Urinalysis
Also known as: urine dipstick, urine test, dipstick
A plastic strip with chemical pads dipped into a fresh urine sample. In sixty seconds it screens for infection, blood, protein, glucose, ketones and how concentrated the urine is, with microscopy for cells and crystals when needed.
- Abbreviations
- UA
- Kind
- Test panel
- Categories
- Kidney & urinary, Point-of-care & home testing
- Specimen
- Midstream urine
- Method
- Dipstick, Microscopy
- Terminology
- LOINC 24356-8
- Type
- Urine test
- Sample
- A midstream urine sample
- Used for
- Urinary infection, kidney disease, diabetes screening, pregnancy checks
- Measures
- Chemical pads for leucocytes, nitrite, blood, protein, glucose, ketones, concentration and acidity; cells and crystals on microscopy
- Result
- Semi-quantitative dipstick pads (negative to 3+), specific gravity and pH, plus microscopy when requested
Why is it used?
- Burning, frequency or urgency (suspected infection)
- Abdominal or loin pain
- Screening in diabetes, high blood pressure and pregnancy
- Unexplained fever in children and older adults
- Kidney disease monitoring
What does it measure?
| Component | What it measures | A higher value may be seen in | A lower value may be seen in |
|---|---|---|---|
| Leucocyte esterase leuc | White cells in the urine | Urinary infection, inflammation of the urinary tract, contamination | Not applicable |
| Nitrite nit | Bacteria that convert nitrate to nitrite | Infection with common gut bacteria (E. coli); a negative result does not exclude infection | Not applicable |
| Blood | Red cells or free haemoglobin/myoglobin | Infection, stones, glomerular disease, tumours, menstruation, exercise, muscle breakdown | Not applicable |
| Albumin Protein | Mainly albumin leaking from the kidney | Kidney disease, diabetes, hypertension, pre-eclampsia, fever, exercise; confirmed with an albumin-to-creatinine ratio | Not applicable |
| Blood glucose Glucose | Glucose spilling over from blood | Diabetes, SGLT2 inhibitor treatment, pregnancy, rare kidney tubular disorders | Not applicable |
| Ketones | Fat-breakdown products | Fasting, diabetic ketoacidosis, low-carbohydrate diets, vomiting | Not applicable |
| Specific gravity and pH SG/pH | Concentration and acidity of the urine | Dehydration (high specific gravity); alkaline urine with some infections and diets | Dilute urine: high fluid intake, diabetes insipidus, kidney concentrating defects |
A high or low value can be associated with several different situations; the result is interpreted with other results, symptoms, history and clinical findings.
How is it performed?
Midstream urine into a clean pot; dipped immediately or sent for microscopy and culture.
Specimen. Midstream urine in a clean container, tested fresh
Do I need to prepare?
Clean the area and catch the middle of the stream; first-morning samples are most concentrated.
What do the results generally mean?
| Finding | What it may indicate |
|---|---|
| Nitrites plus leucocytes with symptoms | Likely urinary tract infection; a culture confirms the organism |
| Blood and protein together | Glomerular disease: needs kidney function tests and specialist review |
| Glucose positive | Check blood glucose for diabetes (or SGLT2 inhibitor treatment) |
| Ketones with high glucose | Possible diabetic ketoacidosis, an emergency |
What can affect the result?
- Contamination from the genital area or menstrual blood
- Delay before testing (bacteria multiply, cells break down) and exposure of the strip to air
- Very dilute or very concentrated urine
- Vitamin C can cause false negatives for blood and glucose; some antibiotics and dyes discolour the sample
- Vigorous exercise, fever and dehydration cause transient protein or blood
Medicines. SGLT2 inhibitors put glucose in the urine by design; nitrofurantoin and some other drugs discolour it; vitamin C causes false negatives; NSAIDs and lithium can cause protein or blood.
What can the test not tell you?
- Whether bacteria in the urine are causing illness: older adults often carry bacteria without infection and should not be treated on the dipstick alone
- How much protein is leaking (quantified by an albumin-to-creatinine ratio)
- The cause of blood in the urine, which needs microscopy, imaging and sometimes cystoscopy
Dipsticks in older adults often show bacteria without infection (asymptomatic bacteriuria) and should not drive antibiotics on their own. Menstrual blood and vigorous exercise cause false positives for blood.
Other tests commonly used with it
Medicines monitored with this test
Each medicine page cites the official document that names this test in its monitoring plan.
Catalogued concepts this page covers
Concepts of the master test taxonomy that resolve to this page; each links to its category.