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Lab Dept:
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Urine/Stool
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Test Name:
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URINALYSIS (UA)
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General Information
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Lab Order Codes:
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UA
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Synonyms:
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Urinalysis, Routine
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CPT Codes:
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81001 - Urinalysis, automated with microscopy
81003 - Urinalysis, automated without microscopy
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Test Includes:
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Bilirubin, blood, clarity, color, glucose, ketones, leukocyte esterase, nitrite, pH, protein, specific gravity, and urobilinogen
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Logistics
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Test Indications:
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Useful as a screen for abnormalities of urine; diagnosing and managing renal diseases, urinary tract infections, urinary tract neoplasms, systemic diseases, inflammatory or neoplastic diseases adjacent to the urinary tract and dehydration.
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Lab Testing Sections:
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Urinalysis
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Phone Numbers:
Minneapolis:
Saint Paul:
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612-813-6280
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651-220-6550
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Test Availability:
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Daily, 24 hours
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Turnaround Time:
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2 hours
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Special Instructions:
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Send to lab within 30 minutes of collection.
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Specimen
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Specimen Type:
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Urine
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Container:
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Urine cup
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Draw Volume:
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Prefer 10 mL urine (Minimum: 1 mL may limit extent of testing)
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Processed Volume:
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Entire volume submitted
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Collection:
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A specimen collected by catheterization is optimal; however, a clean-catch or mid-stream specimen is also acceptable. Random, voided specimens will be accepted, but are the least desirable and are not recommended if a urine culture is also being requested. In all cases, a first morning specimen is most desirable.
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Special Processing:
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N/A
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Patient Preparation:
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Collect a clean-catch urine specimen as follows:
Males: Clean glans with soap and water. Rinse area with wet gauze pads. While holding foreskin retracted, begin voiding. After several mL’s have passed, collect midstream portion without stopping flow of urine. Place the cap on the cup and tighten securely. Refrigerate specimen after collection and promptly forward to the lab.
Females: Thoroughly clean urethral area with soap and water. Rinse area with wet gauze pads. While holding labia apart, begin voiding. After several mL’s have passed, collect midstream portion without stopping the flow of urine. Place the cap on the cup and tighten securely. Refrigerate specimen after collection and promptly forward to the lab.
Note: Indicate type of specimen (catheterized or void) and time of collection on the label.
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Sample Rejection:
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Contamination with feces; urine in cotton balls; specimen decomposition (e.g., pH >9.0); bacterial overgrowth; mislabeled or unlabeled specimens
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Interpretive
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Reference Range:
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Urine Chemistries:
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Blood:
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Negative
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Bilirubin:
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Negative
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Clarity:
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Clear to slightly hazy
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Color:
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Light yellow to amber
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Glucose:
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Negative
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Ketones:
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Negative
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Leukocyte esterase:
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Negative
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Nitrite:
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Negative
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pH:
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5 - 8 pH units
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Protein:
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Negative
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Specific gravity:
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<30 days:
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1.002 – 1.004
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30 days – 1 yr:
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1.002 – 1.006
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≥1 year:
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1.001 – 1.030
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Urobilinogen:
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0.1 – 1.0 Ehrlich Units
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Microscopic:
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RBC:
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0 - 3/hpf
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WBC:
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3 - 5/hpf
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Epithelial cells:
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Only Squamous (unless catheterized)
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Casts:
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0 - 2 hyaline casts
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Crystals:
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Few Calcium oxalate; few amorphous urates or phosphates
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Mucus:
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None to slight
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Bacteria:
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None to few/hpf (none for catheterized specimens)
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Yeast:
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None
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Critical Values:
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N/A
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Limitations:
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Insufficient volume, <1 mL, may limit the extent of procedures performed. Metabolites of Pyridium® may interfere with the dipstick reactions by producing color interference. High Vitamin C intake may cause an underestimate of glucosuria, or a false-negative nitrate test. Survival of WBC's is decreased by low osmolality, alkalinity, and lack of refrigeration. Formed elements in the urine including casts disintegrate rapidly; therefore the specimen should be analyzed as soon as possible after collection. Specific gravity is affected by glucosuria, mannitol infusion, or prior administration of iodinated contrast material for radiologic studies. False-positive tests for protein can also be due to contamination of the urine by an ammonium-containing cleansing solution.
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Methodology:
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Multistix® SG and light microscopy
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References:
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Howaritz PJ, et al (1977) Timeliness of Urinalysis, Arch Path Lab Medicine, Vol 121: 667-671
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Strasinger S (1989) Urinalysis and Body Fluids 2nd ed, FA Davis Company
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Brunzel N (1994) Urine and Body Fluid Analysis, WB Saunders Company
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Ringsrud K, et al (1995) Urinalysis and Body Fluids: A Color Text and Atlas, Mosby
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Updates:
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1/26/2006: Prefered volume changed from 5 mL to 10 mL.
6/13/2012: Reference range update. Expanded ages and upper limit for ≥1 year. Upper limit previously listed as 1.035.
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