Urine Drug Adulteration Test Strip For in vitro use only. Read all instructions, precautions, and
limitations before performing this test.
Specific Gravity: Testing for sample dilution. This test is
based on the apparent pKa change of certain pretreated
polyelectrolytes in relation to the ionic concentration. In the
Clarity Urine Drug Adulteration test strips are a fast
presence of an indicator, the colors range from dark blue or
dip-and-read test for the determination of diluted or adulterated
blue-green in urine of low ionic concentration to green and
urine specimens. It is an important pre-screening test for any
yellow in urine of higher ionic concentration.
Bleach: Testing for the presence of bleach in urine. In this test, SUMMARY AND EXPLANATION
the presence of bleach forms a blue-green color complex.
Clarity Urine drug adulteration tests are firm plastic strips to
which seven different reagent areas are affixed. Clarity Urine
Pyridium Chlorochromate: Testing for the presence of
test strips are ready-to-use and disposable. No equipment is
chromate in urine. In this test, the presence of chromate forms
required for its use. Only fresh and uncentrifuged urine samples
Clarity Urine Drug Adulteration test strips provides tests for
1. Store at room temperature between 15 oC – 30 oC.
Creatinine, Nitrite, pH, Specific Gravity, Glutaraldehyde,
2. All test strips should be stored in the original container. Do
Oxidants, and Pyridium Chlorochromate in urine. Test results
may be useful for assessing the integrity of the urine sample
prior to Drugs-of-Abuse testing; for example, whether the
4. Remove only as many strips required for testing and
sample is possibly diluted with water or other liquids as
immediately recap the container tightly.
indicated by the creatinine and specific gravity tests. Clarity
Urine Adulteration Test strips detects whether the sample
contains commercially available adulterants including nitrite,
glutaraldehyde, bleach, pyridinium chlorochromate and other
oxidizing agents. Clarity Urine Adulteration test strips can also
assess whether the sample is possibly contaminated by acidic
(vinegar) or basic (ammonia solution) adulterants as indicated
1. Collect urine in a clean glass or plastic container.
2. Test urine sample as soon as possible after collection.
Refrigerate urine sample immediately if the sample cannot
be tested within one hour. Bring refrigerated sample to
In general, all seven tests are based on the chemical reactions
room temperature and mix thoroughly before testing.
of the indicator reagents on the pads with components in the
3. Do not centrifuge or add preservatives to the urine sample.
urine sample effecting color changes. Results are obtained by
4. Handle the urine sample as if it is potentially infectious.
comparing the color on each of the test pads with the
5. Aliquot a small portion of the urine sample into another
corresponding pad on the container color chart label.
container for testing in order to avoid contamination of the
whole urine sample. Do not dip Clarity Urine directly into
Creatinine: Testing for sample dilution. In this assay,
creatinine reacts with a creatinine indicator in an alkaline
condition to form a purplish-brown color complex. The
concentration of creatinine is directly proportional to the color
1. Remove from the bottle only enough strips for immediate
2. Completely immerse reagent areas of the strip in fresh,
Glutaraldehyde: Testing for the presence of exogenous
well-mixed urine. Remove the strip immediately to avoid
aldehyde. In this assay, the aldehyde group on the
glutaraldehyde reacts with an indicator to form a pink/purple
3. While removing, touch the side of the strip against the rim
of the urine container to remove excess urine. Blot the
lengthwise edge of the strip on an absorbent paper towel to
Nitrite: Testing for the presence of exogenous nitrite. Nitrite
further remove excess urine and avoid running over
reacts with an aromatic amine to form a diazonium compound in
(contamination from adjacent reagent pads.)
an acid medium. The diazonium compound in turn couples with
4. Compare each reagent area to its corresponding color
an indicator to produce a pink-red/purple color.
blocks on the color chart and read at the times specified.
Proper read time is critical for optimal results.
Oxidants: Testing for presence of oxidizing reagents. In this
5. Obtain results by direct color chart comparison.
reaction, a color indicator reacts with oxidants such as hydrogen
peroxide, ferricyanide, persulfate, or pyridinium chlorochromate to form a blue color complex. Other colors may indicate the presence of other oxidants. pH: Testing for the presence of acidic or alkaline adulterant. This test is based on the well-known double pH indicator method that gives distinguishable colors over wide pH range. The colors range from orange (low pH) to yellow and green to blue (high pH).
Note: All reagent areas may be read between 1 - 2 minutes for
gravity and creatinine values should be considered together to
screening positive urine from negative urine. Changes in color
provide a better picture of whether the sample is adulterated.
after 2 minutes are of no diagnostic value.
Pyridium Chlorochromate: The presence of any chromate in INTERPRETATION OF RESULTS
urine is indicative of adulteration as chromate is not a normal
Semi-quantitative results are obtained by visually comparing
the color of each pad with the corresponding test color block
pictured on the container label. No equipment is required.
1. U.S. Department of Transportation, Drug Testing
For best results, performance of reagent strips should be
2. Young, D.S.et al, Clinical Chemistry, 21 (9), 1975.
confirmed by testing known negative and positive specimens or
3. Friedman, R.B. et.al. Clinical Chemistry: 26 (4), 1980.
controls whenever a new test is performed or whenever a new
4. Tietz, N.W. Clinical Guide to Laboratory Tests, Third
bottle is first opened. Each laboratory should establish its own
Edition, W.B. Saunders Company, p566, 1995.
goals for adequate standard of performance, and should
5. Chu, S.Y. and Sparks. Clinical Chemistry, 17, 1984.
question handling and testing procedures if these standards are
6. Tingsrud, K.M. and Linne, J.J., Urinalysis and body Fluids A
color Test and Atlas, Mosby-Year Book, Inc., 1995.
7. Henry, J.B. et al.: Clinical Diagnosis and Management by
Laboratory Methods, 16th Ed. Philadelphia: Saunders;
Comparison to the color chart is dependent on the interpretation
of the individual. It is therefore, recommended that all
laboratory personnel interpreting the results of these strips be
tested for color blindness. As with all laboratory tests, definitive
diagnostic or therapeutic decisions should not be based on any
Diagnostic Test Group LLC 33 SE 8th Street, Boca Raton-33432 Tech Support: 1-877-485-7877
Some compounds or physical properties that may affect the test result are listed below. Medications that discolor the urine may
also cause abnormal results due to masking of the reactions of
EXPECTED VALUES Creatinine: Daily creatinine excretion, related to muscle mass
of the human body, is usually constant6. The DOT guideline1
states that urine specimens with creatinine levels of less than 20 mg/dl are indications of adulteration. Although these ranges
are affected by age, sex, diet, muscle mass and local population
distribution2, sample with creatinine level of lower than 20 mg/dl should be considered adulterated. Glutaraldehyde: Glutaraldehyde is not a natural component of human urine and it should not be present in normal urine. The presence of glutaraldehyde in the urine sample indicates the possibility of adulteration. However, false positive may result when ketone bodies are presence in urine. Ketone bodies may appear in urine when a person is in ketoacidosis, starvation or other metabolic abnormalities. Nitrite: Although nitrite is not a normal component of urine, nitrite levels of up to 3.6 mg/dl may be found in some urine specimens
contamination or improper storage. Oxidants: The presence of oxidizing reagents in the urine is indicative of adulteration since oxidizing reagents are not normal constituents of urine. Oxidizing reagents include Hydrogen Peroxide, Ferricyanide, Persulfate, and Pyridinium Chlorochromate…etc. pH: Normal urine pH ranges from 4.5 to 8.0. Values below pH 4.0 or above pH 9.0 are indicative of adulteration. Specific Gravity: Random urine may vary in specific gravity from 1.003 - 1.030. Normal adults with normal diets and normal fluid intake will have an average urine specific gravity of 1.016 - 1.0227. Elevated urine specific gravity value may be obtained in the presence of moderate quantities of protein. DOT guidelines1 state that a urine specimen with specific gravity level of less than 1.003 is an indication of adulteration. Specific
Symptoms and signs of heart failure Other investigations: Signs: tachycardia, displaced apex, gallop rhythm, elevated JVP, leg and sacral oedema, hepatomegaly. ascites. Serum natriuretic peptides: Expensive test, please do not use as breathlessness screen ! NTPro-BNP High > 2000 pg/ml (236pmol/l) > 400 pg/ml (>116 pmol/l) Raised 400-2000 pg/ml (47-236pmol/l)