TOXICOLOGY TIMES - SDRL
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Volume 6, Issue 2
TOXICOLOGY TIMES
A FREE Monthly Newsletter for Substance Abuse and Opioid Treatment Programs from San Diego Reference Laboratory
February, 2016
What is NORMAL Human Urine?
Dr. Joseph E. Graas, Scientific Director The collection and measure of this temper- urine. Specimen validity testing is the
Dr. Edward Moore, Medical Director
ature will sort out this purposeful adultera- evaluation of the specimen to determine if
tion. The urine should also look normal. it is consistent with normal human urine
Many drug users attempt to evade detec- It should have a pale yellow to light orange (creatinine values greater than 20 mg/dL).
tion of their drug abuse by adding various color. It is suggested that a "bluing" agent When abnormally large quantities of fluids
materials (adulterants) to their specimen in be used in the collection bathroom to pre- are consumed, the urine becomes diluted
order to produce a false negative result vent the addition of toilet water, and ideal- and the creatinine levels are substantially
when the specimen is screened by immu- ly the water to the sink should be shut off. reduced. At the same time, the dilution of
noassay for drugs of abuse. Adulteration
the urine reduces the amount of drugs and
methods include addition of water to dilute At a minimum, a creatinine test for adul- their metabolites that may be present. Al-
the urine, substitution with a drug free liq- teration should be done. This test should ternately, a donor may try to beat a test by
uid that looks like urine, addition of readi- be done at the laboratory along with the adding water to the urine cup to dilute the
ly available household items (e.g. vinegar, drug testing. The result of the creatinine drug level. San Diego Reference Labora-
baking soda, liquid drain opener, deter- test will indicate whether or not more ex- tory includes the test for creatinine as part
gent, etc.) or addition (tampering) with tensive adulteration testing should be done of the routine drug panels. The creatinine
readily available adulterants for sale on the on the sample.
result will be reported as mg/dL and each
internet such as Urine-Aid (which contains
result will have one of the following mes-
glutaraldehyde) or Klear (which contains Creatine is synthesized from amino acids sages attached:
potassium nitrate) etc.
in the kidney, liver and pancreas. The cre-
atine is then transported in the blood to Consistent with Normal Urine Normal human urine, when voided, will other organs where it is synthesized into creatinine values greater than 20 mg/dL
have a temperature that approximates the creatinine. In the absence of kidney dis- Possible Diluted Urine Sample body temperature. This temperature meas- ease, the urinary creatinine is excreted in creatinine values between 6 and 20 mg/dL
urement should be done at the collection rather constant amounts and represents Possible Substituted Urine Sample site and immediately after the subject has glomerular filtration and active tubular creatinine values of 5 mg/dL or less
voided the sample. The temperature excretion of the kidney.
should be 90-100 degrees Fahrenheit, typi-
Next months issue will be:
cally 93-95 degrees Fahrenheit. Any Because creatinine is excreted from the addition of water or room temperature flu- body at a constant rate, there are expected ids will drastically reduce the temperature. values for creatinine in normal human
Urine Drug Testing: Controlling for Alteration
??? Did You Know ???
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