Complete urinalysis

A basic screening test that evaluates urine color, concentration, protein, glucose, leukocytes, nitrites, and cellular content; it is the first step in evaluating urinary tract infection and kidney disease.

Indication

• Suspected urinary tract infection: burning, frequent urination, lower abdominal pain
• Screening and follow-up of kidney disease (proteinuria, hematuria)
• Diabetes screening and follow-up (glucosuria, ketonuria)
• Hypertension and pregnancy follow-up (preeclampsia screening)
• Routine pre-operative assessment
• Suspected liver disease (bilirubin, urobilinogen)
• Monitoring of drug toxicity or rhabdomyolysis

Preparation

• First-morning urine is preferred (the most concentrated sample)
• Genital area is cleaned before collection
• Mid-stream urine technique is used: discard the first stream and collect from the middle
• Sampling during menstruation should be postponed or noted on the request
• The sample should reach the laboratory within 1-2 hours

How it's performed

1. The patient collects a mid-stream urine sample in a sterile container
2. Physical examination: color, appearance, odor, and concentration are assessed
3. Chemical analysis: pH, protein, glucose, ketones, blood, leukocytes, nitrite, bilirubin, and urobilinogen are read with a dipstick (strip)
4. Microscopic examination: centrifuged sediment is examined for leukocytes, red cells, epithelial cells, casts, crystals, and bacteria
5. Findings are reported on a standard form
6. If infection is suspected, confirmation with urine culture is recommended

Post-procedure

• Positive leukocytes and nitrites suggest urinary tract infection; this is confirmed with culture
• If proteinuria is detected, a 24-hour urine collection or spot protein/creatinine ratio may be requested
• Hematuria (blood): confirmed with a repeat test, and imaging may be planned if needed
• Abnormal findings are interpreted by the physician within the clinical context
• A new sample after treatment is recommended for follow-up

Risks

• The procedure is non-invasive and carries no physical risk
• Incorrect collection technique can lead to false positive or false negative results
• Contamination (poor hygiene) can produce a misleading infection finding
• Menstrual blood mixing into the sample can create the false impression of hematuria

FAQ

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