Understanding Positive POCT Urine Test Results and Follow Up

Understanding POCT Urine Tests

Point-of-care testing (POCT), also known as bedside testing, refers to medical diagnostic testing performed outside of a laboratory setting. POCT urine tests allow rapid analysis of a fresh urine sample using a dipstick, cassette, strip, or small benchtop analyzer right at the point of patient contact. These tests serve as quick and convenient tools for preliminary screening and evaluation of various health conditions.

When is a POCT Urine Test Ordered?

A POCT urine test may be ordered for a variety of reasons including:

• To check for signs of a urinary tract infection
• To look for blood, protein, leukocytes or other abnormalities
• To screen for or help diagnose conditions like diabetes or kidney disease
• To aid in pregnancy testing
• To detect drug or substance use

These tests allow healthcare providers to rapidly obtain actionable information to help guide diagnosis and treatment decisions.

Understanding POCT Urine Test Results

Most POCT urine dipstick tests and cassettes screen for several different substances and parameters at once. The test strip contains various chemical pads or reagents that change color when they come into contact with certain substances present in the urine sample.

Common components analyzed include:

• Leukocyte esterase - suggests presence of white blood cells which could indicate infection
• Nitrites - suggests presence of certain bacteria which could indicate infection
• Protein - elevated levels may indicate kidney disease or other conditions
• Glucose - elevated levels may indicate diabetes
• Ketones - suggests ketoacidosis which may occur in diabetes
• Bilirubin - elevated levels may indicate liver disease or blockage
• Blood - may indicate infection, kidney stones or other issues
• pH - abnormal pH can indicate metabolic, kidney and other disorders

When a POCT Urine Test is Positive

When performing a POCT urine test, the change in color of the reagent pads is compared to a standard color chart to determine if the result is positive or negative. A positive result means an elevated or abnormal level of a substance has been detected.

Common Causes of Positive Results

There are many reasons why a POCT urine test may return a positive result. Some common causes include:

• Urinary tract infection (UTI) - the most common cause; a UTI can lead to positive nitrite, leukocyte esterase, and blood results.
• Kidney disease - may show positive protein, blood, glucose, ketones or abnormal pH levels.
• Diabetes - high glucose levels spill over into the urine along with ketones.
• Pregnancy - HCG hormone is detected showing a positive pregnancy result.
• Contamination - soap, antiseptic or other products can contaminate the sample and skew results.
• Medications and supplements - some over the counter drugs and supplements can impact urine composition.
• Dehydration - insufficient fluid intake concentrates the urine leading to abnormal test levels.

Investigating the Cause of Positive Findings

Whenever a POCT urine test returns a positive result, follow up testing is recommended. This may involve:

• Repeating the POCT urine test using a fresh sample - this can confirm or contradict the original positive result.
• Performing a microscopic urinalysis - examines the urine for cells, crystals, bacteria and other clues.
• Obtaining a urine culture - confirms or rules out infection by identifying specific bacteria.
• Testing blood samples - helps correlate urine findings and check impacted organ function.

By pursuing additional laboratory testing, the exact cause of an abnormal POCT urine test can be uncovered. This facilitates accurate diagnosis and allows appropriate treatment to begin promptly.

How are Positive POCT Urine Test Results Treated?

The course of treatment depends entirely on the underlying cause of the positive POCT urine test result:

• Urinary tract infections are treated with appropriate antibiotics.
• Kidney disorders may require hospitalization, IV fluids, diet changes and medications.
• Diabetes involves glucose monitoring, insulin therapy, diet modification and more.
• Pregnancy leads to prenatal care including nutrition advice, exercise guidelines and birthing plans.
• Dehydration simply requires increased oral fluid intake.
• Medication side effects may warrant stopping the drug or changing dosage.

In addition, treating any underlying condition can prevent recurrent positive findings on future POCT urine testing.

Importance of Follow Up

While POCT urine tests offer quick results, they are not 100% definitive diagnostically. As such:

• Retesting should be performed periodically to confirm abnormal results.
• Urinalysis and urine cultures also provide valuable supplementary information.
• It is vital to follow up any positive POCT urine test with a qualified healthcare provider.
• Ongoing care ensures proper treatment and management of health conditions.

The Takeaway

POCT urine testing provides rapid analysis of fresh urine samples through various test strip and cassette methods. Positive results indicate the detection of abnormal levels of substances suggesting, but not definitively diagnosing, potential underlying conditions.

By pursuing follow up laboratory testing and medical care, positive POCT urine test results can be correctly interpreted. This allows accurate diagnoses to be made so that appropriate treatment can begin promptly.

So in summary:

• POCT urine tests allow rapid analysis for initial diagnosis and screening.
• A positive result means an elevated or abnormal substance level is detected.
• Common causes include UTI, kidney disease, diabetes, pregnancy and more.
• Always follow up positive POCT urine tests with additional testing and medical care.
• Proper treatment relies on determining the precise underlying cause through further investigation.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.