Technical Tips in Clinical Microscopy
Laboratory  The presence of black urine from a
Introduction to Urinalysis
 A high urea and Creatinine content
identifies a fluid as urine
 Never discard a specimen before checking
with a supervisor
 Specimens must be returned to room
temperature before chemical testing is
done, enzymes best react at RT
 When preserving a urine to be sent to
another lab, be sure to check with that lab
concerning the preservative
 Addition of urine formed before the
start of collection period will have false
elevation; Failure to include urine
produced at the end of collective will
have falsely decreased values
 Check the applied bags approx every 15
minutes until needed amount of sample
has been collected
Renal Function
 Glucose appearing in urine of a patient
with normal blood glucose is a result of
tubular damage
 Vapor pressure osmometers- are used
primarily to analyze serum and sweat
microsamples for disorders not related to
renal function, Cystic fibrosis. Used in
chemistry
Physical Examination
 Molality- commonly used because the
solute and the solvent are both expressed
in the same unit
 Because ions such as Sodium, Chloride
and Ammonium are important in
evaluating renal concentrating ability, the
reagent strip method provides additional
info and not affected by Nonionizing
substance like protein, glucose and urea
and radiographic dye
Urine Screening for Metabolic Disorders
patient of any age should be reported to a
supervisor
 Homogentisic acid (Alkaptonuria)
 Malignant melanoma
 Medications
 Melanin may react with sodium
nitroferricyanide (acetone reagent
strip), producing red color
 It is important to differentiate the
presence of Homogentisic acid and
melanin when urine is observed to have
turned black upon standing
 HA- darkening appears under
alkaline condition
 melanin- darkens the urine upon
exposure to air
 Lesch-Nyhan disease should not be
confused with uromodulin-associated
kidney disease
 LND- Uric acid appears early in life
 UAKD- Uric acid appears later in
life
Renal disease
 Uromodulin forms the matrix of urinary
casts seen in many renal disorders.
 The presence of WBC casts is significant
for differentiating between cystitis
(absent) and pyelonephritis (present)