Laboratory Examination -clean midstream catch is usually adequate -in children,urine can be collected by placing a urine collection bag over the urethral meatus Examination of urine urinary pH specific gravity protein glucose ketones bilirubin urobilinogen hemoglobin, leukocytes, and nitrites relies on color changes produced by chemical reactions with substances in the urine

Examination of Urine pH - will reflect the pH of the serum Specific gravity – reflects the hydration status of the patient and the concentrating ability of the kidney Proteinuria – indicate intrinsic renal pathology or the presence of excess protein in the serum. Glucose and Ketones – screening for diabetes – greater than 180 mg/dL

Examination of Urine Bilirubin and high levels of Urobilinogen – liver disease or hemolysis. Hemoglobin, myoglobin, and red blood cells – can produce a positive result on dipstick tests for blood. Leukocytes and nitrites – inflammation, which is most commonly caused by a bacterial infection. Leukocyte esterase, – an enzyme found in neutrophils

Urine Culture Greater than 10 5 organisms/mL – UTI 100 organisms/mL of a known urinary pathogen – bacterial infection Antibiotic sensitiviy testing

Tests for Kidney Function Specific gravity – with a progressive decrease in renal function, the specific gravity does not decrease below approximately Creatinine clearance – volume of plasma from which creatinine is completely removed per unit of time and is a clinical approximation of the glomerular filtration rate (GFR) and renal function – Clearance=UV/P – N: 90 to 110 mL/min

Tests for Kidney Function Gold standard for measuring GFR – Inulin is an ideal substance for measuring GFR because it is completely filtered by the kidney without being secreted or reabsorbed by the tubules. – Vs.Creatinine Secreted in small amounts by the proximal tubule. Therefore, creatinine clearance will slightly overestimate GFR at all levels of kidney function. This effect is most pronounced when kidney function is severely compromised, where creatinine clearance can overestimate GFR by as much as 1.5- to twofold.