Glucose
This test is based on a sequential enzyme reaction. First, glucose oxidase catalyzes the formation of gluconic acid and hydrogen peroxide from the oxidation of glucose. A second enzyme, peroxidase, catalyzes the reaction of hydrogen peroxide with potassium iodide chromogen to oxidize the chromogen to colors ranging from blue through greenish-brown, and brown to dark-brown.
Reactivity of the test decreases as the specific gravity and/or pH of urine increases, and may also vary with temperature.
Ascorbic acid (more than 50 mg/dl) and ketone bodies (more than 40 mg/dl) may cause a false negative result for a specimen containing a small amount of glucose (100 mg/dl). However, the combinations of such ketone levels and low glucose levels are metabolically improbable.
pH
This test is based on double indicators (methyl red and bromothymol blue), which give a broad range of colors covering the entire urinary pH range. Colors range from orange through greenish-yellow and green to blue.
This test indicates the pH values within the range of 5 to 9.
Certain drugs, such as those used for hypertension and heart diseases (acetazolamides) may cause an alkaline urine. Excessive urine on the test strip may wash the acid buffer from the neighboring protein reagent onto the pH area and change the pH reading to an acid pH although the urine being tested may originally have been neutral or alkaline. An accurate reading may be influenced by slight variations of pigments in the urine.
Protein
This test is based on the color change of the indicator tetrabromophenol blue. A positive reaction is indicated by a color change from yellow through green and then to greenish-blue.
The minimum sensitivity of this test is 10 mg/dl of protein in urine. Highly buffered alkaline urines (pH 8.5) may give false
negative results. The interpretation of results is also difficult in turbid urine specimens.
Ketone
This test is based on the reaction of acetoacetic acid in the urine with nitroprusside. The resulting color ranges from tan when no reaction takes place, to purple for a positive reaction. Normal urine specimens ordinarily yield negative results with this reagent.
False positive results may occur with highly pigmented urine specimens or those containing large amounts of levodopa metabolites.
Blood
This test is based on the pseudoperoxidase activity of hemoglobin which catalyzes the reaction of 3,3'5,5'-tetramethylbenzidine and buffered organic peroxide, 2,5-dimethylhexane-2,5-dihydroperoxide. The resulting color ranges from, greenish-yellow through bluish-green to dark blue.
A false positive test result can sometimes occur when bacteria are present in the urine. Ascorbic acid or protein may reduce the reactivity of the blood test. Strong oxidizing substances such as hypochlorites may produce a false positive result. Urine from menstruating females often, but not always, yield positive results.