Urine Analysis Ppt Free Download ((TOP))
Therese Cowden
The aim is to obtain a sample (specimen) of urine from the middle of your bladder. Urine does not normally have any germs (bacteria) in it (urine should be sterile). If bacteria are found in the sample, it means that the urine is infected. A midstream specimen of urine (MSU) is best, as the first bit of urine that you pass may be contaminated with bacteria from the skin.
Hold open the entrance to the vagina (your labia). Pass some urine into the toilet. Then, without stopping the flow of urine, catch some urine in a clean (sterile) bottle. (The bottle is usually provided by a doctor or nurse.) Once you have enough urine in the bottle, finish off passing the rest of your urine into the toilet.
Pull back your foreskin then pass some urine into the toilet. Then, without stopping the flow of urine, catch some urine in a clean (sterile) bottle provided by a doctor or nurse. Finish off by emptying the rest of your urine into the toilet.
Some specimen bottles contain a powder which helps the sample last longer for testing (a preservative). If this is the case, a mark on the bottle will indicate the ideal amount of urine. However, if that is difficult, any amount is better than none.
It is important to make sure that you understand what type of specimen your healthcare professional has asked for. An MSU is the most commonly requested sample, but for some tests (eg, chlamydia and gonorrhoea) you will be specifically asked to give the first part of the urine, rather than the middle of the stream.
If it is difficult to aim your urine stream into the bottle, you may use another container such as a jam jar or a disposable plastic cup. You can then pour the urine into the sterile bottle. If you do this, make sure the container you pass water into is as clean as possible. Wash it well and rinse it with boiling water. You should still pass the first part of your urine stream into the toilet. In this way, you are collecting the urine from the bladder.
The usual way is to catch some urine in the specimen bottle whilst the child is passing urine. This is called the clean catch method. For a child who is toilet trained this is fairly straightforward - just be ready with the open bottle as the child passes urine. (Be careful not to touch the open rim of the bottle with your fingers, as this may contaminate the specimen with germs (bacteria) from your fingers.)
For babies or toddlers who are not toilet trained, having some nappy-free time in the hour after a feed can be a good way to catch a urine sample. Gently rubbing the suprapubic area (the very lowest bit of the abdomen, in the middle) with gauze or cotton wool soaked in cold fluid has also been shown to increase the likelihood of successfully getting a sample. -
One method is to place a special absorbent pad in a nappy. Your doctor or nurse will provide the special pad and tell you how to use it. Basically, when you place the pad in the nappy, check the pad every 10 minutes to see if it is wet with urine. Do not leave in for longer than 30 minutes as this may increase the risk of contamination.
Therefore, replace the pad with a fresh one every 30 minutes until urine has been passed. Then, use the syringe provided to suck the urine from the pad. Then, transfer the urine in the syringe into a sterile container. Do not use any other type of pads, cotton wool balls or gauze as they could alter the results.
These are bags which are placed inside the nappy to collect urine. They are stuck to the skin around the genitals. When the infant passes urine, it collects in the bag. You then take off the bag, cut the corner of the bag and pour the urine into the sterile bottle.
The MSU test is primarily performed to check for infection (see above). However, there are occasions when the urine is clear of infection, but other abnormalities are detected, such as blood in the urine.
In the study, part of the NIH-funded Clinical Trials in Organ Transplantation (CTOT), investigators at five clinical sites collected urine samples from 485 kidney transplant recipients from three days to approximately one year after transplantation. Researchers led by Manikkam Suthanthiran, M.D., of Weill Cornell Medical College in New York and Abraham Shaked, M.D., Ph.D., of the University of Pennsylvania School of Medicine, Philadelphia, assessed the urinary cell levels of several biomarkers that previously have been associated with rejection.
Statistical analysis revealed that a group of three urinary biomarkers formed a diagnostic signature that could distinguish kidney recipients with biopsy-confirmed rejection from those whose biopsies did not show signs of rejection or who did not undergo a biopsy. The biomarkers include two messenger RNA molecules that encode immune system proteins implicated in transplant rejection and one noncoding RNA molecule that participates in protein production. The researchers used the signature to assign values to each urine sample and identify a threshold value indicative of rejection. With this test, they could detect transplant rejection with a high level of accuracy. The investigators obtained similar results when they tested a set of urine samples collected in a separate CTOT clinical trial, thereby validating the diagnostic signature.
To determine whether the urine test also could predict future rejection, the scientists analyzed trends in the diagnostic signature in urine samples taken in the weeks before an episode of rejection. The values for patients who experienced rejection increased slowly but steadily leading up to the event, with a characteristic sharp rise occurring approximately 20 days before biopsy-confirmed rejection had occurred. In contrast, the values for patients who did not show any clinical signs of rejection remained relatively constant and under the threshold for rejection. These findings suggest that it might be possible to treat impending rejection before substantial kidney damage occurs.
Urinalysis, a portmanteau of the words urine and analysis,[1] is a panel of medical tests that includes physical (macroscopic) examination of the urine, chemical evaluation using urine test strips, and microscopic examination. Macroscopic examination targets parameters such as color, clarity, odor, and specific gravity; urine test strips measure chemical properties such as pH, glucose concentration, and protein levels; and microscopy is performed to identify elements such as cells, urinary casts, crystals, and organisms.[2]
Urine is produced by the filtration of blood in the kidneys. The formation of urine takes place in microscopic structures called nephrons, about one million of which are found in a normal human kidney. Blood enters the kidney though the renal artery and flows through the kidney's vasculature into the glomerulus, a tangled knot of capillaries surrounded by Bowman's capsule. The glomerulus and Bowman's capsule together form the renal corpuscle. A healthy glomerulus allows many solutes in the blood to pass through, but does not permit the passage of cells or high-molecular weight substances such as most proteins. The filtrate from the glomerulus enters the capsule and proceeds to the renal tubules, which reabsorb water and solutes from the filtrate into the circulation and secrete substances from the blood into the urine in order to maintain homeostasis.[3][4]
Besides excreting waste products, the process of urine formation helps to maintain fluid, electrolyte and acid-base balance in the body. The composition of urine reflects not only the functioning of the kidneys, but numerous other aspects of the body's regulatory processes.[7] The ease with which a urine sample can be obtained makes it a practical choice for diagnostic testing.[8]
Urinalysis involves assessment of the physical properties of urine, such as color and clarity; chemical analysis using urine test strips; and microscopic examination.[9] Test strips contain pads impregnated with chemical compounds that change color when they interact with specific elements in the sample, such as glucose, protein and blood,[10] and microscopic examination permits the counting and classification of solid elements of the urine, such as cells, crystals, and bacteria.[11]
Urinalysis is one of the most commonly performed medical laboratory tests.[12] It is frequently used to help diagnose urinary tract infections[13] and to investigate other issues with the urinary system, such as incontinence.[14] It may be used to screen for diseases as part of a medical assessment. The results can suggest the presence of conditions such as kidney disease, liver disease and diabetes.[12] In emergency medicine urinalysis is used to investigate numerous symptoms, including abdominal and pelvic pain,[15][16] fever,[17] and confusion.[18] During pregnancy, it may be performed to screen for protein in the urine (proteinuria), which can be a sign of pre-eclampsia,[19] and bacteria in the urine, which is associated with pregnancy complications.[16][20] The analysis of urine is invaluable in the diagnosis and management of kidney diseases.[21]
Samples for urinalysis are collected into a clean (preferably sterile) container.[8][22] The sample can be collected at any time of the day,[23] but the first urine of the morning is preferred because it is more concentrated.[24] To prevent contamination, a "midstream clean-catch" technique is recommended, in which the genital area is cleaned before urinating and the sample is collected partway through the urination.[22] Samples can also be collected from a urinary catheter or by inserting a needle through the abdomen and into the bladder (suprapubic aspiration).[25] In infants and young children, urine may be collected into a bag attached to the genital region, but this is associated with a high risk of contamination.[8] If the sample is not tested promptly, inaccurate results can occur because bacteria in the urine will multiply and elements such as cells and casts will degrade. It is recommended that urinalysis is performed within two hours of sample collection if the urine is not refrigerated.[24]
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