Investigations of ascorbic acid interference in urine test strips

Ascorbic acid at higher concentration in urine samples can lead to false negative results in a number of urine tests, with a potential risk of clinical findings being overlooked, particularly with glucose and hemoglobin. For this reason, the ascorbic acid status of urine samples should always be routinely known so as to establish what adjustment needs to be made. A much better approach, however, is to use a test which is by design largely resistant to ascorbic acid. We compared five very common 10-parameter urine test strips from different manufacturers. The results of this study show that of the strips tested, only the product Combur-Test from Roche Diagnostics is largely resistant to ascorbic acid interference. Even lowest - but clinically relevant - concentrations of erythrocytes (10/microL), hemoglobin (0.03 mg/dL), and glucose (50 mg/dL) were correctly detected with concentrations of up to 400 mg/L ascorbic acid. Higher analyte concentrations correctly reacted positive even in the presence of up to 1000 mg/L ascorbic acid.