A urine test is any

medical test A medical test is a medical procedure performed to detect, diagnose, or monitor diseases, disease processes, susceptibility, or to determine a course of treatment. Medical tests such as, physical and visual exams, diagnostic imaging, genetic ...

performed on a

urine Urine is a liquid by-product of metabolism in humans and many other animals. In placental mammals, urine flows from the Kidney (vertebrates), kidneys through the ureters to the urinary bladder and exits the urethra through the penile meatus (mal ...

specimen. The analysis of urine is a valuable diagnostic tool because its composition reflects the functioning of many body systems, particularly the

kidney In humans, the kidneys are two reddish-brown bean-shaped blood-filtering organ (anatomy), organs that are a multilobar, multipapillary form of mammalian kidneys, usually without signs of external lobulation. They are located on the left and rig ...

s and

urinary system The human urinary system, also known as the urinary tract or renal system, consists of the kidneys, ureters, urinary bladder, bladder, and the urethra. The purpose of the urinary system is to eliminate waste from the body, regulate blood volume ...

, and specimens are easy to obtain. Common urine tests include the routine

urinalysis Urinalysis, a portmanteau of the words ''urine'' and ''analysis'', is a Test panel, panel of medical tests that includes physical (macroscopic) examination of the urine, chemical evaluation using urine test strips, and #Microscopic examination, m ...

, which examines the physical, chemical, and microscopic properties of the urine;

urine drug screen A drug test (also often toxicology screen or tox screen) is a technical analysis of a biological specimen, for example urine, hair, blood, breath, sweat, or oral fluid/saliva—to determine the presence or absence of specified parent drugs o ...

ing; and

urine pregnancy test A pregnancy test is used to determine whether a person is pregnant or not. The two primary methods are testing for the pregnancy hormone (human chorionic gonadotropin (hCG)) in blood or urine using a pregnancy test kit, and scanning with ultras ...

ing.

Background

The value of urine for diagnostic purposes has been recognized since ancient times. Urine examination was practiced in

Sumer Sumer () is the earliest known civilization, located in the historical region of southern Mesopotamia (now south-central Iraq), emerging during the Chalcolithic and Early Bronze Age, early Bronze Ages between the sixth and fifth millennium BC. ...

and

Babylonia Babylonia (; , ) was an Ancient history, ancient Akkadian language, Akkadian-speaking state and cultural area based in the city of Babylon in central-southern Mesopotamia (present-day Iraq and parts of Kuwait, Syria and Iran). It emerged as a ...

as early as 4000 BC, and is described in ancient

Greek Greek may refer to: Anything of, from, or related to Greece, a country in Southern Europe: *Greeks, an ethnic group *Greek language, a branch of the Indo-European language family **Proto-Greek language, the assumed last common ancestor of all kno ...

and

Sanskrit Sanskrit (; stem form ; nominal singular , ,) is a classical language belonging to the Indo-Aryan languages, Indo-Aryan branch of the Indo-European languages. It arose in northwest South Asia after its predecessor languages had Trans-cultural ...

texts. Contemporary urine testing uses a range of methods to investigate the physical and biochemical properties of the urine. For instance, the results of the routine

can provide information about the functioning of the

kidneys In humans, the kidneys are two reddish-brown bean-shaped blood-filtering organs that are a multilobar, multipapillary form of mammalian kidneys, usually without signs of external lobulation. They are located on the left and right in the retro ...

and

; suggest the presence of a

urinary tract infection A urinary tract infection (UTI) is an infection that affects a part of the urinary tract. Lower urinary tract infections may involve the bladder (cystitis) or urethra (urethritis) while upper urinary tract infections affect the kidney (pyel ...

(UTI); and

screen Screen or Screens may refer to: Arts * Screen printing or ''silkscreening'', a printing method * Big screen, a nickname for motion pictures * Split screen (filmmaking), showing two or more images side by side * Stochastic screening and Halftone ...

for possible

diabetes Diabetes mellitus, commonly known as diabetes, is a group of common endocrine diseases characterized by sustained high blood sugar levels. Diabetes is due to either the pancreas not producing enough of the hormone insulin, or the cells of th ...

liver disease Liver disease, or hepatic disease, is any of many diseases of the liver. If long-lasting it is termed chronic liver disease. Although the diseases differ in detail, liver diseases often have features in common. Liver diseases File:Ground gla ...

, among other conditions. A

urine culture Bacteriuria is the presence of bacteria in urine. Bacteriuria accompanied by symptoms is a urinary tract infection while that without is known as asymptomatic bacteriuria. Diagnosis is by urinalysis or urine culture. ''Escherichia coli'' is the ...

can be performed to identify the bacterial species involved in a UTI. Simple point-of-care tests can detect

pregnancy Pregnancy is the time during which one or more offspring gestation, gestates inside a woman's uterus. A multiple birth, multiple pregnancy involves more than one offspring, such as with twins. Conception (biology), Conception usually occurs ...

by identifying the presence of

beta-hCG Human chorionic gonadotropin (hCG) is a hormone for the maternal recognition of pregnancy produced by trophoblast cells that are surrounding a growing embryo (syncytiotrophoblast initially), which eventually forms the placenta after implantatio ...

in the urine and indicate the use of

recreational drugs Recreation is an activity of leisure, leisure being discretionary time. The "need to do something for recreation" is an essential element of human biology and psychology. Recreational activities are often done for enjoyment, amusement, or plea ...

by detecting excreted drugs or their metabolites. Analysis of abnormal cells in urine (

urine cytology Urine cytology is a test that looks for abnormal cells in urine under a microscope. The test commonly checks for infection, inflammatory disease of the urinary tract, cancer, or precancerous conditions. It can be part of a broader urinalysis. If a ...

) can help to diagnose some

cancer Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...

s, and testing for

organic acids An organic acid is an organic compound with acidic properties. The most common organic acids are the carboxylic acids, whose acidity is associated with their carboxyl group –COOH. Sulfonic acids, containing the group –SO2OH, are r ...

amino acids Amino acids are organic compounds that contain both amino and carboxylic acid functional groups. Although over 500 amino acids exist in nature, by far the most important are the Proteinogenic amino acid, 22 α-amino acids incorporated into p ...

in urine can be used to screen for some

genetic disorder A genetic disorder is a health problem caused by one or more abnormalities in the genome. It can be caused by a mutation in a single gene (monogenic) or multiple genes (polygenic) or by a chromosome abnormality. Although polygenic disorders ...

Specimen collection

Trace metal-free 24 hour urine container

The techniques used to collect urine specimens vary based on the desired test. A random urine, meaning a specimen that is collected at any time, can be used for many tests. However, a sample collected during the first urination of the morning (first morning specimen) is preferred for tests like urinalysis and pregnancy screening because it is typically more concentrated, making the test more sensitive. Because the concentration of many substances in the urine varies throughout the day, some tests require timed urine collections, in which the patient collects all of their urine into a container for a given period of time (commonly 24 hours). A small amount of the specimen is then removed for testing. Timed collections are commonly used to measure

creatinine Creatinine (; ) is a breakdown product of creatine phosphate from muscle and protein metabolism. It is released at a constant rate by the body (depending on muscle mass). Biological relevance Serum creatinine (a blood measurement) is an impor ...

urea Urea, also called carbamide (because it is a diamide of carbonic acid), is an organic compound with chemical formula . This amide has two Amine, amino groups (–) joined by a carbonyl functional group (–C(=O)–). It is thus the simplest am ...

, urine protein,

hormones A hormone (from the Greek participle , "setting in motion") is a class of signaling molecules in multicellular organisms that are sent to distant organs or tissues by complex biological processes to regulate physiology and behavior. Hormones a ...

and

electrolytes An electrolyte is a substance that conducts electricity through the movement of ions, but not through the movement of electrons. This includes most soluble salts, acids, and bases, dissolved in a polar solvent like water. Upon dissolving, t ...

. If urine is needed for

microbiological culture A microbiological culture, or microbial culture, is a method of multiplying microorganism, microbial organisms by letting them reproduce in predetermined culture medium under controlled laboratory conditions. Microbial cultures are foundational a ...

, it is important that the sample is not contaminated. In this case, the proper collection procedure involves cleaning the genital area, beginning to urinate into the toilet, and then filling the specimen container before completing the urination into the toilet. This is called a "midstream clean catch" collection. Research has shown many women are unsure of how to take a midstream sample or why it is needed. If the subject is not able to urinate voluntarily, samples can be obtained using a

urinary catheter The human urinary system, also known as the urinary tract or renal system, consists of the kidneys, ureters, bladder, and the urethra. The purpose of the urinary system is to eliminate waste from the body, regulate blood volume and blood pr ...

or by inserting a needle through the abdomen and into the bladder (

suprapubic aspiration Suprapubic aspiration is a procedure to take a urine sample. It involves putting a needle through the skin just above the pubic bone into the bladder. It is typically used as a method to collect urine in child less than 2 years of age who is not y ...

). In infants and young children, urine can be collected into a bag attached to the genital region, but this is associated with a high risk of contamination.

Types

Some examples of urine tests include:

Chemistry

Urinalysis Urinalysis, a portmanteau of the words ''urine'' and ''analysis'', is a Test panel, panel of medical tests that includes physical (macroscopic) examination of the urine, chemical evaluation using urine test strips, and #Microscopic examination, m ...

— assessment of the visual properties of the urine, chemical evaluation using

urine test strips A urine test strip or dipstick is a basic medical diagnosis, diagnostic tool used to determine pathology, pathological changes in a patient's urine in standard urinalysis. A standard urine test strip may comprise up to 10 different chemical pads ...

, and microscopic examination *

Urine creatinine Creatinine (; ) is a breakdown product of creatine phosphate from muscle and protein metabolism. It is released at a constant rate by the body (depending on muscle mass). Biological relevance Serum creatinine (a blood measurement) is an import ...

creatinine clearance Assessment of kidney function occurs in different ways, using the presence of symptoms and signs, as well as measurements using urine tests, blood tests, and medical imaging. Functions of a healthy kidney include maintaining a person's fluid ...

— used to assess

kidney function Assessment of kidney function occurs in different ways, using the presence of symptoms and medical sign, signs, as well as measurements using urine tests, blood tests, and medical imaging. Renal physiology, Functions of a healthy kidney include ...

* Albumin/creatinine ratio — used to diagnose

microalbuminuria Microalbuminuria is a term to describe a moderate increase in the level of urine albumin. It occurs when the kidney leaks small amounts of albumin into the urine, in other words, when an abnormally high permeability for albumin in the glomerulus o ...

Urine osmolality Urine osmolality is a measure of urine concentration, in which large values indicate concentrated urine and small values indicate diluted urine. Consumption of water (including water contained in food) affects the osmolality of urine. Overview ...

— measure of the

solute In chemistry, a solution is defined by IUPAC as "A liquid or solid phase containing more than one substance, when for convenience one (or more) substance, which is called the solvent, is treated differently from the other substances, which are ...

concentration of urine *

Urine specific gravity Specific gravity, in the context of clinical pathology, is a urinalysis parameter commonly used in the evaluation of kidney function and can aid in the diagnosis of various renal diseases. Background One of the main roles of the kidneys i ...

― another measure of urine concentration *

Urine electrolyte levels Urine electrolyte levels can be measured in a medical laboratory for diagnostic purposes. The urine concentrations of sodium, chlorine and potassium may be used to investigate conditions such as abnormal blood electrolyte levels, acute kidney inj ...

— measurement of

such as

sodium Sodium is a chemical element; it has Symbol (chemistry), symbol Na (from Neo-Latin ) and atomic number 11. It is a soft, silvery-white, highly reactive metal. Sodium is an alkali metal, being in group 1 element, group 1 of the peri ...

and

potassium Potassium is a chemical element; it has Symbol (chemistry), symbol K (from Neo-Latin ) and atomic number19. It is a silvery white metal that is soft enough to easily cut with a knife. Potassium metal reacts rapidly with atmospheric oxygen to ...

in urine *

Urine anion gap In clinical chemistry, the urine anion gap is calculated using measured ions found in the urine. It is used to aid in the differential diagnosis of metabolic acidosis. The term "anion gap" without qualification usually implies serum anion gap. ...

— used to distinguish between some causes of

metabolic acidosis Metabolic acidosis is a serious electrolyte disorder characterized by an imbalance in the body's acid-base balance. Metabolic acidosis has three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidn ...

Hormones

Urine pregnancy test A pregnancy test is used to determine whether a person is pregnant or not. The two primary methods are testing for the pregnancy hormone (human chorionic gonadotropin (hCG)) in blood or urine using a pregnancy test kit, and scanning with ultras ...

― detects

human chorionic gonadotropin Human chorionic gonadotropin (hCG) is a hormone for the maternal recognition of pregnancy produced by trophoblast cells that are surrounding a growing embryo (syncytiotrophoblast initially), which eventually forms the placenta after implantat ...

in urine *

Urine cortisol Urine is a liquid by-product of metabolism in humans and many other animals. In placental mammals, urine flows from the kidneys through the ureters to the urinary bladder and exits the urethra through the penile meatus (males) or urethral meatu ...

― used to investigate disorders of the

adrenal gland The adrenal glands (also known as suprarenal glands) are endocrine glands that produce a variety of hormones including adrenaline and the steroids aldosterone and cortisol. They are found above the kidneys. Each gland has an outer adrenal corte ...

s * Urine metanephrines ― used to help diagnose some rare

tumour A neoplasm () is a type of abnormal and excessive growth of tissue (biology), tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tiss ...

Microbiology

Urine cultured on Oxoid Brilliance UTI Agar plate

Urine culture Bacteriuria is the presence of bacteria in urine. Bacteriuria accompanied by symptoms is a urinary tract infection while that without is known as asymptomatic bacteriuria. Diagnosis is by urinalysis or urine culture. ''Escherichia coli'' is the ...

—

of urine samples, used to identify bacteria causing

Miscellaneous

Urine drug screen A drug test (also often toxicology screen or tox screen) is a technical analysis of a biological specimen, for example urine, hair, blood, breath, sweat, or oral fluid/saliva—to determine the presence or absence of specified parent drugs o ...

— screen for usage of

recreational drug Recreational drug use is the use of one or more psychoactive drugs to induce an altered state of consciousness, either for pleasure or for some other casual purpose or pastime. When a psychoactive drug enters the user's body, it induces an Sub ...

s *

Urine cytology Urine cytology is a test that looks for abnormal cells in urine under a microscope. The test commonly checks for infection, inflammatory disease of the urinary tract, cancer, or precancerous conditions. It can be part of a broader urinalysis. If a ...

—

cytopathological Cytopathology (from Greek , ''kytos'', "a hollow"; , ''pathos'', "fate, harm"; and , ''-logia'') is a branch of pathology that studies and diagnoses diseases on the cellular level. The discipline was founded by George Nicolas Papanicolaou in 1 ...

examination of cells in the urine, used to screen for cancer *

Urine protein electrophoresis Protein electrophoresis is a method for analysing the proteins in a fluid or an extract. The electrophoresis may be performed with a small volume of sample in a number of alternative ways with or without a supporting medium, namely agarose or poly ...

— classification and measurement of different

protein Proteins are large biomolecules and macromolecules that comprise one or more long chains of amino acid residue (biochemistry), residues. Proteins perform a vast array of functions within organisms, including Enzyme catalysis, catalysing metab ...

s in the urine; used to help diagnose monoclonal gammopathies *

Urine organic acids Urine organic acids is a medical diagnostic test that measures organic acid metabolites in the urine. The metabolites can come from host cells or from flora. The test can be used to exclude the possibility that a person has an inborn error of metab ...

urine amino acids Aminoaciduria occurs when the urine contains abnormally high amounts of amino acids. In the healthy kidney, the glomerulus (kidney), glomeruli filter all amino acids out of the blood, and the renal tubules then reabsorb over 95% of the filtered am ...

— used to test for some

inborn errors of metabolism Inborn errors of metabolism form a large class of genetic diseases involving congenital disorders of enzyme activities. The majority are due to defects of single genes that code for enzymes that facilitate conversion of various substances ( substr ...

References

Works cited

* * * * * * {{Urine tests Urine tests