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Positive ResultSignificanceCauseAction
Glucose (raised BS) Found when concentration exceeds renal threshhold. Diabetes Mellitus or glucose infusion Blood glucose. Further action may follow.
Bilirubin Indicates excess of conjugated bilirubin in plasma. Stale urine may give false -ve. Liver cell injury (viral/drug Hep, paracetamol o/d, late stage cirrhosis) Biliary tract obstruction (gallstones, carcinoma of head of pancreas, biliary atresia in infants) Always report for further investigations
Glucose (no raised BS) Not normally detectable in urine. Found when concentration exceeds renal threshhold. Pregnancy or renal glycosuria Perform BS. Further action may be needed.
Ketones Indicates accumulation of acetoacetate secondary to excessive breakdown of body fat. Some drugs e.g. L-dopa may give false +ve. Fasting, particularly with fever and/or vomiting. Most often in children. Diabetic ketoacidosis. Ketotic hypoglycaemia in young children. Urgent action if known diabetic.
Specific Gravity Measure of total solute concentration in urine. In health varies widely according to the need to excrete water and solutes. High: dehydration, impaired kidney function e.g. chronic renal failure Low: high fluid intake, diabetes insipidus, chronic renal failure, hypercalcaemia, hypokalaemia.
Blood May be haematuria (intact blood cells) or haemoglobinuria (excreted from plasma or liberated from red cells in urine) Haematuria: kidney disorder e.g. glomerulonephritis, polycystic kidneys, tumours, infection, benign prostatic enlargement. Haemoglobinuria: severe haemolysis e.g. sickle cell crisis. Report. Follow up pending tests and clinical picture.
pH 4.5 - 8.0 healthy. Low: Diabetic ketoacidosis, starvation, potassium depletion. High: Stale urine, alkalaemia e.g. vomiting and over-consumption of antacids, renal tubular acidosis, UTI with ammonia-forming organisms. Depends on other results.
Protein Test most sensitive to albumin. -ve doesn't rule out other proteins. Acute/chronic glomerulonephritis, UTI, glomerular involvement in systemic lupus, erythematosus, nephrotic syndrome, pre-eclampsia, fever, heart failure, postural (orthostatic) proteinuria. Persistent +ve needs investigation. Consider other tests and clinical picture.
Urobilinogen Combined effects of bilirubin production, its conversion to urobilinogen in gut, and its reabsorption into blood stream. Stale urine gives false -ve Increase: increased production (e.g. sickle cell), decreased uptake by liver (e.g. viral Hepatitis and cirrhosis) Decrease: biliary tract obstruction (e.g. gall stones, pancreatic carcinoma, sterilization of colon by unabsorbable antibiotics e.g neomycin Urgent investigation.
Nitrite Converted from dietary nitrate by UTI enzymes. UTI by nitrite-producing organisms. Absense doesn't exclude UTI. Send specimen for microscopy and culture.
Leucocytes Leucocytes from inflamed tissue are shed in urine. UTI, especially when acute inflammation of UT. Send specimen for microscopy and culture.
Created by: kuc