Current and future trends of urine analysis

In-vitro testing is playing increasingly important role in medical field. Blood test, urine test, and stool tests are three major routine examinations in modern medicine, and they are important part of in-vitro testing. Around 6000 years ago, laboratory medicine began to study human urine, which they termed as uroscopy, which later became urinalysis.

Urine is the liquid waste product of metabolic activities in the body, and using it for medical testing has many advantages like, noninvasiveness, easy collection and handling. In addition to these advantages urine testing is gaining importance because many times the metabolic waste product is unaffected by the regulatory changes in body and many significant disease markers can be easily monitored while using urine as a sample rather than blood as a sample. Hence, as the awareness amongst the clinicians grows, the potential for urine testing also grows significantly.

Urine analysis is classically done by various methods like physical examination, chemical composition analysis, microscopic examination, urine microbiological testing as well as examination of 24-hours urine specimen. Out of these examinations, urine chemistry, which is done to study the chemical composition of urine, is having a major role to play and it is now done using urine reagent strips which is becoming game changer in urinalysis. Analyzing variety of substances like metabolites, waste molecules, pH, blood cells, etc., using simpler and easy methodology, it is helping clinicians to detect and monitor variety of clinical conditions.

Today, urinalysis has become the gold standard and reaches beyond glucose testing. The ubiquitous urine test detects pregnancy to ph, bacteria to bilirubin, and ketones to kidney function. From early warning of diabetes and kidney failure to population health management, urine testing helps doctors fight the world’s most threatening diseases.

The global urine test strip market was estimated to be of USD 621.58 million in 2022 and is expected to reach USD 897.23 million by 2030 with a CAGR of 4.69 percent.

In the modern times, there are many new biomarkers that are detected using urine as sample has advantage of early detection. Compared with blood, urine has no homeostasis mechanism, and can adapt to subtle and comprehensive changes, especially in early stages of disease. Many early disease markers in urine appear earlier than in the blood, and even earlier than the patient’s symptoms, signs, and imaging pathology examinations.

New technological advances have paved the way for significant progress in automated urinalysis. Quantitative reading of urinary test strips using reflectometry has become possible, while complementary metal oxide semiconductor (CMOS) technology has enhanced analytical sensitivity and shown promise in microalbuminuria testing. Microscopy-based urine particle analysis has greatly progressed, enabling high throughput in clinical laboratories. Urinary flow cytometry is an alternative for automated microscopy, and more thorough analysis of flow cytometric data has enabled rapid differentiation of urinary microorganisms.

With the introduction of laboratory-on-a-chip approaches and the use of microfluidics, new affordable applications for quantitative urinalysis and readout on cell phones may become available.

Like in many other fields of diagnosis, artificial intelligence has emerged as a promising and transformative tool in the field of urinalysis, offering advancements in disease diagnosis, and the development of predictive models for monitoring treatment responses. By bridging the gap between research and clinical implementation, AI can reshape the landscape of urinalysis, paving the way for more personalized and effective patient care.