tetrabromophenol blue) in the presence of varying concentrations of protein when the pH is held constant. The protein test is based on a change in color of a pH indicator (e.g. Pigmented urine can interfere with pH readings. Bacterial contaminants, blood in the urine and contamination by genital secretions can alter urine pH. Heavy bacterial growth may cause an alkaline shift in urine pH by converting urea to ammonia. A diet high in protein produces a more acid urine, while a vegetarian diet often produces a pH greater than 6. The average adult urine pH varies between 5 and 8. Metabolism produces acids that are excreted by the lungs and kidneys. The pH of urine is an indication of the kidney’s ability to maintain a normal plasma pH. pH should be measured in fresh urine and read quickly. Colors range from orange through yellow and green to blue. The test is based on a double indicator method (methyl red and bromthymol blue) that covers the entire range of urine pH. The principle and performance of each dipstick test is summarized below. Urine dipsticks are plastic strips with attached reagent pads for pH, protein, glucose, ketone, bilirubin, urobilinogen, blood, nitrite, and leukocyte esterase. However, most of the missed cases are clinically insignificant and are often due to contaminating bacteria multiplying after urine collection. Numerous studies have determined that 6 to 20% of patients with urine sediment abnormalities are missed by this testing strategy. Performing microscopic analysis on only dipstick positive urine samples is cost effective when the patient population being tested has a low incidence of potential disease. Urine samples are initially screened with dipsticks. Hematuria, hemoglobinuria, myoglobinuria, porphyriaīeets, blackberries, rhubarb, Phenolphthalein, rifampin Phenothiazines, phenazopyridine (Pyridium) Phosphorus, pyuria, chyluria, lipiduria, hyperoxaluriaĭiet high in purine-rich foods causing uricosuriaįava beans, Levodopa, metronidazole (Flagyl), nitrofurantoin, anti-malarial drugsĪmitriptyline, indigo, carmine, IV cimetidine (Tagamet), IV promethazine (Phenergan), methylene blue, triamterene (Dyrenium)
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