Not “Urinetown,” but Urine Test.

You’ve heard of the very successful musical, “Urinetown”?  Surprisingly, it’s not really about urine, but this blog is.  By the way, the play is running at Paradise Valley Community College in Arizona from the 12th to the 21st of November.


The 24 Hour Urine Collection Tests

There’s a 24 hour urine collection analysis requested on my yearly script and probably on yours, too . The written instructions about cleaning your genitals may not be clear.  If not, ask.  It’s better to take a few extra minutes of the P.A. or M.A.’s time for an explanation than having to collect the urine all over again due to contamination.  Your nephrologist will have already given you the container for collection and, if you are female, a collection seat (for lack of a better term).  This is something you place over your open toilet seat to insure you don’t waste any of the urine.

Well, that is, after the first urination of the day.  That one goes directly down the toilet and is not part of the collection. You’ll also be instructed to do what should be obvious: wash your hands both before and after you urinate and be sure not to allow any foreign substance like menstrual blood, toilet paper, or fecal matter to get into your urine collection.

You’ll need to refrigerate the specimens as you collect them during the 24 hour urine collection. It’s important to catch all the urine you produce during this time period since the amount of urine you produce [the volume] is used in the equation that determines your stage of CKD.  That means you’re going to have a large opaque container that is highly reminiscent of a milk container in your refrigerator for 24 hours.  Surely, the need to label the container is clear.

You’ve got to make certain the lab understands your doctor’s orders and your doctor has really ordered the tests you’re taking.  I recently had the unhappy experience of having my 24 hour urine collection tossed by the lab.  It wasn’t on the script I brought them from my nephrologist, and when they called his office at my insistence, they were told it wasn’t time for that and not to accept the specimen.  At my next doctor’s appointment when I told him what had happened, he said nothing – just pantomimed banging his head against the wall.

One of the tests ordered is 1100 Creatinine Clearance. When compared to the amount of creatinine in your blood, this is the most accurate test to assess how well the kidneys are filtering the creatinine from your blood. Remember, creatinine is the waste product from muscle metabolism. The less creatinine in your urine, the more in your blood, which means the kidneys are not working as well as they should be.

You need to be aware that creatinine clearance values go down as you age.  One source suggested 6.5 mL/min for every 10 years past age 20. You’ll see your mL/min on your test results. The decrease in clearance values as you age meant quite a bit of figuring for me since I’m in my mid sixties. It only reaffirmed that you just can’t get away from math with this disease.

Another test, 1101, also deals with creatinine, but this is slightly different in that the urine is timed. Since creatinine is not recycled in the blood, it is produced at a constant rate and only the kidneys filter it out of the blood. This test is a more exact determination of how well or poorly the kidneys are doing their job.

Then there’s 2043, Protein, Urine Timed which checks for protein in the urine during a specific time period, 24 hours in this case.  Since one of the jobs of the kidneys is to filter the protein from your blood and then reabsorb it, there should be very little to no protein in your urine if your kidneys are functioning well.

I read these test explanations again and again as I blog, monitor Kidney Matters on the OTC Facebook page, and finish editing the book and I am amazed at what your blood and urine can say about the condition of your health.  I don’t think I’d be at all surprised if one day soon someone invented an at home CKD urine test, sort of like the at home pregnancy tests that are now available.

I doubt that will happen before Tuesday, so until then,

Keep loving your life (“keep living” didn’t quite say what I meant)!

Published in: on November 5, 2010 at 7:01 pm  Leave a Comment  

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