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REAGENT STRIP

• Consists of chemical-impregnated absorbent pads attached to a plastic strip.

• Color-producing chemical reaction takes place when absorbent pads comes in contact with the urine specimen

REAGENT STRIP

• Results are obtained by comparing the color formed on the pads with the color on the chart supplied by the manufacturer.

• Semiquantitative value : Trace, 1+, 2+,. . . Or an estimated of mg/dL

C. Store below 30°C and do not freeze

What is the recommended storage condition for reagent strips?
a) Store above 30°C
b) Store in direct sunlight
c) Store below 30°C and do not freeze
d) Store in a transparent container

False

True or False:
It is acceptable to use reagent strips past their expiration date if they appear visually intact.

c) Investigate further and resolve the control results by additional testing

A technician notices that the control results for reagent strips are consistently out of range. What should be the next step?
a) Ignore the results and continue testing patients
b) Document the issue but continue using the strips
c) Investigate further and resolve the control results by additional testing
d) Dispose of the strips immediately and order a new batch

60 secs.

Any degree of uniform pink color

What is the Reading time and positive result of nitrite

pH

Along with the lungs, kidneys are the major regulators of acid-base content of the body.

pH

- Determined by the concentration of Free H ion*

- Measured by using pH meter, litmus paper or nitrazine paper and reagent strip

✓Random samples: pH 4.5 - 8.0

✓First Morning Urine: pH 5.0 - 6.0

✓With normal protein diet: 4.5 to 6.5

pH of random sample

First Morning Urine:

With normal protein diet

PROTEIN

Most indicative of renal disease

• First indicator of renal disease

< 10 mg/dL or 100 - 150 mg/24 hrs.

Normally urine protein level

✓ALBUMIN - major serum protein

✓TAMM HORSFALL GLYCOPROTEIN produced by the tubules

✓Serum and tubular microglobulins

✓CHONs from prostatic, seminal and vaginal secretions

Proteins found in urine include:

> 30 mg/dL (300 mg/L).

Clinical proteinuria is indicated at what levels?

3.4 to 33.9 mg/mmol

Abnormal Albumin:Creatinine Ratio

Prerenal proteinuria

• conditions affecting the plasma prior to its reaching the kidney

• caused by increased levels of LMW plasma proteins such as Hgb, myoglobin and acute phase reactants*

Prerenal proteinuria

Not indicative of actual renal disease & not detected by rgt strip

Prerenal proteinuria

Not indicative of actual renal disease & not detected by rgt strip

BENCE-JONES PROTEIN (BJP)

• Monoclonal immunoglobulin light chains

• Abnormal protein found in patients with multiple

myeloma (MM)

Immunofixation electrophoresis (IEP)

Bence jones protein confirmatory tests

False

True or False:

Prerenal proteinuria is indicative of actual renal disease.

C

Which of the following is NOT a cause of prerenal proteinuria?

a) Increased levels of hemoglobin

b) Muscle injury leading to elevated myoglobin

c) Chronic kidney disease

d) Severely increased acute phase reactants

C) Multiple myeloma

A patient presents with abnormal protein in their urine. Upon heating the urine sample, the protein precipitates at 50°C and dissolves at 100°C. What is the most likely diagnosis?

a) Chronic kidney disease

b) Prerenal proteinuria

c) Multiple myeloma

d) Muscle injury

RENAL PROTEINURIA

• Glomerular and tubular Proteinuria*

• Damage to the glomerular membrane impairs its selective filtration capability.

Renal proteinuria

• Results in an increase amounts of serum proteins, red and white cells that are excreted in the urine.

• Conditions that present the glomerular membrane with abnormal substances and increased blood pressure entering the glomerulus are the major causes of proteinuria.*

- Primary Glomerular Damage

- Disorders that cause glomerular damage

- Transitory glomerular changes.

renal proteinuria it may be categorized into three:

- Glomerulonephritis

- Glomerulosclerosis

- Minimal Change Disease

Primary Glomerular Damage

Associated Disease:

- Post-Streptococcal Glomerulonephritis (PSGN)

- Diabetes Mellitus (DM)

- Lupus Erythematosus (LE)

- Amyloidosis

- Sickle Cell Anemia (SCA)

Disorders that Cause Glomerular Damage

Associated Disease:

- Strenuous Exercise

̈ Fever

̈ Dehydration

̈ Hypertension

̈ Postural Proteinuria

Transitory Glomerular Changes

Associated Disease: