Why the Doctor Asks for a Urine Sample

It's probably safe to say that no one really relishes giving a urine sample. But the truth is that few tests can match the routine urine analysis for telling your physician about what's going on inside your body.

The bladder can hold almost 2 cups of urine for 2 to 5 hours comfortably, and excretes 2 quarts of waste products and additional water daily. And just as you use a dipstick to check your car's engine oil, physicians rely on a specially treated "dipstick," a plastic stick that has segments imbedded with different chemical indicators on it, to test urine. Unusual amounts of certain substances in your urine can indicate conditions ranging from minor urinary tract infections to diabetes and other more serious conditions.

One portion of the dipstick, for instance, measures the specific gravity (a measure of the amount of substances dissolved in the urine). The higher the specific gravity, the more concentrated the urine is. Using a numerical scale, the dipstick shows whether you're drinking enough fluids and how well your kidneys are filtering wastes from your body. Very concentrated urine suggests you are probably not drinking enough fluids, making it harder for your body to flush wastes. Urine is normally darker -- more concentrated -- in the morning, because your body's been storing wastes all night.

The dipstick registers the presence of a variety of chemicals that the kidneys filter such as glucose, or minerals. Healthy people generally don't excrete sugar in their urine. Its presence may mean that you have diabetes or another condition that prevents the body from efficiently converting blood sugar into energy.

The urine test also can indicate infections by measuring nitrites and leukocytes. Bacteria produce an enzyme that converts nitrates normally present in urine to nitrites. Leukocytes are the white blood cells that fight infection. The presence of either indicates that your body may be fighting an infection in the bladder or somewhere else along the urinary tract. They also can indicate something even more serious, such as a tumor, but further tests are needed to confirm these findings.

The dipstick gauges protein and pH levels. Urine shouldn't contain much, if any, protein, although some perfectly normal people do excrete tiny amounts. Urine pH, or acidity, normally ranges between 4.5 and 8, with most people's urine falling between 5.5 and 6.5. Significantly high protein or pH levels can suggest kidney or other renal dysfunction.

Ketones can be detected by dipsticks. They are substances produced when fat is used by the body for energy. They are eliminated from the body in the urine. Large amounts of urinary ketones indicate a diet low in carbohydrates, starvation, or, in a person with diabetes, a dangerous condition known as diabetic ketoacidosis.


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