Stability of urine specimens stored with and without preservatives at room temperature and on ice prior to urinalysis

Objectives: Laboratories determine the most appropriate approach for the collection and transport of urine specimens. We investigated the effect of a chlorhexidine-based preservative tube on sample stability, compared the results of refrigerated polystyrene tubes with no additives, and investigated the effect of temperature on the performance of preservative tubes. Design and methods: Fresh urine specimen (n = 48) aliquots in BD Vacutainer® Plus Urinalysis Preservative Tubes and polystyrene tubes were analyzed on an Iris Diagnostics iQ200. Samples in polystyrene tubes were refrigerated for 4 and 8 h Four aliquots in preservative tubes were kept at room temperature for 4, 8, 24, and 72 h, while two aliquots were kept on ice for 4 and 8 h. Results: There was good agreement for all chemistry and microscopy parameters with the exceptions of white blood cells (WBCs) at 24 and 72 h and red blood cells (RBCs) at 72 h. Preservative tubes on ice showed a significant decrease in concordance of WBCs and calcium oxalate (CaOx) parameters compared with the results at room temperature. Results of refrigerated polystyrene tubes showed good agreement with the exceptions of WBC clumps and amorphous crystal at 8 h. Conclusions: A chlorhexidine-containing preservative tube seems advantageous for urine sample transport from outside healthcare services. A preservative tube offers comparable results with urine samples kept in a refrigerator for 4-8 h for the majority of parameters. Keeping samples at room temperature is recommended when preservative tubes are used because ice produces a negative effect on WBCs and CaOx.