - 6
Alkaline tide – more alkaline pH following meals
Considered Normal = 4.5 – 8.0
Aid in determining existence of systemic acid-base disorders of metabolic or respiratory origin
pH diet
High protein & meat = acidic
High vegetables & fruits = alkaline
pH color
Methyl red = red – yellow = 4 – 6
Bromothymol blue = yellow – blue = 6 – 9
Protein
Proteinuria - most indicative of renal disease
Normal is < 10 mg/dL
Albumin – low molecular weight protein, major serum protein found in urine, most is reabsorbed by tubules
Tamm-Horsfall protein (uromodulin) – produced by renal tubular epithelial cells
Prerenal Proteinuria
Caused by conditions affecting plasma prior to reaching the kidney – NOT Indicative of actual renal disease
Reneal proteinuria
associated w/ true renal disease, may be the result of either glomerular or tubular damage
Glomerular proteinuria
Glomerular membrane damage = increased serum protein & RBCs & WBCs in urine
Microalbuminuria
Diabetes 1&2 may cause diabetic nephropathy & may lead to reduced glomerular filtration & possibly renal failure
Onset of renal complications can be predicted by detection
Associated w/ increased risk of cardiovascular disease
Orthostatic (postural) proteinuria
persistent benign proteinuria following periods spent in vertical position & disappears when horizontal
Tubular proteinuria
Due to exposure to toxic substances & heavy metals, severe viral infections and:
Fanconi syndrome - rare kidney disorder
Postrenal Proteinuria
Added when passed through ureters, bladder, urethra, prostate, vagina
Bacteria & fungal infections & inflammation produce exudates (cells & fluid from blood vessels) w/ protein from interstitial fluid (fluid surrounding cells)
Blood from injury or menstrual contamination contains protein as does sperm & prostatic fluid
Protein reagent strip
As protein increases color goes from yellow (negative) to green to blue at a pH of 3
Confirmatory test for protein
sulfosalicylic acid
Glucose
Early diagnosis of diabetes mellitus through blood & urine glucose tests improves prognosis
Almost all glucose filtered by glomerulus is reabsorbed by proximal convoluted tubule
Confirmatory test for glucose
copper reduction test
Gestational Diabetes –
Gestational Diabetes – hyperglycemia during pregnancy
Glycogenesis –
Glycogenesis – insulin converts glucose to glycogen for storage
Glycogenolysis –
Glycogenolysis – breakdown of glycogen to glucose
Renal Glycosuria –
Renal Glycosuria – glycosuria occurring in absence of hyperglycemia due to compromised renal tubules
Hyperglycemia
Hyperglycemia -tubular transport of glucose reached renal threshold (160-180 mg/dL) = glucose in urine
