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Understand urine tests

Here we explain different urine tests, what can be tested with them and what the results can mean.

What does the nature of the urine say?

The fact that urine is excreted is very important for various functions of the body. On the one hand, the body's water balance is regulated in this way. On the other hand, substances are excreted with the urine that arise during the metabolism and are no longer needed by the body. This also includes toxic substances that have been ingested through food or drugs. By examining the urine, indications of diseases of the kidney and urinary system can be discovered, but also of metabolic diseases such as diabetes or diseases of the liver.

The color, smell and the amount of urine excreted can help to determine whether something is wrong. Very little and very dark urine can show, for example, that you have not consumed enough fluids - or that the kidneys are no longer working properly. Cloudy or flaky urine can indicate a urinary tract infection. If the urine is reddish, there may be blood in it. In order to find out more, an examination in the laboratory is then necessary.

There are five standard urine tests that can be used to examine different components of the urine. Two of them can be done at home, the other three can only be done in a laboratory.

How do you take a urine sample?

Since urine can easily be contaminated with bacteria, cells and other substances, it makes sense to clean the genital area with water - but without soap - before the test. In order to obtain an unadulterated result and to avoid contamination with bacteria, one uses "clean" central stream urine for a urine test: One speaks of central stream urine if the stream is stopped after a few seconds and only the middle part of the urine is in a cup. If there is anything else to consider with the respective test, the doctor will point this out.

Rapid urine test

What is a rapid urine test?

The quickest way to check your urine is to do a rapid urine test. A test strip with small, square colored fields on it is dipped into the urine for a few seconds. Then you have to wait a bit until the result is shown. Depending on the concentration of the respective substance, the fields of the test strip change color. Then the color of the fields is compared with a color table. Such a color table is shown on the urine test tube and shows which colors indicate normal and deviating values.

A rapid urine test is usually carried out during routine examinations - for example in the family doctor's practice, during preventive examinations during pregnancy, when being admitted to a hospital or before an operation. Rapid tests are also used for acute complaints such as abdominal pain, abdominal or back pain, frequent painful urination or blood in the urine. Some people with diabetes also check their sugar levels this way.

The rapid urine test can be carried out in practices, clinics or independently at home. The test strips are available from pharmacies and on the Internet without a prescription. However, the tests are not intended for self-diagnosis, but should be used in consultation with a doctor.

What can be checked with a rapid urine test?

Many substances can usually only be detected in a certain amount in the urine. Higher or lower values ​​therefore mean a deviation from the norm. "Norm negative" means that a substance is normally not present in the urine.

The following substances can be checked with a urine rapid test:

  • pH value (indicates the acidity of the urine, norm depending on diet approx. 5 to 7, with a value below 5 indicating too much and a value above 7 indicating too little acid)
  • Protein (proteins, norm negative)
  • Sugar (glucose, norm negative)
  • Nitrite (norm negative)
  • Ketone (a metabolic product, norm negative)
  • Bilirubin (breakdown product of the red blood pigment, norm negative)
  • Urobilinogen (breakdown product of bilirubin, norm negative)
  • Red blood cells (erythrocytes, norm negative)
  • White blood cells (leukocytes, norm negative)

What do the results say?

Whether the results are in the normal range or are conspicuous can be determined from the package insert or the color table on the tube. Among other things, the pH value is used to find out whether the risk of the formation of urinary stones is increased. This is the case with "acidic" values ​​below 5. A pH value above 7, on the other hand, can indicate a bacterial urinary tract infection. In addition, for example

  • increased protein levels indicate inflammation of the kidneys,
  • Ketone and sugar indicate increased sugar levels and
  • White blood cells and nitrite indicate bacterial infection.

If the results are abnormal, it is necessary to speak to a doctor. Like all tests, urine tests do not always give reliable results. Therefore, if the values ​​are abnormal, a more detailed examination in the laboratory could be useful.

What is a urine status?

With a urine status, the most important values ​​in the urine are checked as the first basic examination. It can be part of a routine check-up and is often done on hospital admission and before surgery. The examination may also have been preceded by an abnormal urine test, which is checked using the urine status.

A complete urine status is done in a laboratory. It usually consists of three parts:

  1. Assessment of the color, clarity and concentration of the urine
  2. Examination of the chemical composition of the urine with a test strip
  3. Examination of the urine with the microscope for bacteria, cells and cell components

A urine status is used to clarify or monitor urinary tract infections, bleeding in the kidney or urinary system, and diseases of the kidney or liver. It can also be used for diabetes, certain blood diseases and urinary stones.

What can be checked with a urine status?

In addition to the substances that are checked by a rapid test, a urine status can examine the urine for:

  • Creatinine (breakdown product of muscle metabolism; can be used to check kidney function)
  • Bacteria (norm negative)
  • Cylinders (elongated structures glued together that arise in the renal tubules, norm negative)
  • Crystals (found in the urine at high concentrations of certain substances, norm negative)
  • Epithelial cells (line the ureters, bladder and urethra)

What do the results say?

On the basis of these values, a laboratory can also determine the following information with the aid of a urine status:

  • For example, cholesterol crystals can be due to a high cholesterol level.
  • In most cases, cylinders are an expression of kidney disease, such as pelvic inflammation.

If the values ​​are conspicuous, more detailed examinations, such as a blood test, can follow.

What is a urine culture?

A urine culture tests whether the urine contains pathogens. In a laboratory, a midstream urine sample is placed in a container. Then platelets with culture media on which pathogens can grow are dipped into the sample and the container is tightly closed. The urine culture is then placed in an incubator for one to two days. If bacteria or fungi are present in the urine, they can grow into colonies.

What can be checked with a urine culture?

A urine culture can be used to check whether there are bacteria or fungi in the urine. If this is the case, the size, shape and color of the colonies often give an indication of which bacteria or fungi are involved.

What do the results say?

A urine culture is usually done to identify bacteria and fungi in the urine if a urinary tract infection is suspected. If bacteria are found in the laboratory, it is usually checked at the same time which antibiotic can be used.

What is a 24-hour urine collection?

For this test, the urine is collected over 24 hours: the first urine sample after getting up is not used, but the time is written down. From this point on, every drop of urine is collected in a container for a period of 24 hours. After the 24 hours have elapsed, the bladder is emptied one last time and this urine is added to the amount already collected.

The doctor's office provides the container for the urine collection. Most of the time it already contains an additive to prevent bacteria from growing during the collection period. The urine should be kept in the refrigerator for the full 24 hours. The urine is then examined in a laboratory.

What can be checked with a 24-hour urine collection?

A 24-hour urine collection examines how much the body excretes of certain substances (e.g. proteins, hormones, salts, metabolic products).

What do the results say?

The test result can provide information about the protein and creatinine content in the urine, among other things. If, for example, too little of the waste product creatinine is filtered out of the blood by the kidneys, this can be an indication that the kidneys are no longer functioning properly. An increased protein content in the urine, a so-called proteinuria, can occur, for example, in the following diseases: heart failure, diabetes mellitus, inflammation of the kidney pelvis, urinary tract infections, kidney diseases or kidney carcinoma.

Some diseases of the endocrine system lead to an increased excretion of hormones and their metabolic products in the urine. In order to detect such diseases, the urine is often collected and examined over a period of 24 hours, among other things.

What is a pregnancy test?

If there is no menstrual period, there are special tests that are designed to show whether a woman is pregnant. But they cannot deliver 100 percent reliable results. Most tests can check whether you are pregnant just eight to ten days after the period has not been performed. They are usually done like a quick urine test after waking up with the morning urine. The package insert provides information on the exact application. Pregnancy tests are available in pharmacies, drug stores, department stores or on the Internet.

What can be checked with a pregnancy test?

The urine of pregnant women contains a special hormone, human chorionic gonadotropin (hCG). It is formed in the placenta.

What do the results say?

For many women, a pregnancy test is the first step in finding out if they are pregnant. If the test is used too early, the woman is taking certain medications or has been drinking a lot, the result may be falsified. In order to determine or rule out a pregnancy with certainty, it is necessary to consult a doctor.

More urine tests

Drugs can also be detected in the urine for a certain period of time. Depending on the test used, cannabis can be detected for up to several weeks after use, drugs such as cocaine, ecstasy or heroin for up to five days. There are also various methods here: rapid tests that can help the police quickly find their way around the scene, for example, and tests that are reserved for laboratories. Urine samples can be used for doping tests from athletes. This checks whether someone has used illegal substances to improve performance.