Urinalysis

Urinalysis is a series of tests on your pee. If trace amounts of protein are detected, and depending on the person's signs, symptoms and medical history, a repeat urinalysis and dipstick protein may be performed at a later time to see if there is still protein in the urine or if it has dropped back to undetectable levels.
However, isomorphic RBCs are not specific to glomerular disease and can be seen with a number of extraglomerular (AIN and renal cell carcinoma) and extrarenal processes (nephrolithiasis, urologic cancers, urinary tract infections, excessive anticoagulation, etc).
If the dipstick result is positive for blood but no RBCs are found in the urinary sediment when analyzed on urine microscopy, then that indicates myoglobinuria (caused by rhabdomyolysis or myoglobinuric blood test renal failure) or hemoglobinuria (caused by infections such as Plasmodium falciparum or Clostridium welchii, transfusion-related reactions, or paroxysmal nocturnal hemoglobinuria).

Urinalysis interpretation is summarized in TABLE 1, with the first four tests most commonly evaluated for information leading to the diagnosis of UTI.1 At many institutions, a reflex urine culture is sent if the urine meets set criteria regardless of patient symptoms.
If the dipstick test or the microscopic test shows white blood cells, red blood cells, or bacteria (possible signs of a kidney or bladder infection), the doctor may send the urine to a lab for a urine culture to identify the bacteria that may be causing the infection.
The change from urine microscopy to urinary flow cytometry has been accompanied by a significant decrease in imprecision ( 15 ). Because urinalysis test strips are often used for checking urinary flow cytometry data ( 11 ), there is a need for a more quantitative evaluation of urinalysis test strips.

Tests done include the following; PVR which shows the amount of urine left after urination, urinalysis or urine content which reveals the bacteria that caused the UTI, X-rays with contrast dye, urinary stress test, cystoscopy, urodynamic studies and for women a pelvic or abdominal ultra sound test.
Imaging tests, such as an ultrasound, computed tomography (CT) , or magnetic resonance imaging (MRI) , may be also be used to determine whether the problem is located before the kidneys (pre-renal), in the kidneys (renal), or after the kidneys (post-renal).
In addition, it can provide useful information related to screening and diagnosis of other conditions, including malignancy, proteinuria, glycosuria, ketonuria, and renal calculi.1 Accurate interpretation of urinalysis results is a key concept for health care providers in order to diagnose and treat patients appropriately.

A simple, color-changing paper test, dipped into the specimen, can measure levels of glucose, blood, protein and other chemicals, which in turn can indicate evidence of kidney disease, diabetes, urinary tract infections and even signs of bladder cancer.
Hemoglobinuria is suggestive of in vivo hemolysis, but must be distinguished from hematuria In case of hemoglobinuria, a urine dipstick shows presence of blood, but no RBCs are seen on microscopic examination. Urinary Tract Infections are one of the most common causes of healthcare visits.

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