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Urinalysis (cont.)

What Is Macroscopic Urinalysis?

The term macroscopic refers to observations that are visible with the naked eye and do not require examination under a microscope. Macroscopic analysis of the urine is done by inspecting the physical appearance of the urine. Normal urine is light yellow and clear. Macroscopic urinalysis notes the amount, color, and clarity of the urine as well as any other visible characteristics of the urine such as the presence of blood or blood clots, precipitates, or sediments.

The information from the macroscopic urinalysis may provide important clues to the health care practitioner performing the test. A normal urine sample may be reported as clear and yellow without any cloudiness.

  • Obvious abnormalities in color, clarity, and cloudiness may suggest conditions such as:
  • Certain medications may change the color of urine.
  • Visible blood in the urine (gross hematuria) may suggest a kidney stone or more serious causes such as cancer of the urinary tract.
  • Foamy urine may indicate the presence of protein in the urine (proteinuria) due to certain kidney conditions that spill protein out of the kidney from circulating blood (nephrotic syndrome).
  • A dipstick test is usually performed on the urine specimen to check for:
    • glucose (sugar) in the urine,
    • ketone in the urine (metabolic waste product),
    • blood in the urine (detected as hemoglobin in the urine),
    • leukocyte esterase (suggests white blood cell in the urine),
    • nitrites (evidence of any bacteria in the urine),
    • bilirubin, and
    • urobilinogen in the urine (related to an elevated bilirubin level, denoting possible liver disease or red blood cell breakdown in the body).

The color change in each of the squares on the dipstick signifies a specific abnormality found in the urine represented by that specific color. If there are no abnormalities in the urine, the squares maintain their original color. The changes in color may take from a few seconds up to a couple of minutes to occur. The interpretation of the urinalysis by a dipstick is simply done by comparing the colors on the stick to the reference color changes that are readily available on the dipstick box.

What Are Pros and Cons of Dipstick Test?

The main advantage of the urine dipstick test is that it is a convenient and rapid test. The results are usually determined within a few minutes after collecting the sample. Therefore, it is very useful in settings such emergency departments, urgent care facilities, or the doctor's office. It is also very cost effective and does not require special training to perform the test.

However, the dipstick may not be very accurate as the color changes are very time sensitive. For example, if the dipstick is not promptly analyzed as it is taken out of the urine sample, then the color changes may be inaccurate after more than a few minutes of exposure to urine. The information that urine dipstick provides may also be limited, as it is generally a qualitative test and not a quantitative one.

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