Urinalysis (Urine Test)

  • Medical Author:
    Siamak N. 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.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    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.

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What are the pros and cons of dip sticks?

The main advantage of dipsticks is that they are convenient, easy to interpret, and cost-effective. They can be analyzed within minutes of urine collection in the doctor's office or in the emergency room to provide valuable information.

However, what can be learned from a dipstick is limited by the design of the dipstick. The main disadvantage is that the information may not be very accurate, as the test is time-sensitive. It also provides limited information about the urine, as it is qualitative test and not a quantitative test (for example, it does not give a precise measure of the quantity of abnormality). Therefore, normal and abnormal values are not reported as part of urinalysis results.

What is microscopic urinalysis?

The microscopic urinalysis is the study of the urine sample under a microscope. It requires only a relatively inexpensive light microscope. Cells and cellular debris, bacteria, and crystals in the urine can be detected by this examination to provide further clinical clues.

How is microscopic urinalysis done?

Microscopic urinalysis is done simply pouring the urine sample into a test tube and centrifuging it (spinning it down in a machine) for a few minutes. The top liquid part (the supernatant) is discarded. The solid part left in the bottom of the test tube (the urine sediment) is mixed with the remaining drop of urine in the test tube and one drop is analyzed under a microscope.

The sediment is examined through the microscope under low-power to identify what are called casts, crystals, squamous (flat) cells, and other large objects.

Examination is then performed through the microscope at higher power to further identify any cells, bacteria and clumps of cells or debris called casts.

What kind of cells can be detected?

Epithelial (flat cells), 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 from 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.

Medically Reviewed by a Doctor on 7/13/2016

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