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Laboratory: Clinical Biochemistry
Test Name:
URINALYSIS - URINE RENAL WORKUP - (U)
Test Code: UR+URR
Clinical Information:
Test Indications: Renal workup to assess acute and chronic kidney diseases consists of two components: dipstick analysis (Urine Dipstick only (UR)), and microscopic examination of the urine sediment ONLY if the dipstick is positive for protein, blood or leukocytes. If the dipstick is negative for protein, blood or leukocytes, there will be no microscopic examination. Renal workup is NOT indicated for investigation of UTI.
Recommendations:  Specimen must be transported to lab without delay. Urinalysis should be performed within 2 hours from time of voiding. Delayed in processing and prolonged exposure at room temperature may result in microbial contamination with changes in the pH and a shift to alkaline. Thus, this will cause false positive protein tests. Also, urine with glucose may decrease as growing microorganisms utilize the sugar. Bacterial growth will also cause false positive blood reactions. It is highly recommended that urine samples labeled with patient’s identifiers including recorded time of void by nursing staff, and are brought to the lab for processing in less than 2 hours from collection time to ensure reporting accurate results.
Patient Preparation Instructions:  Fresh random urine collected without preservative using "clean catch" method (Link to: Patient Instructions for Clean-Catch Midstream Urine Collection).
Clinical Information: Renal workup is NOT indicated for investigation of UTI. Please refer to Clinical Practice Change issued regarding UTI investigation (https://sharedhealthmb.ca/health-providers/diagnostic-services/clinical-practice-changes/#38-328-clinical-biochemistry).
Collection Devices:
Specimen Required:
Urine: 10.0 mL
Pediatric Urine: 10.0 mL

Collection Information: When Urine Renal Workup is ordered, urine samples CAN NOT be refrigerated and must be transported to testing laboratories in regular collection containers within 2 hours from time of void. If urine samples arrive to the testing laboratory refrigerated, it will only be examined by dipstick. Refrigerated samples are not suitable for microscopy.
 
If specimen is not likely to be received by testing lab in 2 hours at room temperature or 24 hours (refrigerated samples) then preservative tube should be used (BD Vacutainer TM Plus Plastic Conical Urinalysis Preservative Tube Catalogue #364992 with Urine Transfer Straws Cat # 364966).

Specimen Stability: 
Ambient: 2 hours
Refrigerated: not acceptable 

Stability of urine in preservative tube is 72 hours at 15 to 25 °C. DO NOT refrigerate urine samples before transferring to preservative tubes.
 
BD Vacutainer TM Plus Plastic Conical Urinalysis Preservative Tube Catalogue #364992 is the only approved preservative tubes for urinalysis by Shared Health Laboratories. Samples collected in other preservative tubes such as ones contain boric acid are not acceptable and will be rejected.
Referral:
Urine: 10.0 mL
Pediatric Urine: 10.0 mL
Requisition:
Reference Values:
Urine Microscopic Examination:
White Cells           0-2/HPF
Red Blood Cells   0-2/HPF
Epithelial              Occasional squamous/HPF
Mucus                   Absent/Slight
Bateria                  Absent
Amorphous           Absent/ Slight
Casts                    Occasional hyaline cast/HPF


Urine dipstick reference ranges:
Glucose               Negative
Bilirubin               Negative
Ketones               Negative
Specfic Gravity    1.005 - 1.030
Blood                   Negative
pH                        5.0 - 8.0
Protein                 Negative
Urobilinogen         3 - 16 micromol/L
Nitrate                  Negative
Leucocytes           Negative
Availability:
Daily or Stat
See Also:
More Information: