What is Urinalysis (UA)

Urinalysis (UA) test may be ordered:

• As part of routine wellness screening.
• Before surgery.
• During pregnancy.

You may also need to have this test if you have:

• Kidney disease.
• Symptoms of a urinary tract infection (UTI).
• Diabetes.
• Conditions that cause an imbalance in your hormones.

What is being tested?

A urinalysis is a series of tests done on a sample of your urine. Your kidneys filter your blood to make urine. They get rid of waste products and save the important parts of your blood, such as proteins and minerals (electrolytes).

UA is divided into three parts:

• A visual exam of your urine sample to check for color or cloudiness.
• A dipstick test to check for:
  • Proteins.
  • Concentration (specific gravity).
  • Acidity (pH).
  • Glucose.
  • Ketones. These are by-products of your body burning fat for energy instead of sugar.
  • A waste product from red blood cells (bilirubin).
  • A product of white blood cells (leukocyte esterase).
  • A product of bacteria (nitrite).
  • Blood.
• A microscopic exam to check for:
  • Red blood cells.
  • White blood cells.
  • Tube-shaped proteins (hyaline casts).
  • Crystal structures.
  • Bacteria.
  • Epithelial cells. These are cells that line your urinary tract.
  • Yeast.

You may need more testing if your UA shows too much:

• Protein.
• Sugar (glucose).
• Blood cells.
• Bacteria.

What kind of sample is taken?

A urine sample is required for this test. It is usually collected by passing urine into a clean cup. You may be asked to collect a urine sample first thing in the morning. When collecting a urine sample at home, make sure you:

• Use supplies and instructions that you received from the lab.
• Collect urine only in the germ-free (sterile) cup that you received from the lab.
• Do not let any toilet paper or stool (feces) get into the cup.
• Refrigerate the sample until you can return it to the lab.
• Return the sample to the lab as instructed.

How do I prepare for this test?

Some medicines can affect the results of your UA. Let your health care provider know about all medicines you are taking, including vitamins, supplements, herbs, and over-the-counter medicines.

How are the results reported?

Some of your test results will be reported as values. Your health care provider will compare your results to normal ranges that were established after testing a large group of people (reference ranges). Reference ranges may vary among different labs and hospitals. For this test, common reference ranges are:

• pH: 4.6–8.0 (average, 6.0).
• Protein:
  • 0–8 mg/dL.
  • 50–80 mg/24 hr (at rest).
  • Less than 250 mg/24 hr (during exercise).
• Specific gravity:
  • Adult: 1.005–1.030 (usually, 1.010–1.025).
  • Elderly: values decrease with age.
  • Newborn: 1.001–1.020.
• Nitrites: none.
• Ketones: none.
• Bilirubin: none.
• Urobilinogen: 0.01–1 Ehrlich unit/mL.
• Crystals: none.
• Casts: none.
• Glucose:
  • Fresh specimen: none.
  • 24-hour specimen: 50–300 mg/24 hr or 0.3–1.7 mmol/day (SI units).
• White blood cells (WBCs): 0–4 per low-power field.
• WBC casts: none.
• Red blood cells (RBCs): Less than or equal to 2.
• RBC casts: none.
• Epithelial cells: Few or 0–4 per low-power field.
• Bacteria: none.
• Yeast: none.

Other results may be reported based on the appearance and odor of the sample. For this test, normal results are:

• Appearance: clear.
• Color: amber yellow.
• Odor: aromatic.

Still other results may be reported as positive or negative. For this test, normal results are:

• Negative for leukocyte esterase.

What do the results mean?

Many conditions can cause abnormal UA results:

• Cloudy urine may be a sign of a UTI.
• Acetone odor may indicate a buildup of blood acids in people who have diabetes (diabetic ketoacidosis).
• Fecal odor can indicate an abnormal connection (fistula) between the intestine and the bladder.
• Ammonia odor can occur after a person holds urine in the bladder for too long.
• Pungent odor may indicate a UTI.
• Blood in the urine may be a sign of kidney disease, UTI, or other conditions.
• White blood cells may be a sign of a UTI.
• Crystals may be a sign of a kidney stone or other kidney disease.
• High pH may mean you have a kidney stone, UTI, or kidney disease.
• Protein may be a sign of kidney disease, high blood pressure in pregnancy (toxemia), or other conditions.
• Glucose may be a sign of diabetes.
• Urobilinogen may be a sign of liver disease.
• Leukocyte esterase may indicate a UTI.
• Nitrites may indicate a UTI.

Talk with your health care provider about what your results mean.

Questions to ask your health care provider

Ask your health care provider, or the department that is doing the test:

• When will my results be ready?
• How will I get my results?
• What are my treatment options?
• What other tests do I need?
• What are my next steps?

Summary

• A urinalysis (UA) is a series of tests done on a sample of your urine. The test may be ordered as part of a routine exam, during pregnancy, before surgery, or if you have certain symptoms.
• The urinalysis is divided into three parts: a visual exam, a dipstick test, and a microscopic exam.
• Your health care provider will compare your results to normal ranges that were established after testing a large group of people (reference ranges).
• Talk with your health care provider about what your results mean.