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Urine Testing - Dealing With Kidney Disorders

Urine Testing - Dealing With Kidney Disorders

Posted By HealthcareOnTime Team Posted on 2021-10-20

What exactly is urine?
urinary pH is produced by the kidneys by filtering out the waste from the bloodstream which helps in regulating the amount of water in the body, conserving proteins, electrolyte, and other compounds that the body can use again. Anything that is not needed by the body is eliminated in the urine, which is usually clear and yellowish in colour, but the colour, quantity, concentration, and content of the Urine will be slightly different each time an individual urinates, due to varying constituents. Many illnesses and disorders associated mostly with the main excretory organ i.e. kidneys, affect this process of elimination, which in turn affects the appearance, concentration, and content of your urine. Therefore, urine testing can aid in the early diagnosis of such disorders.

Urine Testing - Dealing With Kidney Disorders

What is urinalysis?
Urine testing, often referred to as "urinalysis" (urine analysis) is a simple Pathology Test that examines a small sample of your urine. It is used to diagnose and monitor a wide range of disorders including kidneys such as infections, chronic kidney disease, acute kidney failure or kidney stones, urinary tract infections, liver disease and diabetes.

Why is urine testing important?
urine microscopy test can be performed for several reasons as below:
- Asessing the overall health as a part of a routine medical exam, pre-surgery preparation, pregnancy checkup, or on hospital admission to screen for a variety of disorders such as a kidney disease or liver disease.

- To identify the cause of symptoms like abdominal pain, back pain, painful or frequent urination, blood in urine and can aid in the early diagnosis of disorders.

How do you give a urine sample?
Although, urine can be collected at any time of the day, in some cases, a first morning sample may be requested as it is more concentrated and more likely to detect abnormalities. Urine collection usually utilizes the "clean-catch" technique, which helps prevent bacteria from the external genital surface from contaminating the sample and interfering with the test results interpretation. In this technique, the urethra is initially cleaned with water, a few drops of urine are discarded and 30-60 ml of midstream urine is then collected in the sterile container provided. After urine collection, the lid should be closed carefully and touching the inside of the cup should be avoided to prevent contamination. In some cases, it is suggested to use a catheter inserted in the bladder for urine collection which may cause mild discomfort.

Is fasting required for urine test?
No fasting is required before a urine test but the consumption of food that could discolour the urine like beet and food dyes could be avoided before taking the test. It is advised to let the doctor know about all the medications or supplements you are taking beforehand as some drugs might affect the urinalysis results.

Drinking sufficient amount of water before the test is essential, so that an adequate amount of urine sample can be collected for accurate results. However, drinking excessive amount of water may lead to inaccurate results and should be avoided.

What are the types of urine test?
1. Urinalysis It consists of specific physical, it chemical and microscopic tests that detect the presence or/and measure abnormal levels of several substances in the urine, such as byproducts of normal and abnormal metabolism, cells, cellular fragments, and bacteria that might help in early detection of certain disorders or illnesses. A healthy kidney does not allow proteins like urine to pass into the urine but when the kidneys are damaged, it may allow some proteins to leak into the urine which is one of the earliest signs of a kidney disease.

Visual Examination: It involves the visual (macroscopic) examination of the urine sample for colour, clarity and for various abnormalities like:
Clouded appearance-Indicates an infection
Reddish/brownish appearance Indicates the presence of blood in the urine
Foamy appearance- Indicates kidney disorders
Abnormal odours

Dipstick Test: It involves using a dipstick, i.e. a thin plastic strip

treated with chemicals which is dipped into the urine sample to detect abnormalities in its chemical composition. A change in the colour of the dipstick indicates that certain substances are present at a level that is above normal. It not only reveals the presence of a substance, but also estimates how much of the substance is present.

Some of the parameters of a dipstick examination can check for include:

Acidity (pH)-An abnormal pH may be a sign of kidney stones, chronic kidney disease, urinary infections, or other disorders.

Protein- Abnormally high protein levels may be indicative of a kidney problem

Glucose or ketones- A high sugar content or ketones is a marker for diabetes.

WBCs (pus cells).These are signs of infection or inflammation, either in the kidneys or anywhere else along urinary tract.

Bilirubin (a product of RBC breakdown)-Its presence may indicate liver damage or disease.

Blood- It may be a sign of an infection, kidney damage, kidney or bladder stones, kidney or bladder cancer, blood disorders, etc. However, it can also be caused by certain medicines, or even heavy exercise

Nitrites or leukocyte esterase (product of WBCs)- It is indicative of an infection with certain kinds of bacteria or urinary tract infection.

Microscopic Examination: It involves examining a small amount of urine under a microscope to check, identify and measure the substances that are usually absent in normal urine such as:

WBCS-It may indicate an infection or inflammation in the kidneys, bladder or other areas.

RBCS- It may be a sign of kidney disease or kidney stones, infection, a blood disorder (like sickle cell disease) or another underlying medical condition (like bladder cancer).

Bacteria or yeasts. It may be indicative of an infection in the body.

Casts (tube-shaped proteins)- developing a kidney disease, such as They may form as a result of kidney diabetes or high blood pressure. disorders.

Crystals (clumps of minerals) They form from chemicals in the urine and may be a sign of kidney stones.

The sample might be sent for a urine culture if the dipstick test or the microscopic examination shows any abnormality, in order to identify the microorganism that may be causing the infection. Several factors like diet, dehydration, medicines, exercise, etc., can affect the result of urinalysis and one might be asked to produce a fresh sample in such cases.

2. Albumin-to-Creatinine Ratio (urine) or Microalbuminuria tests ACR test helps to measure the levels of albumin (protein in the blood) in the urine. It measures and compares the amount of albumin with the amount of creatinine in the urine sample and if excess amount of albumin (>30mg/g) is found to be eliminated in the urine, it may be a indicative of a kidney disease. Albumin levels can also rise in case of excessive exercise, high blood sugar or bladder infections. Being more sensitive, Microalbuminuria test can be used to detect traces of albumin in urine and is usually suggested for patients having a higher risk of

3. Creatinine Clearance Test a 24-hour sample of urine. is a waste product formed in the body stones. from daily use in the muscles. amount of creatinine in the urine sample is compared to the levels of kidneys in the blood which indicates how much waste the kidneys are filtering out each day and the the overall heath of the kidneys.

Urine analysis might not answer all the questions about one's health as it does not provide a definitive diagnosis, but it provides various clues on the body's condition and health status of various organs of the body, especially the kidneys. An unusual urinalysis report can lead to more tests to understand the root of the problem and therefore, can help to detect various kidney disorders at an earlier stage, before the symptoms start to appear. Early diagnosis would prove to be useful in Successfully treating a serious condition such as kidney damage or kidney stones before it worsens. Hence, if you are asked to "pee in the cup" the next time, you now know how it is related to your kidney's health!


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