Urine Dipstick Test
A urine dipstick test is a test of urine, using a special strip of paper that is dipped into a sample of urine. The result is available almost immediately. It is sometimes called a rapid urine test.
Urine is normally sterile - this means it's completely free of germs (bacteria) - and only has in it waste chemicals from all of the millions of chemical reactions that go on in your body all of the time.
But in some conditions chemicals that shouldn't normally be there get through the filtering systems in your kidneys and get into your urine. This is where urine dipstick testing comes in.
What is a urine dipstick test?
A urine dipstick test is the quickest way to test urine. It involves dipping a specially treated paper strip into a sample of your urine. This can be done during your appointment with your doctor, midwife or other health professional. The results are usually available within 60-120 seconds. Your sample doesn't need to be sent to a laboratory for a urine dipstick test, although if the test is abnormal you might need to do another sample to be sent for further testing in a laboratory.
What do you need to do for a urine dipstick test?
To have a urine dipstick test done you will need to give your medical professional a sample of your urine. This needs to be in a sterile container. Sterile means it has no living germs (bacteria) in it. Usually if you are asked to provide a sample, you will be given a sterile pot to use. Your urine can still be tested for some things if it isn't in a sterile container but the results might not be as accurate and your urine can't be tested for infection.
To get your sample, you need to pee (urinate) straight into the pot. Ideally you shouldn't pee into something else and then transfer it to the special pot, as then it won't be sterile any more. The best sample is one which is called a midstream specimen of urine (MSU). This means that you start to pee then pass the open pot into the stream of urine and then take it away again when you have caught enough urine. You don't stop peeing while doing this. Tightly put the lid on the pot then wash your hands and the pot.
How is a urine dipstick test done?
Your health professional will use a urine testing strip to test your urine. There are several different kinds of urine testing strips that test for different things in the urine. The strip has squares on it that change colour in the presence of certain substances. The strip will then be compared to a chart on the side of the urine testing strip package. Often the more intense the colour change, the more of the substance there is in the urine.
How to read a urine dipstick
Your doctor or nurse may read your dipstick result for you. However, sometimes you may be asked to monitor your own urine at home.
Some urine dipsticks test for just one or two of the abnormalities below. Others test for many of these substances.
To read your dipstick, you should:
- Take a urine sample as above.
- Dip one of the sticks into the sample, making sure all the test zones on the stick are submerged.
- Remove the stick, tap to remove excess urine and hold it horizontally so urine doesn't drip.
- Check on the label of the dipstick bottle how long you need to wait (the length of time varies for the different tests below, usually from 30 seconds to 2 minutes).
- After the relevant time, hold the dipstick up against the colour chart on the dipstick bottle.
- Each test will be colour-coded and there will be several different shades of that colour. A darker shade indicates that there is more of the relevant substance - blood, glucose etc - in your urine.
- Record the result next to the matching colour on the label - this may be given in the form of '+' signs or numbers.
Why is a urine dipstick test done?
A urine dipstick test is done for lots of different reasons, such as:
- A routine check when you're pregnant.
- To screen for diabetes.
- If you think you might have a urine infection.
- If you have tummy (abdominal) pain.
- If you have back pain.
- If you think you've seen blood in your urine (haematuria).
- Some people with diabetes will do their own urine dipstick testing.
The first thing that your health professional will do is look at your urine. Normal urine varies in colour from colourless to dark yellow. Various things can affect the way your urine looks, from how much you've been drinking to what you've eaten recently. The smell can also vary widely and is not a good gauge of illness.
What are the results of a urine dipstick test?
A urine dipstick test can look for the following:
- Not normally found in the urine.
- May be present if there is an infection.
- Can be due to significant underlying disease, such as cancer, in the bladder or kidney (and the prostate gland in men).
- In women, it may be contamination if you are on your period at the time of doing the sample.
- Will always need to be confirmed by sending the sample for a full laboratory test, as the dipstick test can be positive when there's nothing wrong.
- Protein is normally found in the urine in tiny amounts but these tiny amounts aren't usually picked up on a urine dipstick test.
- Protein may be found in larger amounts if there is an infection or if you're pregnant and are developing pre-eclampsia.
- Can be the first sign of kidney disease.
- Glucose, a type of sugar, is never normally found in the urine.
- The only exception is if you have type 2 diabetes and are taking a medicine called an SGLT2 inhibitor (such as canagliflozin, dapagliflozin, empagliflozin or ertugliflozin). These medicines can help reduce your blood sugar partly by reducing the amount of glucose you reabsorb into your system as it passes through the kidneys. Having glucose in your urine if you're taking one of these medicines is normal.
- Glucose in the urine may be the first sign of diabetes.
- Ketones are chemicals made by the body when it's breaking down fat for energy, which is what we do when we are starving and have used up all, or nearly all, of our stores of sugar (glucose). This is normal.
- Ketones are not usually found in the urine.
- Ketones may be present if you have diabetes and it's out of control and the levels of glucose in the blood are very high.
- Ketones may also be present in women who are pregnant.
Bilirubin and urobilinogen
- Bilirubin and urobilinogen are chemicals produced by the liver. They are not normally found in the urine.
- If bilirubin is found in the urine it usually means there's a problem with the liver.
- Small amounts of urobilinogen may be found in the urine but large amounts suggest a problem with the liver or with red blood cells being destroyed too quickly.
Leukocyte esterase and nitrite
- These are both tests for the presence of infection.
- Leukocyte esterase test looks for a reaction that only happens if there are lots of white cells in the urine. White cells get into the urine when there is an infection.
- Nitrite is not normally found in the urine but will appear there if there are lots of germs (bacteria) in the urine.
- Nitrite test can be negative even if there are lots of bacteria in the urine if the urine hasn't been in the bladder for long. For example it will be negative if you do your urine sample soon after having passed urine. Ideally you should wait at least four hours from the last time you had a pee before doing your urine sample.
The urine dipstick test also measures how concentrated the urine is and how acidic it is.
Further reading and references
Fertility Awareness Methods; Faculty of Sexual and Reproductive Healthcare (June 2015 - updated November 2015)
Krogsboll LT, Jorgensen KJ, Gotzsche PC; Screening with urinary dipsticks for reducing morbidity and mortality. Cochrane Database Syst Rev. 2015 Jan 281:CD010007. doi: 10.1002/14651858.CD010007.pub2.
Krogsboll LT; Guidelines for screening with urinary dipsticks differ substantially - a systematic review. Dan Med J. 2014 Feb61(2):A4781.