The normal urobilinogen range obtained with this test
is 0.2 to 1.0 mg/dL. A result of 2.0 mg/dL represents the
transition from normal to abnormal, and the patient and/
or urine specimen should be evaluated further.
Specific Performance Characteristics
Specific performance characteristics are based on clinical
and analytical studies. In clinical specimens, the sensitivity
depends upon several factors: the variability of color
perception, the presence or absence of inhibitory factors
typically found in urine, the specific gravity, and the pH
(see Limitations of Procedures section); and the lighting
conditions when the product is read visually. Because
the color of each reagent area changes as the analyte
concentration increases, the percentage of specimens
detected as positive will increase with the analyte
Each color block or instrumental display value
represents a range of values. Because of specimen and
reading variability/specimens with analyte concentrations
that fall between nominal levels may give results at either
level. Results at levels greater than the second positive level
for the glucose, ketone, protein and urobilinogen tests will
usually be within one ‘level of the true concentration. Exact
agreement between visual results and instrumental results
might not be found because of the inherent differences
between the perception of the human eye and the optical
The following table lists the generally detectable levels
of analytes in contrived urine; however, because of the
inherent variability of clinical urines, lesser concentrations
may be detected under certain conditions.
Bilirubin 0.4–0.8 mg/dL bilirubin
Ketone 5–10 mg/dL acetocetic acid
Blood 0.015–0.062 mg/dL hemoglobin
The test is specific for glucose; no substance excreted
in urine other than glucose is known to give a positive
result. The reagent area does not react with lactose,
galactose, fructose nor reducing metabolites of drugs
(e.g. salicylates and nalidixic acid. This test may be used
to determine whether the reducing substance found
in urine is glucose. Reactivity may be influenced by
urine specific gravity and temperature. In dilute urines
containing less than 5 mg/dL ascorbic acid, as little as 40
mg/dL glucose may produce a color change that might be
interpreted as positive. The test is more sensitive than the
copper reduction test (e.g. Clinitest Reagent Tablets).
If the color appears somewhat mottled at the higher
glucose concentrations, match the darkest color to the
The test has a sensitivity of 0.4–0.8 mg/dL bilirubin.
The test reacts with acetoacetic acid in urine. It does not
react with acetone or (3-hydroxybutyric acid. Some high
specific gravity/low pH urines may give reactions up to and
including Trace. Clinical judgment is needed to determine
the significance of reactions up to and including Trace.
The specific gravity test permits determination of urine
specific gravity between 1.000 and 1.030. In general, it
correlates within 0.005 with values obtained with the
refractive index method. For increased accuracy, 0.005
may be added to readings from urines with pH equal
to or greater than 6.5. Strips read instrumentally are
automatically adjusted for pH by the instrument. The
Bayer SG test is not affected by certain nonionic urine
constituents such as glucose nor by the presence of
The sensitivity of this test may be reduced in urines with high
specific gravity. The test is equally sensitive to myoglobin as
to hemoglobin. The appearance of green spots on the reacted
reagent area indicates the presence of intact erythrocytes in
the urine. The color chart includes examples of trace and
moderate nonhemolyzed color blocks. Reactions ranging
from trace to large, with proportionately more numerous
spots, may be observed, (A hemoglobin concentration of
0.015-0.062 mg/dL is approximately equivalent to 5–20
intact red blood cells per microliter). Because of the optical
systems of urine chemistry instruments, the sensitivity to
intact erythrocytes is lower than that perceived visually.
The pH test area measures pH values generally to within
1 unit in the range of 5–8.5 visually and 5–9 instrumentally.
pH readings are not affected by variations in the urinary
The reagent area is more sensitive to albumin than to
This test area will detect urobilinogen in concentrations
as low as 0.2 mg/dL (approximately 0.2 EU/dL) in urine.
The absence of urobilinogen in the specimen cannot be
Multistix Urinalysis Strips (Fig. 5.3)
Dependable Results When and Where You Need
Bayer’s Multistix strips lead the market in providing a
range of rapid urine testing results. When read visually
or automatically on either the Clinitek 50 or Clinitek 500
readers they enable on the spot clinical decisions to be
made with confidence (Table 5.5).
¾ Fast, reliable results available in 1–2 minutes
¾ Automated reading provided in 1 minute using.
TABLE 5.5: Multistix configurations
Leuc Nitrite Urobil Prot pH Blood SG Ket Bill Gluc
Multistix 10 SG √ √ √ √ √ √ √ √ √ √
Multistix 8 SG √ √ √ √ √ √ √ √
N-Multistix SG √ √ √ √ √ √ √ √ √
FIG. 5.4: Dip FIG. 5.6: Read at correct time
First Line Health Screen for a Variety of Settings
¾ Menu: Glucose, ketones, bilirubin, urobilinogen,
specific gravity, blood , pH, protein, nitrite, leukocytes.
¾ Diabetes Management/Renal checks using microalbumin (Albumin : Creatinine Ratio) while the patient
¾ Screens out non-infected urine samples so that only
the positives need to be referred for laboratory followup in cases of urinary tract infection.
Clinitek Status® Urine Analyzer (Fig. 5.7)
Dependable Results in Any Patient Setting
Introducing the new Clinitek Status. Providing simple,
accurate results for higher standards in urinalysis;
Urinalysis has long been an essential tool in health care,
but visually read results may be less than ideal today’s
world. The Clinitek Status can help (Fig. 5.8):
¾ New levels of precision and reliability
FIG. 5.8: Clinitek Status instrument (Courtesy: Siemens Medical Solutions)
Dimensions Weight Instrument memory Computer powered
¾ Reassuringly proven performance
¾ Pregnancy test capability using the NEW CIinitest hCG
¾ Automation reduces the risk of errors.
A Wide Range of Test Parameters
Clinitek status is suitable for use with a wide range of
FIG. 5.10: Etiological basis of positive test results
Leukocytes A passive result may indicate renal disease or
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