THE CHEMICAL EXAMINATION OF The 4, 10, and 12 parameters.

URINE
 OBJECTIVES:
Discuss the proper technique for performing reagent strip testing, know its purpose
and advantages to different urinalysis test.

Proper storage of reagent strips, to avoid premature deterioration.

Determine the step by step procedure of reading the reagent strips, start from
handling, reading, and correlate the result from different reagent pad result.

Know how to do quality control of reagent strips

REAGENT STRIPS: INTRODUCTION
Routine chemical examination of urine has changed
dramatically since the early days of urine testing.

Contributing to the modernize chemical testing of

urine, gaining:
• efficiency
• accuracy
• precision
• rapid testing
• and a wide range of availability of test.
THE TWO MAJOR TYPES OF REAGENT
STRIPS BRAND

Multistix((Siemens
Medical Solutions
Diagnostics,
Tarrytown, N.Y.)
THE TWO MAJOR TYPES OF REAGENT
STRIPS BRAND

Chemstrip
(Roche
Diagnostics,
Indianapolis,
Ind.)
Single testing - 1 reagent for 1 strip.
REAGENT STRIPS
REAGENT STRIPS

Philippine
Brand Name:
• Insight
REAGENT STRIPS

the brand and number of tests used are a

matter of laboratory preference.

Certain variations relating to chemical

reactions, sensitivity, specificity, and interfering
substances occur among the products.
REAGENT STRIPS
Multiple reagents.
4 parameters
10 parameters
12 parameters
REAGENT STRIPS: 4 PARAMETERS

Glucose

Protein

pH

Specific Gravity
 REAGENT STRIP: 10 PARAMETERS
Blood Ketones
Bilirubin Proteins(albumin)
Urobilinogen Specific Gravity
Glucose Nitrate
pH Leukocyte esterase
reduction
Reagent Strip: 12 parameters
Blood Nitrate
Bilirubin Leukocyte esterase reduction.
Urobilinogen Ascorbic acid
Glucose Micral test.
pH
Ketones
Proteins(albumin)
Specific Gravity
REAGENT STRIPS
Reagent strips consist of chemical-impregnated absorbent pads
attached to a plastic strip.

A color-producing chemical reaction takes place when the absorbent

pad comes in contact with urine.

The reactions are interpreted by comparing the color produced on the

pad with a chart supplied by the manufacturer.

a semiquantitative value of trace, 1+, 2+, 3+, or 4+ can be reported.

 MANNER OF REPORTING
a semiquantitative
value of trace, 1+, pH (6.0-9.0) specific gravity
2+, 3+, or 4+ can (1.005-1.030).
be reported.

Examples: glucose
and protein
REAGENT STRIP TECHNIQUE
REAGENT STRIP TECHNIQUE
Improper techinque can result in errors:
unmixed or using a centrifuge specimen.
Formed elements and sunstancec will sink to the bottom
and will be undetected.
REAGENT STRIP TECHNIQUE
Improper techinque can result in errors:
Allowing the strip to remain in the urine for an
extended period.
may cause leaching of reagents from the pads.
(example. Protein strips)
REAGENT STRIP TECHNIQUE

Improper • urine remaining on the strip after

techinque its removal from the specimen
• produce a runover between
can chemicals on adjacent pads,
result in producing distortion of the
colors.
errors:
REAGENT STRIP TECHNIQUE
Improper • wrong timing of reading.
• time needed for reactions to take place
techinque can varies between tests and manufacturers.
result in errors: • Example: LE test(2 mins.)

when precise
• reactions can be read between
timing cannot be 60 and 120 seconds.
achieved.
REAGENT STRIP TECHNIQUE

Improper • Performing dipstick on

techinque regfrigerated specimen.
can • Enzymatic reactions on
result in the strips are
temperature dependent.
errors:
 REAGENT STRIP TECHNIQUE
• The strip must be held close to the color chart without
actually being placed on the chart.
• A good light source is, of course, essential for accurate
interpretation of color reactions.
REAGENT STRIP TECHNIQUE SUMMARY
Dip the reagent strip briefly into a well-mixed uncentrifuged
urine specimen at room temperature.
Remove excess urine by touching the edge of the strip to the
container as the strip is withdrawn.
Blot the edge of the strip on a disposable absorbent pad.

Wait the specified amount of time for the reaction to occur.

Compare the color reaction of the strip pads to the
manufacturer’s color chart in good lighting.
 Automated
REAGENT STRIP TECHNIQUE reagent strip
instruments
AUTOMATED REAGENT STRIPS READING
Automation of reagent strip • Color
• Interpretation
reading produce a standardize: • And timing

Also doesn’t need room lighting or

inconsistency among lab personnel.

AUTOMATED REAGENT STRIP READING

The disadvanteges:
It’s a close system.
HANDLING AND STORAGE OF
REAGENT STRIPS
 HANDLING AND STORAGE OF REAGENT
STRIPS
Proper care of reagent strips is an addition of
proper reagent strip testing.

reagent strips • Moisture (reagent strip bottles

must be has a dessicant (silica gel)).
protected from
deterioration • volatile chemicals(gasoline,
benzene, formaldehyde, )
caused by:
 HANDLING AND STORAGE OF REAGENT
STRIPS
Proper care of reagent strips is an addition of
proper reagent strip testing.

reagent strips • Heat or Cold(It must be

must be stored at room temparature)
protected from
deterioration • Light(for photo-sensitive
caused by: reagent)
HANDLING AND STORAGE OF REAGENT
STRIPS
Strips are removed just prior to testing, and the bottle is
tightly resealed immediately.

All bottles are stamped with an expiration date that

represents the functional life expectancy of the chemical
pads.
Care must be taken not to touch the chemical pads when
removing the strips.
QUALITY CONTROL OF REAGENT STRIPS
Quality control testing, checks both Positive and
negative controls:
• Reagent strips must be checked minimum of once
every 24 hours. Other laboratories prefer every shift.
• New bottle of reagent strips is opened.
• Questionable results are obtained.
• There is concern about the integrity of the strips.
(examples: discolored strips and out of date.)
QUALITY CONTROL OF REAGENT STRIPS

All quality control results must be

recorded following laboratory
protocol.
• There are commercially available controls for
reagent strips.
• Others use a pooled patient sample.
•Distilled water is not recommended.
QUALITY CONTROL OF REAGENT STRIPS
All readings of the negative control must
be negative.

Positive control readings should agree with

the published value by one color block.
CHART OF RESOLVING QUALITY
CONTROL.
 QUALITY CONTROL OF REAGENT STRIPS
Demonstration of Interfering substances in the urine (example:
chemically acceptable orange pigment present in the urinepersons
reagent strips does not taking phenazopyridine compounds)
entirely rule out the
possibility of inaccurate technical carelessness(reading multiple
results. strips at once.)

color blindness
 Nonreagent Questionable
strip testing results are
procedures obtained
QUALITY using
CONTROL tablets and Specimen with
OF liquid interfering
REAGENT chemicals substances
STRIPS
Used to confirm
positive result.
SUMMARY OF REAGENT STRIP TESTING
Care of 1. Store with desiccant in an opaque, tightly closed
container.
Reagent 2. Store below 30C; do not freeze.
Strips
3. Do not expose to volatile fumes.

4. Do not use past the expiration date.

5. Do not use if chemical pads become discolored.

6. Remove strips immediately prior to use.

 SUMMARY OF REAGENT STRIP TESTING
• Mix specimen well.
• Let refrigerated specimens warm to room temperature before
testing.
• Dip the strip completely, but briefly, into specimen.
• Remove excess urine by withdrawing the strip against the rim
of the container and by blotting the edge of the strip.
• Compare reaction colors with the manufacturer’s chart under
a good light source at the specified time.

Technique • Perform backup tests when indicated.

• Be alert for the presence of interfering substances.
• Understand the principles and significance of the test, read
package inserts
• Relate chemical findings to each other and to the physical and
microscopic urinalysis results.
SUMMARY OF REAGENT STRIP TESTING
• 1.Test open bottles of reagent strips with known
positive and negative controls every 24 hr.
• 2. Resolve control results that are out of range by
further testing.
Quality • 3.Test reagents used in backup tests with positive
and negative controls.
Control
• 4. Perform positive and negative controls on new
reagents and newly opened bottles of reagent
strips.
• 5. Record all control results and reagent lot
numbers.