The primary study that established the effectiveness of urinary alkalinization for reducing nephrotoxicity during high-dose MTX therapy used the Clinitek (Siemens Healthcare Diagnostics, Tarrytown NY) urine dipstick pH method [4]. The Clinitek method was designed to yield urine pH values close to a pH meter result [7], although the manufacturer cautions that abnormally colored urine samples may produce incorrect results [6]. Therefore hospitals and stat laboratories performing dipstick urine pH testing often refer highly colored urine samples to a core laboratory to measure urine pH using a meter. Recently nurses at our institution caring for patients receiving high-dose MTX therapy noted apparent discrepancies between urine pH readings performed in the stat laboratory (Clinitek dipstick method) and core laboratory (pH meter). We therefore prospectively investigated the correlation and clinical concordance of urine pH measured by the Clinitek dipstick and a pH meter.