Reasons for acidic urine pH include: a high-meat diet, respiratory/metabolic acidosis, and hypochloridemia. A urine with a high concentration of glucose may also have a lower pH.

An alkaline pH may be the result of a vegetarian diet, respiratory/metabolic alkalosis, or a bacterial infection caused by urease-producing bacteria. Urine that contains bacteria can become more alkaline if the specimen remains at room temperature for an extended period of time.

A pH can be falsely interpreted as more acidic than it actually is if improper technique is used and excess urine is allowed to pool on the reagent strip. The reagents from the protein pad, that includes an acid buffer, can run over into the pH pad if the strip has these two tests located next to each other.