URINE PRESERVATIVES

R.Hemamalini
I yr biochemistry pg
Stanley medical college
 Types of urine sample
• Random
• First morning sample
• 2hrs postprandial sample
• Timed sample(1hr,4hrs,24hrs)
• Mid stream clean catch sample
• Catheterized sample
• Suprapubic aspirated sample
RANDOM:
collected untimed,whenever needed
suitable only for few chemical tests
FIRST MORNING:
clean,early morning ,fasting specimen is
usually concerntrated
preferred for proteins,unusual
compounds,chorionic gonadotropin
2HRS POST PRANDIAL:
immediately after taking meal,2hrs after
taking ,meals for diabetes
TIMED URINE SAMPLE:
collected over specified period of time
to minimize the influence of biological variations
patient’s close adherence to instructions is
important
bladder must be emptied at the time of collection
is to begin, and this urine is discarded.thereafter all
urine must be collected untill the end of scheduled
time
after each collection sample should be transferred
into seperate container then the large container
container stored at 4 deg c throughout the period
of collection
• Single bottle-adequate mixing,prevents possible
loss of some of specimen if second doesn’t reach
the lab
• 2hrs- 1l;12 hrs -2l; 24 hrs-4l
• Aliquots should not be removed when collection is
in process
• Appropriate information regarding collection
including warnings with respectto handling of the
specimen should appear on the bottle label
• For renal
parameters ,protein,hormones,minerals,cathecola
mines
• Time consuming,collection standards protocols
Timed sample container
Mid stream clean catch
• Non invasive,minimal contamination
• For routine analysis,cultuire and senstivity
CATHETERIZED:
under sterile conditions,by trained medical
personel
for urinary tract infections
SUPRAPUBIC ASPIRATION
 Why urine sample is preserved?
• To maintain the integrity of the sample
• To reduce bacterial action
• Urea splitting bacteria splits urea ,producing
ammonia which increases pH of the urine
sample-decompostion of casts and certain cells
• Not suitable for measuring urea,pH,ammonia
• Bacteria and yeast act on glucose present in the
sample
• TO PREVENT CHEMICAL DECOMPOSITION:
• Bilirubin gets oxidised by light to biliverdin
• Urobilinogen gets oxidised to urobilin
• Co2 loss –increase in pH
• Rapid oxidation of ascorbic acid
• Precipitation of phosphates at alkaline ph
• Uric acid and urates gets deposited as they are
less soluble in cool urine when kept for long time
• Volatilization of acetone
Changes in urine with delayed testing
• Ideally urine sample should be processed within
one hour of collection
• Any delay it should be preserved
• Best method is immediate refrigeration after
collection
• By this urine sample can be preserved upto 6 to 8
hrs with no preservatives/no gross alterations
• For 24 hrs sample chemical preservatives are
added and stored at 4 degree celcius throughout
the period of collection
 URINE PRESERVATIVES
Hydrochloric acid
6mol/l -30ml for 24 hrs collection
establishes pH<3,good for chemical
testing
urea,ammonia,total
nitrogen,calcium,VMA,catecholamines,cystine
,oxalates,hydroxy proline,steroids
disadvantages: precipitates urates ,not
suitable for uric acid measurement,destroys
formed elements
Boric acid:
10g/24 hrs collection
maintains pH at 6
preserves protein and formed elements
for culture and sensitivity
measuring
aldosterone,cortisol,estriol,estrogen
disadvantages:precipitates urates,not
bactericidal,doesnot prevent the growth of
yeast,interfere with drug and hormone
analysis
Acetic acid:
10% conc acetic acid for ascorbic acid
Nitric acid:
6mol/l; 15ml for 24 hrs collection;for
mercury analysis
5% metaphosphoric acid:for ascorbic acid
sodium bicarbonate:
5g for 24 hrs collection
for porphyrins,urobilinogen,uric acid
analysis
Sodium fluoride:
0.5 g is used
inhibits glycolysis and bacterial growth
Formaldehyde/formalin:
3 to 4 drops added
acts by fixing the formed elements in urinary
sediment
preservative tablets that readily release
formaldehyde are commercially available
disadvantages:
interferes with reduction tests for urine sugar
forms precipitate with urea interfering the
microscopic examination of sediment
inhibits certain reactions eg:dipstick esterase
test for leucocytes
THYMOL:
10% in isopropanol;10 ml per 24 hr
collection
it is satisfactory for
sodium,potassium,chloride,bicarbonate,calcium
,phospate,urea,reducing substance,ketone
bodies,amylase
Disadvantages:
interfere with tests for urine protein and
bilirubin
TOLUENE:
30 ml per 24 hrs collection
organic
forms a barrier between air and surface of the
specimen
it should be skimmed off or the urine pipetted from
beneath should be used
Disadvantages:
it prevents only surface contamination
already introduced bacteria tend to multiply
its flammable
doesn’t prevent the growth of anaerobic micro
organisms
BD VACUTAINER PLUS PLASTIC UA
preservative tube contains propietary
additives(chlorhexidine,ethyl paraben,sodium
propionate)that maintains sample integrity
upto 72 hours without refrigeration.
Specimen preservatives guidelines
Chemical preservatives should be non mercuric and
environment friendly
To ensure accurate results proper specimen to
additive ratio must be maintained
for microbiological examination sample must be
stored at 2 to 8 degree celcius
Evacuvated tube system is designed to achieve
proper fill volume,to ensure proper additive ratio
and proper preservative function
It also reduces the risk of exsposure of health care
worker to the specimen