Urine Samples
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A urine test is any
medical test A medical test is a medical procedure performed to detect, diagnose, or monitor diseases, disease processes, susceptibility, or to determine a course of treatment. Medical tests such as, physical and visual exams, diagnostic imaging, genetic ...
performed on a
urine Urine is a liquid by-product of metabolism in humans and many other animals. In placental mammals, urine flows from the Kidney (vertebrates), kidneys through the ureters to the urinary bladder and exits the urethra through the penile meatus (mal ...
specimen. The analysis of urine is a valuable diagnostic tool because its composition reflects the functioning of many body systems, particularly the
kidney In humans, the kidneys are two reddish-brown bean-shaped blood-filtering organ (anatomy), organs that are a multilobar, multipapillary form of mammalian kidneys, usually without signs of external lobulation. They are located on the left and rig ...
s and
urinary system The human urinary system, also known as the urinary tract or renal system, consists of the kidneys, ureters, urinary bladder, bladder, and the urethra. The purpose of the urinary system is to eliminate waste from the body, regulate blood volume ...
, and specimens are easy to obtain. Common urine tests include the routine
urinalysis Urinalysis, a portmanteau of the words ''urine'' and ''analysis'', is a Test panel, panel of medical tests that includes physical (macroscopic) examination of the urine, chemical evaluation using urine test strips, and #Microscopic examination, m ...
, which examines the physical, chemical, and microscopic properties of the urine;
urine drug screen A drug test (also often toxicology screen or tox screen) is a technical analysis of a biological specimen, for example urine, hair, blood, breath, sweat, or oral fluid/saliva—to determine the presence or absence of specified parent drugs o ...
ing; and urine pregnancy testing.


Background

The value of urine for diagnostic purposes has been recognized since ancient times. Urine examination was practiced in
Sumer Sumer () is the earliest known civilization, located in the historical region of southern Mesopotamia (now south-central Iraq), emerging during the Chalcolithic and Early Bronze Age, early Bronze Ages between the sixth and fifth millennium BC. ...
and
Babylonia Babylonia (; , ) was an Ancient history, ancient Akkadian language, Akkadian-speaking state and cultural area based in the city of Babylon in central-southern Mesopotamia (present-day Iraq and parts of Kuwait, Syria and Iran). It emerged as a ...
as early as 4000 BC, and is described in ancient
Greek Greek may refer to: Anything of, from, or related to Greece, a country in Southern Europe: *Greeks, an ethnic group *Greek language, a branch of the Indo-European language family **Proto-Greek language, the assumed last common ancestor of all kno ...
and
Sanskrit Sanskrit (; stem form ; nominal singular , ,) is a classical language belonging to the Indo-Aryan languages, Indo-Aryan branch of the Indo-European languages. It arose in northwest South Asia after its predecessor languages had Trans-cultural ...
texts. Contemporary urine testing uses a range of methods to investigate the physical and biochemical properties of the urine. For instance, the results of the routine
urinalysis Urinalysis, a portmanteau of the words ''urine'' and ''analysis'', is a Test panel, panel of medical tests that includes physical (macroscopic) examination of the urine, chemical evaluation using urine test strips, and #Microscopic examination, m ...
can provide information about the functioning of the
kidneys In humans, the kidneys are two reddish-brown bean-shaped blood-filtering organs that are a multilobar, multipapillary form of mammalian kidneys, usually without signs of external lobulation. They are located on the left and right in the retro ...
and
urinary system The human urinary system, also known as the urinary tract or renal system, consists of the kidneys, ureters, urinary bladder, bladder, and the urethra. The purpose of the urinary system is to eliminate waste from the body, regulate blood volume ...
; suggest the presence of a
urinary tract infection A urinary tract infection (UTI) is an infection that affects a part of the urinary tract. Lower urinary tract infections may involve the bladder (cystitis) or urethra (urethritis) while upper urinary tract infections affect the kidney (pyel ...
(UTI); and screen for possible
diabetes Diabetes mellitus, commonly known as diabetes, is a group of common endocrine diseases characterized by sustained high blood sugar levels. Diabetes is due to either the pancreas not producing enough of the hormone insulin, or the cells of th ...
or
liver disease Liver disease, or hepatic disease, is any of many diseases of the liver. If long-lasting it is termed chronic liver disease. Although the diseases differ in detail, liver diseases often have features in common. Liver diseases File:Ground gla ...
, among other conditions. A urine culture can be performed to identify the bacterial species involved in a UTI. Simple point-of-care tests can detect
pregnancy Pregnancy is the time during which one or more offspring gestation, gestates inside a woman's uterus. A multiple birth, multiple pregnancy involves more than one offspring, such as with twins. Conception (biology), Conception usually occurs ...
by identifying the presence of beta-hCG in the urine and indicate the use of
recreational drugs Recreation is an activity of leisure, leisure being discretionary time. The "need to do something for recreation" is an essential element of human biology and psychology. Recreational activities are often done for enjoyment, amusement, or plea ...
by detecting excreted drugs or their metabolites. Analysis of abnormal cells in urine (
urine cytology Urine cytology is a test that looks for abnormal cells in urine under a microscope. The test commonly checks for infection, inflammatory disease of the urinary tract, cancer, or precancerous conditions. It can be part of a broader urinalysis. If a ...
) can help to diagnose some
cancer Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...
s, and testing for organic acids or
amino acids Amino acids are organic compounds that contain both amino and carboxylic acid functional groups. Although over 500 amino acids exist in nature, by far the most important are the Proteinogenic amino acid, 22 α-amino acids incorporated into p ...
in urine can be used to screen for some
genetic disorder A genetic disorder is a health problem caused by one or more abnormalities in the genome. It can be caused by a mutation in a single gene (monogenic) or multiple genes (polygenic) or by a chromosome abnormality. Although polygenic disorders ...
s.


Specimen collection

The techniques used to collect urine specimens vary based on the desired test. A random urine, meaning a specimen that is collected at any time, can be used for many tests. However, a sample collected during the first urination of the morning (first morning specimen) is preferred for tests like urinalysis and pregnancy screening because it is typically more concentrated, making the test more sensitive. Because the concentration of many substances in the urine varies throughout the day, some tests require timed urine collections, in which the patient collects all of their urine into a container for a given period of time (commonly 24 hours). A small amount of the specimen is then removed for testing. Timed collections are commonly used to measure
creatinine Creatinine (; ) is a breakdown product of creatine phosphate from muscle and protein metabolism. It is released at a constant rate by the body (depending on muscle mass). Biological relevance Serum creatinine (a blood measurement) is an impor ...
,
urea Urea, also called carbamide (because it is a diamide of carbonic acid), is an organic compound with chemical formula . This amide has two Amine, amino groups (–) joined by a carbonyl functional group (–C(=O)–). It is thus the simplest am ...
, urine protein,
hormones A hormone (from the Greek participle , "setting in motion") is a class of signaling molecules in multicellular organisms that are sent to distant organs or tissues by complex biological processes to regulate physiology and behavior. Hormones a ...
and
electrolytes An electrolyte is a substance that conducts electricity through the movement of ions, but not through the movement of electrons. This includes most soluble salts, acids, and bases, dissolved in a polar solvent like water. Upon dissolving, t ...
. If urine is needed for
microbiological culture A microbiological culture, or microbial culture, is a method of multiplying microorganism, microbial organisms by letting them reproduce in predetermined culture medium under controlled laboratory conditions. Microbial cultures are foundational a ...
, it is important that the sample is not contaminated. In this case, the proper collection procedure involves cleaning the genital area, beginning to urinate into the toilet, and then filling the specimen container before completing the urination into the toilet. This is called a "midstream clean catch" collection. Research has shown many women are unsure of how to take a midstream sample or why it is needed. If the subject is not able to urinate voluntarily, samples can be obtained using a urinary catheter or by inserting a needle through the abdomen and into the bladder ( suprapubic aspiration). In infants and young children, urine can be collected into a bag attached to the genital region, but this is associated with a high risk of contamination.


Types

Some examples of urine tests include:


Chemistry

*
Urinalysis Urinalysis, a portmanteau of the words ''urine'' and ''analysis'', is a Test panel, panel of medical tests that includes physical (macroscopic) examination of the urine, chemical evaluation using urine test strips, and #Microscopic examination, m ...
— assessment of the visual properties of the urine, chemical evaluation using urine test strips, and microscopic examination * Urine creatinine, creatinine clearance — used to assess
kidney function Assessment of kidney function occurs in different ways, using the presence of symptoms and medical sign, signs, as well as measurements using urine tests, blood tests, and medical imaging. Renal physiology, Functions of a healthy kidney include ...
* Albumin/creatinine ratio — used to diagnose microalbuminuria * Urine osmolality — measure of the
solute In chemistry, a solution is defined by IUPAC as "A liquid or solid phase containing more than one substance, when for convenience one (or more) substance, which is called the solvent, is treated differently from the other substances, which are ...
concentration of urine *
Urine specific gravity Specific gravity, in the context of clinical pathology, is a urinalysis parameter commonly used in the evaluation of kidney function and can aid in the diagnosis of various renal diseases. Background One of the main roles of the kidneys i ...
― another measure of urine concentration * Urine electrolyte levels — measurement of
electrolytes An electrolyte is a substance that conducts electricity through the movement of ions, but not through the movement of electrons. This includes most soluble salts, acids, and bases, dissolved in a polar solvent like water. Upon dissolving, t ...
such as
sodium Sodium is a chemical element; it has Symbol (chemistry), symbol Na (from Neo-Latin ) and atomic number 11. It is a soft, silvery-white, highly reactive metal. Sodium is an alkali metal, being in group 1 element, group 1 of the peri ...
and
potassium Potassium is a chemical element; it has Symbol (chemistry), symbol K (from Neo-Latin ) and atomic number19. It is a silvery white metal that is soft enough to easily cut with a knife. Potassium metal reacts rapidly with atmospheric oxygen to ...
in urine * Urine anion gap — used to distinguish between some causes of
metabolic acidosis Metabolic acidosis is a serious electrolyte disorder characterized by an imbalance in the body's acid-base balance. Metabolic acidosis has three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidn ...


Hormones

* Urine pregnancy test ― detects
human chorionic gonadotropin Human chorionic gonadotropin (hCG) is a hormone for the maternal recognition of pregnancy produced by trophoblast cells that are surrounding a growing embryo (syncytiotrophoblast initially), which eventually forms the placenta after implantat ...
in urine * Urine cortisol ― used to investigate disorders of the
adrenal gland The adrenal glands (also known as suprarenal glands) are endocrine glands that produce a variety of hormones including adrenaline and the steroids aldosterone and cortisol. They are found above the kidneys. Each gland has an outer adrenal corte ...
s * Urine metanephrines ― used to help diagnose some rare
tumour A neoplasm () is a type of abnormal and excessive growth of tissue (biology), tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tiss ...
s


Microbiology

* Urine culture
microbiological culture A microbiological culture, or microbial culture, is a method of multiplying microorganism, microbial organisms by letting them reproduce in predetermined culture medium under controlled laboratory conditions. Microbial cultures are foundational a ...
of urine samples, used to identify bacteria causing
urinary tract infection A urinary tract infection (UTI) is an infection that affects a part of the urinary tract. Lower urinary tract infections may involve the bladder (cystitis) or urethra (urethritis) while upper urinary tract infections affect the kidney (pyel ...
s


Miscellaneous

*
Urine drug screen A drug test (also often toxicology screen or tox screen) is a technical analysis of a biological specimen, for example urine, hair, blood, breath, sweat, or oral fluid/saliva—to determine the presence or absence of specified parent drugs o ...
— screen for usage of
recreational drug Recreational drug use is the use of one or more psychoactive drugs to induce an altered state of consciousness, either for pleasure or for some other casual purpose or pastime. When a psychoactive drug enters the user's body, it induces an Sub ...
s *
Urine cytology Urine cytology is a test that looks for abnormal cells in urine under a microscope. The test commonly checks for infection, inflammatory disease of the urinary tract, cancer, or precancerous conditions. It can be part of a broader urinalysis. If a ...
cytopathological examination of cells in the urine, used to screen for cancer * Urine protein electrophoresis — classification and measurement of different
protein Proteins are large biomolecules and macromolecules that comprise one or more long chains of amino acid residue (biochemistry), residues. Proteins perform a vast array of functions within organisms, including Enzyme catalysis, catalysing metab ...
s in the urine; used to help diagnose monoclonal gammopathies * Urine organic acids, urine amino acids — used to test for some inborn errors of metabolism


References


Works cited

* * * * * * {{Urine tests Urine tests