Urinary dipstick

Corticosteroids Hypertension, hyperglycemia, hyperlipidemia, hypokalemia, osteoporosis, avascular necrosis, cataract, weight gain, infections, fluid retention Blood pressure, bone densitometry, glucose, potassium, cholesterol, triglycerides (HDL, LDL) Polyuria, polydipsia, edema, shortness of breath, blood pressure, visual changes, bone pain Urinary dipstick for glucose every 3-6 months, total cholesterol yearly, bone densitometry yearly to assess osteoporosis... 

Consumption of cranberry juice (100-150 ml daily) for 7 weeks was reported to interfere with urinary dipstick tests for glucose and hemoglobin (Kilbourn 1987). 

Urinary Total Protein and Albumin Urinary total protein and albumin have been nsed for decades as glomerular injury biomarkers and, more recently, were qualified as measurements of glomerular filtration and tubular reabsorption function (Ferguson et al., 2008 Bonventre et al., 2010). Compared with blood concentrations of protein/albumin, a small amount of protein and albumin (microalbumin, which is below the albumin detection threshold by the conventional urinary dipstick 30-300 mg/L) enters the filtrate by the glomerulus and is reabsorbed and subsequently catabolized in the normal kidney proximal tubnle (Vaidya et al., 2008 Charlton et al., 2014). Therefore, increased urinary protein/albumin can reflect glomerular injury, tubular injury, or combined effects, though albuminuria can be observed in rats secondary to other effects such as dehydration or hypertensive conditions (Haschek et al., 2013). 

The primary marker of structural kidney damage is proteinuria, even in patients with normal GFR. Clinically significant proteinuria is defined as urinary protein excretion greater than 300 mg/day or greater than 20 mcg/minute in a timed urine collection. Significant proteinuria can also be determined by a spot urine dipstick greater than 30 mg/dL or... 

Drug/Lab test interactions Because false-positive readings were reported with the Ames N-Muitistix SG dipstick test for urinary protein when gabapentin was added to other antiepileptic drugs, the more specific sulfosalicylic acid precipitation procedure is recommended to determine the presence of urine protein. 

A 59-year-old woman presents to an urgent care clinic with a 4-day history of frequent and painful urination. She has had fevers, chills, and flank pain for the last 2 days. Her physician advised her to immediately come to the clinic for evaluation. In the clinic she is febrile (38.5°C [101.3°F]) but otherwise stable and states she is not experiencing any nausea or vomiting. Her urine dipstick test is positive for leukocyte esterase. Urinalysis and urine culture are also ordered. Her past medical history is significant for three urinary tract infections in the past year. Each of these episodes was uncomplicated, treated with trimethoprim-sulfamethoxazole, and promptly resolved. She also has osteoporosis for which she takes a daily calcium supplement. The decision is made to treat her with oral antibiotics for a complicated urinary tract infection with close follow-up. Given her history what would be a reasonable empiric antibiotic choice Depending on the antibiotic choice are there potential drug interactions she should be counseled on ... 

For enzyme inhibition assays, urine is the preferred specimen [4]. Interestingly, Bik can be measured by the inhibition of trypsin in urine but not in plasma. Urinary Bik analysis may also be performed by antibody staining, latex agglutination, and radioimmunoassay (RIA) [4]. Despite the analytical approach used, all Bik forms are measured together. The enzyme inhibition method involves adding known amounts of trypsin to the specimen and monitoring trypsin inhibition. Trypsin activity is assessed by detection of by-products from a cleavable substrate. Dipstick methods are available for the rapid detection of trypsin inhibitors in urine [15, 17 19]. 

Pugia MJ, Sommer R, Corey P, Lott JA, Anderson L, Gleason S, et al. The uristatin dipstick is useful in distinguishing upper respiratory from urinary tract infections. Clin Chim Acta 2004 341 73-81. 

The glucose oxidase method (used in the dipsticks and by many automated analyzers) can show a false positive result in some species (e.g, dog, mouse) with high urinary ascorbate levels or in urine contaminated with hypochlorite (bleach) used as a disinfectant (Finco 1997 Loeb and Quimby 1999). 

Richards D, Toop L, Chambers S and Fletcher L (2005) Response to antibiotics of women with symptoms of urinary tract infection but negative dipstick urine test results double blind randomised controlled trial. British Medical Journal 331(7509) 143. 

A urine dipstick indicates a urinary glucose of >25 mmol/L but is negative for nitrites and leucocyte esterase. 

The urinary tract is normally sterile and dipsticks or reagent test strips are used to detect bacteriuria (presence of bacteria in the urine) by testing for nitrites (all common UTI bacteria convert nitrate to nitrite) or leucocyte esterase (enzyme indicating the presence of white blood cells). 

False positive readings with the Ames N-Multistix SG dipstick test for urinary protein have been reported when gabapentin was administered with other anticonvulsants... 

Imipenem caused positive dipstick tests for leukocytes in patients with agranulocytosis and normal urinary sediments. This phenomenon was reproducible in vitro with imipenem, meropenem, and clavulanic acid. Sulbactam, tazobactam, three penicillins, three cephalosporins, and the basic structures of penicillins, cephalosporins, and monobactams tested negative (50). 

Urine LE and nitrite Does this patient have a urinary tract infection Normal dipstick result Do not send urine to laboratory, look for alternative cause of symptoms Inappropriate antibiotic ti eatment avoided, unnecessary laboratory work avoided... 

Microalbuminuria is defined as an increase in urinary excretion of albumin above the reference mterval for healthy nondiabetic subjects but at a concentration that is not generally detectable by crude clinical tests, such as dipsticks designed to measure total protein. With improved methodology, these low concentrations of albumin can now be measured, and microalbuminuria is now considered a clinically important indicator of deteriorating renal function in diabetic subjects. For example, it is now accepted by both European and U.S. diabetes societies that regular screening... 

WooUiandler S, Pels RJ, Bor DH, Himmelstein DU, Lawrence RS. Dipstick urinalysis screening of asymptomatic adults for urinary tract disorders. I. Hematuria and proteinuria. JAMA 1989 262 1214-9. 

In the past, measurement of the urinary protein excretion rate was accomplished using a 24-hour urine collection in patients at risk for CKD. Use of an untimed "spot" urine sample with either an albumin-specific dipstick or measurement of albumin creatinine ratio is now recommended by some because it is more convenient than the extended-interval urine collection. 

Several biochemical tests have been developed for screening mine for the presence of bacteria. A common dipstick test detects the presence of nitrite in the urine, which is formed by bacteria that rednce nitrate normally present in the urine. False-positive tests are nncommon. False-negative tests are more common and freqnently are cansed by the presence of gram-positive organisms or P. aeruginosa that do not reduce nitrate. Other causes of false tests include low urinary pEf, frequent voiding, and dilute urine. 

Renal failure was usually not suspected and was, in most of the cases, discovered by routine blood testing. Dipstick analysis for proteinuria was negative and urinary sediment was unremarkable. Blood pressure was initially normal in half of the patients. Anemia was present and usually more severe that might be anticipated from the degree of renal failure [19]. Further investigations of renal functions indicated that proximal tubular cells were a primary target in Aristolochia nephropathy. First, some cases presented with a Fan-... 

Lachs MS, Nchamkin I, Edelstein PH, Goldman J, Feinstein AR, Schwartz JS. Spectrum bias in the evaluation of diagnostic tests lessons from the rapid dipstick test for urinary tract infection. Ann Intern Med 1992 117 135-140. 

Despite the introduction of SI unitage (Appendix B), many investigators prefer to use pH values for urine. Bacterial growth may increase urinary pH if analyses are delayed. For critical decisions concerning pH, measurements should be made using a pH meter in preference to a reagent strip or dipstick (Heuter, Buffington, and Chew... 

A dipstick test manufactured by Ames for the simultaneous detection of ketones, glucose, protein and haemoglobin in urine and also for the measurement of urinary pH. 

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