Urine analysis involves inspection and testing of a urine sample to screen for disease and infection. Collection of uncontaminated urine from an infant or small child can be challenging, but your pediatrician will give you advice regarding the method that is likely to work best for your child. Any medication, including vitamins, may affect the outcome of the urine analysis, so be sure to give your pediatrician a complete list of any drugs, vitamins or nutritional supplements your child takes.
Purpose
Doctors use urine analysis to screen for diabetes, kidney disease, urinary tract infection and liver disease. In many cases, urine analysis is a first step. Other tests, such as a culture growth, may be necessary to confirm the preliminary diagnosis. Doctors also use urine analysis to monitor the progression of a disease or the success of treatment. For example, analysis of blood sugar levels in your child's urine will help determine if her diabetes is under control and a white blood cell count will indicate whether antibiotics are bringing an infection under control.
Procedure
Normally, fasting is not necessary for urine collection, but it is best to get a sample first thing in the morning if possible. Wash your child's external genitalia and rectal area before taking the sample. After you have collected the sample, label it with your child's name and the date so there is no confusion at the laboratory. If you are keeping the sample for longer than 30 minutes, store it in your refrigerator.
Methods
If your child is old enough, you may be able to capture his urine in the specimen cup in mid-stream. This lessens the possibility of contaminants in the sample. If your child is an infant or a toddler, your doctor may give you a special sanitized bag to tape over his genital area to capture urine. This bag can go under a diaper. The risk of contamination with this procedure is greater, so your pediatrician may decide to collect urine via a catheter or a needle that she inserts directly into your child's bladder through his abdomen.
Findings
In the lab, a technician will examine the appearance of the urine sample. Cloudiness can be an indicator of infection and a reddish or brownish color may signal the presence of blood in the urine. The technician also will use a dipstick with strips of chemicals to test for the presence of acid or protein, which may signal a kidney disorder. The dipstick test also may reveal the presence of sugar or ketones in the urine, which could indicate your child has diabetes. The presence of biliruben could indicate a liver disorder and the presence of nitrites and leukocytes -- byproducts of white blood cells -- could indicate an infection. The technician also will observe a portion of the sample under a microscope to look for white or red blood cells, epithelial cells, bacteria, yeast, proteins or crystals, which may indicate infection or a kidney problem.
Followup
Because of the possibility of contamination, if the urine analysis indicates possible infection, you doctor may decide to repeat the test or he may order a urine culture to confirm the results. In most cases, doctors prescribe a course of antibiotic treatment while awaiting the results of the followup tests. If the second test comes back negative, the doctor will tell you to discontinue the antibiotics. If the urine analysis indicates other problems, such as kidney or liver disease or diabetes, your pediatrician probably will order additional tests to confirm the diagnosis and determine the severity of the condition.
