Urinalysis (cont.)
Siamak T. Nabili, MD, MPH
Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is a urinalysis?
- What can urinalysis results show?
- Who is involved in the interpretation of urinalysis?
- What does urinalysis involve?
- What is macroscopic urinalysis?
- What is urine dipstick chemical analysis?
- What are the pros and cons of dip sticks?
- What is microscopic urinalysis?
- How is microscopic urinalysis done?
- What kind of cells can be detected?
- What can the presence of red blood cells in the urine mean?
- What can the presence of white blood cells in the urine mean?
- Other than urinalysis, what are other common urine tests available?
What kind of cells can be detected?
Epithelial (flat cells) and red and white blood cells may be seen in the urine.
Sometimes cells, cellular debris, and casts are seen in the microscopic urinalysis. Epithelial cells (cells in the lining of the bladder or urethra) may suggest inflammation within the bladder, but they also may originate form the skin and could be contamination.
Casts and cellular debris originate from higher up in the urinary tract, such as in the kidneys. These are material shed from kidney cell lining due to injury or inflammation and travel down through the urinary tubes. These usually suggest an injury to the kidney from an inflammation or lack of blood flow to the kidneys. Rarely, tumor cells can be in the urine suggesting a urinary tract cancer.
What can the presence of red blood cells in the urine mean?
Red blood cells can enter the urine from the vagina in menstruation or from the trauma of bladder catheterization.
A high count of red blood cells in the urine can indicate infection, trauma, tumors, or kidney stones. If red blood cells seen under microscopy look distorted, they suggest kidney as the possible source and may arise due to kidney inflammation (glomerulonephritis). Small amounts of red blood cells in the urine are sometimes seen young healthy people and usually are not indicative of any disease.
What can the presence of white blood cells in the urine mean?
Urine is a generally thought of as a sterile body fluid, therefore, evidence of white blood cells or bacteria in the urine is considered abnormal and may suggest a urinary tract infection such as, bladder infection (cystitis), infection of kidney (pyelonephritis). White blood cells may be detected in the urine through a microscopic examination (pyuria or leukocytes in the blood). They can be seen under high power field and the number of cells are recorded (quantitative).
White cells from the vagina or the opening of the urethra (in males, too) can contaminate a urine sample. Such contamination aside, the presence of abnormal numbers of white blood cells in the urine is significant.
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