Urinalysis

Urinalysis is a simple, cheap, high-value test on a urine sample — and an under-used screening tool in Indian practice. It can pick up urinary infections, kidney disease, diabetes, dehydration, liver problems, and occasionally malignancies before symptoms appear.

What's tested

• Colour, clarity, smell — bright yellow/orange suggests dehydration or drugs; red/brown suggests blood; cloudy suggests infection.
• Specific gravity / concentration — hydration status.
• pH.
• Protein — raised in kidney disease, fever, exercise, pregnancy, diabetes.
• Glucose — suggests diabetes if high.
• Ketones — DKA, prolonged fasting, keto diet.
• Blood — infection, stones, kidney disease, cancer, exercise.
• Leukocyte esterase + nitrites — urinary tract infection.
• Bilirubin / urobilinogen — liver disease.
• Microscopy — cells, casts, crystals.

Practical notes

• Mid-stream, clean-catch sample — discard the first and last bits; collect the middle stream.
• First-morning sample is best for most screening (most concentrated).
• Women should not give a sample during their menstrual period — blood confounds results.
• A freshly passed sample should reach the lab within 1 hour; otherwise refrigerate.
• Vitamin C and B vitamins can give false-negative dipstick results.

When to follow up an abnormal result

• Protein — repeat test; check urine albumin-to-creatinine ratio; screen for diabetes, BP, kidney disease.
• Blood — microscopy, imaging (ultrasound), urology assessment if persistent.
• WBC / nitrites — urine culture, antibiotic based on sensitivity.
• Glucose — fasting glucose / HbA1c.
• Ketones — check blood sugar; if high, rule out DKA.
• Always interpret with the clinical picture — dipstick alone is a screen, not a diagnosis.