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Urine reagent test strips shows PH 5 with blood 50Ery/ul and PH 7 with no blood. What could this be?

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General & Family Physician
Practicing since : 1986
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I have been diagnosed with uric kidney stones. I notice when testing using urine reagent test strips that when ever my PH is low my strip also shows the presents of blood I.E. PH 5, blood is greater than 50 Ery/ul. When PH is 7.4 no blood is detected. What are your thoughts?
Posted Sun, 8 Dec 2013 in Urinary and Bladder Problems
Answered by Dr. Haseena Hamdani 1 hour later
Brief Answer: Blood cells PH can affect Urine Ph Detailed Answer: Hi, Welcome to Health Care Magic Your observation is correct. When there are many RBC's in urine , it can affect the overall Ph of urine. As Ph of blood is slightly Alkaline and Urinary Ph is Acidic. Though it has no clinical implications as such. You are passing blood in urine due to Uric Acid stones. I hope you are taking proper diet and under proper care of a Urosurgeon. I hope I have answered your question. take care Dr H Hamdani
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Follow-up: Urine reagent test strips shows PH 5 with blood 50Ery/ul and PH 7 with no blood. What could this be? 7 hours later
I have been under the care of an Urologist and an Endocrinologist. The urologist is treating me with Potassium Citrate, and the Endocrinologist referred me to a Nurse and a Dietician. They put me on a high carbohydrate, low fat diet. I was not happy with the diet, because of the high acid found in my urine, and spiking of my blood sugars, and weight gain The endocrinologist told me that I did not need to monitor urine; PH, ketones, Proteen, blood, ect., and to only look at blood sugars before and 2 hrs after. As a result I am following my own diet based on Dr Bernstines diabetic diet book. In that book he cautions one to stay away from complex and simple carbohydrates. In particular the high fiber foods that have lots of Purine’s, like asparagus, and tuna. Eat more calories of fat instead. Fat contains no Purine;s or sugar. As a result of doing this I am almost drug free from 2000mg of Metformmin and 10mg of Glipocide, Down to one 500mg of Metform per day and no Glipocide. I now have a average blood sugar of below 120. I also check blood uric acid levels and they are 6.9-8.1 on average daily. I am still struggling with the Urine PH and Ketones. To repeat, I notice lower the PH in Urine and blood the more blood found in urine. Or what do you suggest? My goal is to dissolve the stone with water and Potassium Citrate, and high PH (low Carbohydrate) diet. Is this a realistic goal? Should I take more than (4) 1008 mg tablets of Potassium Citrate?
Answered by Dr. Haseena Hamdani 11 hours later
Brief Answer: Aim to keep Urine PH between 6 and 7 Detailed Answer: Hi, Welcome back to XXXXXXX As you have Type 2 DM and High uric acid level in blood and Uric Acid stone, your aim should be to have tight control of Blood glucose level, and Urine PH should be between 6 and 7. you needed to be treat and advise diet and medicines tailored to your health condition, and you needed to be followed up regularly by a Doctor. I would like you to understand that your diet should be rich in Potassium, low in fat (Avoid Saturated fat, Choose Mono or poly unsaturated fat) , low in Animal Protein and choose complex Carbohydrate over simple Carbohydrate. Your complex carbohydrate will raise your blood sugar level slowly and will persist for longer time, that is low hypoglycemic food. Asparagus and Cauliflower are vegetable source of Purine, but their effects are not similar as purine content of Animal fat. You are allowed to eat a limited amount of purine. I hope you have not stopped or reduced your anti Diabetic medicine without advise of your Doctor. For blood glucose montitoring, you must check blood glucose before and two hours after each meal initially when you do any change in your medicines. You must go for HBA1C test also every three months, and blood investigation for your Kidney function, Heart , Eyes , Blood pressure monitoring Don't increase the dose of potassium citrate. It can cause disturbances in your Eletrolytes, specially Potassium, which could be detrimental to your heart. Do not take Alcohol, Diuretics, or anything which can cause dehydration. Reduce your weight, if Overweight or Obese. You must check your Ph of urine regularly and according to Your Ph level , you can increase your water intake and lemonated drink. RBC's in urine is due to uric Acid stone, but your Doctor must rule out any other cause for it, and you must filter urine, to see whether you have passed any stones. I hope this answer would be very useful to you, if you understand it and follow it properly. For any other query, you are most welcome. Dr H Hamdani
Above answer was peer-reviewed by
Follow-up: Urine reagent test strips shows PH 5 with blood 50Ery/ul and PH 7 with no blood. What could this be? 3 hours later
I came to discover the kidney stones after a pre surgical physical for my bad knee (Very Painful) due to the pain, exercise had been non-existent, for the past 2 years. Weight gain was eminent. Cortisone only helps for about 3 months. Back in XXXXXXX of 2013 for no apparent reason my knee swelled up and became intolerably painful. The drugs that had worked until then did not. The only relief at night was to sleep in a hot tub for 2 hrs. When the swelling went down a huge purple and red bruise had shown up, with streaks going up and down my leg. I went for an ultra sound to make sure no clot was in the femoral artery. Nothing was found, x rays did not show anything. The MRI did show a torn meniscus and arthritis in the joint as well as soft tissue damage. Surgery was my best option and so it was scheduled in late August 2013. In a pre surgical physical blood was found on my urine, and so, the much needed surgery was canceled. I was sent to a urologist and had another urine teat as well as a cryoscopy of my blather and urethra was preformed. It was in that exam that sugar ketones protein as well as blood were all found in the urine. Nothing causing blood was found via cysocopy so it was assumed the cause was was higher up, and a abdomen x ray and CT scan was ordered. I took out my old medical supplies including reagent urine test strips and discovered not only blood in the urine but also high levels of acid, ketones, protein, and sugar. I immediately took action to cut out all sugars from my diet and bought new equipment. A week later I was still unable to lower blood glucose below 200. My urine was full of ketone’s, protein and acid, but was able to stop the sugar spillage. I contacted my Physician via the My Chart Epic soft wares email about this. After a week of no response I called the office only to find out my Physician was out of town for one more week. I explained the situation to his nurse whom set me up with an appointment with the doctor whom was covering for my doctor while he was out of town. The Doctor did review my data and confirmed my suspicions of being a diabetic. He assured me I did the right thing to come in as soon as I did. He drew blood and took the first A1c test as well as test for the amount of insulin in my blood. He put me on Metformin and told me to continue monitoring Glucose and I could stop the Metformin if my Glucose drops below 100. He also told me to take a glucose tablet or drink sugar soda if my Blood sugar went below 70, and to follow up with my doctor ASAP. I met with my doctor September 17,2013, the results of my A1c was 9.5%. I was still having trouble with getting blood sugar below 200 so he raised the Metformine to( 2) 500mg pills in the morning and (one) at bedtime. On September 20, 2013, I was still having trouble so he added 2.5 mg of Glipizide to the mix. This helped but I was still running Blood sugar between 150-200, On Monday 9/23/13, He raised the Glipizide to 10mg and that did bring my blood sugar below 200 permanently. I was still concerned with the ketones, protein and hi acid in urine so I asked to get a referral to seen and endocrinologist. I set an appointment with him immediately. I met with the Endocrinologist 10/10/13. I had lots of questions about my urine spills and high liver enzymes as well as blood sugar and weight gain. I attempted to review my concerns with the Endocrinologist when I was told that I do not need to keep track of all those things. Just take blood sugar reading before meals and two hours after. In the mean time I did find a book written by Dr. XXXXXXX Bernstien. He has a good diet and answers all the questions I had about the disease as well as other complications like kidneys. Low PH, Ect. My new diet plan eliminates meals. I eat small amounts every two to three hours so it is impossible to follow his request. I am still experimenting on what food race my blood sugar values so I can follow through with eating less, but more often, so as to not spike my glucose, or lower PH. As a result it I have lowered my need for drugs to control l average glucose readings below 120. Many times I had below 95, so a reduction of medication was done and I notified my doctor as I have in the past of my changes. Dr. Bernstin’s diabetic diet has a lot of good nutritious choices on his menu but portions have to be kept small. My A1c is now 7.1 and other elevated readings have all come down including my weight. The blood is no longer present in my urine but I find at times for no apparent reason the PH drops below 6 especially in the morning. If I eat a high PH breakfast melon vegetable soup. I can get it back up to 7.4. I test my blood for uric acid and it is also higher in the morning 8.0. If I do not eat the above my PH will not go down and I start to get blood in my urine. As a result I have been given the go ahead to have my Knee fixed. I am worried that while I am fasting for the operation my levels will go bad and I start to bleed again causing another delay in the surgery. Other than what I have been doing, and what has been suggested, is there something that I could take two days before surgery that will have long lasting effects on my PH? And would I need to have my doctor write a prescription for it? My long term goals are as follows. A1c DOWN TO 4% NOTE! Work in progress to date not running glucose down to 85 AST/SGOT FROM 119U/L DOWN TO 34U/L ALT/SGPT FROM 160U/L DOWN TO 44U/L TRYGLCERIDES FROM 244 DOWN TO 149mg/dl HDL FROM 28 UP TO 40mg/dl NOTE! Hard to do without exercise LDL FROM 132 DOWN TO 128mg/dl This can be accomplished only by following strict low carb diet. As I have read in many publications. And after my knee is fixed exercise.
Answered by Dr. Haseena Hamdani 8 hours later
Brief Answer: DO strictly under medical supervision. Detailed Answer: Hi, welcome back to XXXXXXX Before any surgey, it is the necessary step to go for pre operative check ups, specially for Diabetics. Depending on the expected time for surgery, we decide the management for Diabetics, to have tight control of sugar, pre-operatively, operatively and post operatively. Your Doctor may start you on Insulin Injections also temporarily. I do not advise you to decide your own medicines and Diet plan without supervision of Doctor. Books are fine for a basic understanding and guide, but do not skip your Doctor's advise. However, if you are not satisfied with one Doctor, you may go to another for second opinion. You must take small portions five meals, not too frequent. You may not see immediate effect of diet on urine. Our aim is to maintain HBA1c between 6.5 to 7. Sometimes half knowledge can be XXXXXXX it is very good to be educated, aware and know about your illnesses, but do under strict Doctor's supervision. Wish you good luck. DR H Hamdani
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