Urine tests now obsolete?
Wojtek Ciszak M.D.
For thousands of years, doctors looked at, smelled and even tasted their patients’ urine in order to make far-reaching pronouncements about the patient’s present and future health. Routine urine test are still done by the millions, but the expectations of their usefulness are much lower. Routine screening urine tests are notorious for false positives. Perfectly healthy young people, especially females, can sometimes have very abnormal urine, showing protein, blood or glucose. At the same time, the urine test tells us nothing about the most important thing: kidney function.
For these reasons, around 2018, the IRCC Medical Branch introduced routine kidney function screening (“serum creatinine”) to the Immigration Medical Examination process. Urine tests are still required but their importance is deprecated. The main emphasis is now on detecting impaired kidney function, as many people who have it will eventually require dialysis or kidney transplantation, both extremely expensive.
Australian immigration authorities abandoned requiring urine tests completely in 2023, now relying exclusively on serum creatinine.
New Zealand, and many other countries, still require urine tests for their immigration process, and object to abnormal results. This often causes a lot of unnecessary worry, extra expense and delays, while seldom detecting any previously unrecognized disease.
How to get the best possible result from a urine test
- Stay very well hydrated for 24 hours before the test
- Avoid any severe exertion or contact sports for 3 days before the test
- Avoid sexual activity for 3 days before the test
- Do not submit your first morning urine
- Do not do the test at any time during or around your period
- Submit a “midstream sample”
- Do not inadvertently (or purposely) dilute the sample with water – such tampering may be detected by the lab, by using specific gravity measurements.
How to produce a midstream sample
- Gently clean yourself, using plain warm water
- Start peeing with a strong continuous stream, making sure the stream does not touch the skin around the orifice
- When you are about half way through, pass the specimen container across the urine stream, without touching your body. The container only needs to be 25% full.
