Chemical

Examination
of Urine
Arianne Rose A. Lim, RMT
College of Medical Laboratory Science
De La Salle Medical and Health
Sciences Institute
At the end of the lesson, the student should be able to:
1. Enumerate properly all the chemical
examinations done in routine urinalysis.
2. Discuss properly the principles behind each
chemical examination and its clinical
significance.
3. Precisely discuss the principle and significance of
using reagent strips in urinalysis testing.
4. Discuss sequentially the steps in performing both
reagent strip testing and manual testing of a
chemical constituent of routine urinalysis; and
5. precisely differentiate the advantages and
disadvantages of using manual and reagent strip
testing.

Urinalysis: Chemical Examination of Urine | 2

A. Reagent strips
B. pH
C. Protein
D. Glucose
E. Ketones
F. Blood
G. Bilirubin
H. Urobilinogen
I. Nitrite
J. Leukocyte esterase
K. Specific gravity

Urinalysis: Chemical Examination of Urine | 3

• Consist of chemical-impregnated absorbent pads
attached to a plastic strip.
• 4 parameter urinalysis reagent strip
• 10 parameter urinalysis reagent strip
• Reagent strip technique
• Errors caused by improper technique
• Handling and storing reagent strips
• Quality control of reagent strips
• Confirmatory testing

Urinalysis: Chemical Examination of Urine | 4

• First morning specimen
• slightly acidic pH of 5.0 to 6.0.
• more alkaline pH is found following meals
• Normal random samples: 4.5 to 8.0.

• Clinical significance of urinary pH

• determining the existence of systemic acid–base
disorders and;
• management of urinary conditions requiring urine to
be maintained at a specific pH.
• Reagent strip reactions
• double-indicator system of methyl red and
bromthymol blue
• 60 seconds
Urinalysis: Chemical Examination of Urine | 5
• Most indicative of renal disease.
• Proteinuria
• associated with early renal disease
• Normal urine
• < 10 mg/dL or 100 mg per 24 hours is excreted.
• Clinical significance
• Prerenal
• Renal
• Post renal
• Reagent strip reactions
• Protein error of indicators
• 60 seconds
• Reaction interference
Urinalysis: Chemical Examination of Urine | 6
• Most frequently performed chemical analysis on
urine.
• Clinical significance
• Hyperglycemia – associated
• Renal – associated
• Reagent strip (Glucose oxidase) reaction
• 30 seconds
• Reaction interference
• Copper reduction test (Clinitest)
• Clinical significance of Clinitest

Urinalysis: Chemical Examination of Urine | 7

• Three intermediate products of fat metabolism:
• Acetone (2%)
• Acetoacetic acid (20%)
• β -hydroxybutyrate (78%)
• Clinical significance
• Ketonuria
• Reagent strip reaction
• Sodium nitroprusside (nitroferricyanide)
• 40 seconds
• Reaction interference
• Acetest tablets

Urinalysis: Chemical Examination of Urine | 8

• Hematuria: cloudy red urine
• Hemoglobinuria: clear red specimen

• Clinical significance
• Hematuria
• Hemoglobinuria
• Myoglobinuria
• Reagent strip reaction
• Pseudoperoxidase activity
• Chromogen tetramethylbenzidine
• 60 seconds
• Reaction interference
Urinalysis: Chemical Examination of Urine | 9
• Early indication of liver disease.
• Often detected long before the patient exhibits
jaundice.
• Bilirubin
• highly pigmented yellow compound
• degradation product of hemoglobin
• Clinical significance
• Only conjugated bilirubin can appear in the
urine.
• Reagent strip (Diazo) reactions
• 30 seconds
• Reaction interference
• Ictotest tablet
Urinalysis: Chemical Examination of Urine | 10
• Circulates in the blood back to the liver.
• Passes through the kidney and is filtered by the
glomerulus.
• <1 mg/dL or Ehrlich unit

• Clinical significance
• greater than 1 mg/dL is seen in liver disease and
hemolytic disorders.
• Reagent strip reaction
• 60 seconds

• Reaction interference

Urinalysis: Chemical Examination of Urine | 11

• Provides a rapid screening test for the presence
of urinary tract infection (UTI ).

• Reagent strip reactions

• Greiss reaction
• Results are reported only as negative or
positive.
• 60 seconds
• Reaction interference

Urinalysis: Chemical Examination of Urine | 12

• Detection of increased urinary leukocytes required
microscopic examination of the urine sediment.

• Clinical significance
• Normal values for leukocytes:
• based on the microscopic sediment examination
• vary from 0 to 2 to 0 to 5 per highpower field
• Reagent strip reaction
• Requires the longest time of all the reagent strip
reactions.
• 120 seconds
• Reaction interference

Urinalysis: Chemical Examination of Urine | 13

• Reagent strip test for specific gravity
• included as part of the physical examination of
urine

• Reagent strip reaction

• change in pKa (dissociation constant) of a
polyelectrolyte in an alkaline medium
• 45 seconds
• Reaction interferences

Urinalysis: Chemical Examination of Urine | 14

 Chemical
Examination
of Urine
Arianne Rose A. Lim, RMT
College of Medical Laboratory Science
De La Salle Medical and Health
Sciences Institute