The chemical physical analysis in the urine summary as a triage in clinical management




Urine; Qualitative analysis; Sediments.


The summary urine test consists of physical-chemical analysis and sedimentoscopy. When the physical-chemical phase is normal, it is discussed not carrying out the sedimentoscopy step. This study aimed to evaluate the importance of normal physicochemical results of urine as a screening test for sedimentoscopy. The results of 3661 routine urine summary tests (medium jet) performed at the Clementino Fraga Laboratory, Fortaleza-Ceará, in January 2018 were analyzed. The collected data were recorded, tabulated and analyzed in the SPSS software version 17.0. It was observed that 77.92% of the urine tests showed no physical-chemical alterations. Of the 2658 urines with normal physicochemical analyses, 87.06% had normal sedimentoscopies within a confidence interval of 85.78% - 88.34%. Analyzing the negative predictive value (NPV) of urine with normal physicochemical and correlating it with the alterations found in the sedimentoscopies, we verified that this method has 99.8% of accuracy for all the elements found. The absence of leukocyte esterase and red blood cells in the physical-chemical analysis has an accuracy for sedimentoscopy of 97.5% and 98.2%, respectively. The present study suggests the use of normal physicochemical analysis as an exclusion factor for sedimentoscopy.


Altekin, E., Kadiçesme, O., Akan, P., Kume, T., Vupa, O., Ergor, G., & Abacioglu, H. (2010). New generation IQ‐200 automated urine microscopy analyzer compared with KOVA cell chamber. Journal of clinical laboratory analysis, 24(2), 67-71.

Beer, J. H., Vogt, A., Neftel, K., & Cottagnoud, P. (1996). False positive results for leucocytes in urine dipstick test with common antibiotics. British medical journal, 313(7048), 25-26.

Chien, T. I., Kao, J. T., Liu, H. L., Lin, P. C., Hong, J. S., Hsieh, H. P., & Chien, M. J. (2007). Urine sediment examination: a comparison of automated urinalysis systems and manual microscopy. Clinica Chimica Acta, 384(1-2), 28-34.

Cho, E. J., Ko, D. H., Lee, W., Chun, S., Lee, H. K., & Min, W. K. (2018). The efficient workflow to decrease the manual microscopic examination of urine sediment using on-screen review of images. Clinical Biochemistry, 56, 70-74.

Christenson, R. H., Tucker, J. A., & Allen, E. (1985). Results of dipstick tests, visual inspection, microscopic examination of urine sediment, and microbiological cultures of urine compared for simplifying urinalysis. Clinical chemistry, 31(3), 448-451.

Costaval, J. A. D., Massote, A. D. P., Cerqueira, C. M. M., Costaval, A. P. D., Auler, A., & Martins, G. J. (2001). Qual o valor da sedimentoscopia em urinas com características físico-químicas normais?. Jornal Brasileiro de Patologia e Medicina Laboratorial, 37, 261-265.

Dewulf, G., Harrois, D., Mazars, E., Cattoen, C., & Canis, F. (2009). Evaluation of the performances of the iQ (®) 200 ELITE automated urine microscopy analyser and comparison with manual microscopy method. Pathologie-biologie, 59(5), 264-268.

Fonseca, F. L. A., Santos, P. M., Belardo, T. M. G., Fonseca, A. L. A., Caputto, L. Z., & Alves, B. C. A. (2016). Análise de leucócitos em urina de pacientes com uroculturas positivas. Revista Brasileira de Análises Clínicas, 48(3), 258-261.

Giovanni, B. F., Garigali, G. (2018) Urinalysis. In: Floege J, Johnson RJ, FeehallY J. Comprehensive Clinical Nephrology. 6th ed. Saint Louis, Elsevier Health Sciences, 39-52.

Grossfeld, G. D., Litwin, M. S., Wolf, J. S., Hricak, H., Shuler, C. L., Agerter, D. C., & Carroll, P. R. (2001). Evaluation of asymptomatic microscopic hematuria in adults: the American Urological Association best practice policy—part II: patient evaluation, cytology, voided markers, imaging, cystoscopy, nephrology evaluation, and follow-up1. Urology, 57(4), 604-610.

Hamoudi, A. C., Bubis, S. C., & Thompson, C. (1986). Can the cost savings of eliminating urine microscopy in biochemically negative urines be extended to the pediatric population?. American journal of clinical pathology, 86(5), 658-660.

Heggendornn, L. H., Silva, N. A., & Cunha, G. A. (2014). Urinálise: a importância da sedimentoscopia em exames físico-químicos normais. Revistra Eletrônica de Biologia, 7(4), 431-43.

Hermida, F. J., Soto, S., & Benitez, A. J. (2016). Evaluation of the Urine Protein/Creatinine Ratio Measured with the Dipsticks Clinitek Atlas PRO 12. Clinical Laboratory, 62(4), 735-738. DOI: 10.7754/Clin.Lab.2015.150727

İnce, F. D., Ellidağ, H. Y., Koseoğlu, M., Şimşek, N., Yalçın, H., & Zengin, M. O. (2016). The comparison of automated urine analyzers with manual microscopic examination for urinalysis automated urine analyzers and manual urinalysis. Practical laboratory medicine, 5, 14-20.

Lam, M. H. (1995). False hematuria due to bacteriuria. Archives of pathology & laboratory medicine, 119(8), 717-721.

Lee, W., Kim, Y., Chang, S., Lee, A. J., & Jeon, C. H. (2017). The influence of vitamin C on the urine dipstick tests in the clinical specimens: a multicenter study. Journal of Clinical Laboratory Analysis, 31(5), e22080.

Logsetty, S. (1994). Screening for bladder cancer. The Canadian Guide to Clinical Preventive Health Care.

Oyaert, M., & Delanghe, J. R. (2019). Semiquantitative, fully automated urine test strip analysis. Journal of Clinical Laboratory Analysis, 33(5), e22870.

Miler, M., & Nikolac, N. (2018). Patient safety is not compromised by excluding microscopic examination of negative urine dipstick. Annals of Clinical Biochemistry, 55(1), 77-83.

Misdraji, J., & Nguyen, P. L. (1996). Urinalysis: when—and when not—to order. Postgraduate medicine, 100(1), 173-192.

Okada, H., Sakai, Y., Kawabata, G., Fujisawa, M., Arakawa, S., Hamaguchi, Y., & Kamidono, S. (2001). Automated urinalysis: evaluation of the Sysmex UF-50. American journal of clinical pathology, 115(4), 605-610.

Pereira, A. S., Shitsuka, D. M., Parreira, F. J., Shitsuka, R. (2018). Metodologia da pesquisa científica. [free e-book]. Santa Maria/RS. Ed. UAB/NTE/UFSM.

Previtali, G., Ravasio, R., Seghezzi, M., Buoro, S., & Alessio, M. G. (2017). Performance evaluation of the new fully automated urine particle analyser UF-5000 compared to the reference method of the Fuchs-Rosenthal chamber. Clinica Chimica Acta, 472, 123-130.

Ramlakhan, S. L., Burke, D. P., & Goldman, R. S. (2011). Dipstick urinalysis for the emergency department evaluation of urinary tract infections in infants aged less than 2 years. European journal of emergency medicine, 18(4), 221-224. DOI: 10.1097/MEJ.0b013e3283440e88

Ringsrud, K. M., Linné, J. J., & Linné, J. J. (1995). Urinalysis and body fluids: a colortext and atlas. Mosby Incorporated.

Sánchez-Mora, C., Acevedo, D., Porres, M. A., Chaqués, A. M., Zapardiel, J., Gallego-Cabrera, A., ... & Maesa, J. M. (2017). Comparison of automated devices UX-2000 and SediMAX/AutionMax for urine samples screening: A multicenter Spanish study. Clinical biochemistry, 50(12), 714-718.

Strasinger, S., DiLorenzo MS. (2009). King. Uroanálise e Fluídos Biológicos. São Paulo: LMP.

Aitekenov, S., Gaipov, A., & Bukasov, R. (2021). Detection and quantification of proteins in human urine. Talanta, 223, 121718.

US Preventive Services Task Force. (1990). Screening for asymptomatic bacteriuria, hematuria and proteinuria. Am Fam Physician, 42, 389-95.

Tomson, C., & Porter, T. (2002). Asymptomatic microscopic or dipstick haematuria in adults: which investigations for which patients? A review of the evidence. BJU international, 90(3), 185-198.

Van Delft, S., Goedhart, A., Spigt, M., van Pinxteren, B., de Wit, N., & Hopstaken, R. (2016). Prospective, observational study comparing automated and visual point-of-care urinalysis in general practice. BMJ open, 6(8), e011230.



How to Cite

SOUSA, P. C. P. de .; PETROLA, A. N. S. .; FÉRRER, C. M. .; VALE, L. A. .; XAVIER, L. G. M. .; KUBRUSLY, M. . The chemical physical analysis in the urine summary as a triage in clinical management. Research, Society and Development, [S. l.], v. 12, n. 2, p. e8012239922, 2023. DOI: 10.33448/rsd-v12i2.39922. Disponível em: Acesso em: 7 jun. 2023.



Health Sciences