Table of ContentsView AllTable of ContentsPurpose of TestTypesRisks and ContraindicationsBefore the TestTaking the TestInterpreting the Results
Table of ContentsView All
View All
Table of Contents
Purpose of Test
Types
Risks and Contraindications
Before the Test
Taking the Test
Interpreting the Results
A urinalysis is a common test used to analyze the content and chemical makeup of your urine. A urinalysis may be used at a healthcare provider’s office if kidney disease, a urinary tract infection, or other urinary-related disorder is suspected.
A urinalysis should not be confused with a urine drug screening, used to check for recent illicit drug use, or a home pregnancy test, used to detect the pregnancy hormone hCG in urine.
The urinary tract is composed of the kidneys, ureter, bladder, and urethra. Its primary role is to filter waste and regulate the balance of water, electrolytes, proteins, acids, and other substances in the body.
If any part of this system is damaged or impaired, it will alter the chemical composition and/or volume of urine. The urinalysis is a direct means of assessing these changes.
While a urinalysis is not diagnostic (meaning that it cannot determine the cause of a disease), it can suggest the nature of a disease and may be used to support a diagnosis.
A urinalysis can also be used to monitor and manage a wide range of disorders, most specifically kidney (renal) disorders.Among its applications, a urinalysis may be used to:
A urinalysis is also often included as a part of a routine physical.
When we refer to a urinalysis, we typically assume that to mean peeing in a cup at your healthcare provider’s office. In truth, that is just one of the ways urinalysis is performed in clinical practice.
A urinalysis may refer to:
While aurine culture(in which a urine sample is placed in a growth medium to check for bacteria or fungi) is not technically a form of urinalysis, it may be an extension of the test if a UTI is suspected. It can even be performed using the same urine sample.
Hyaline Casts in Urine: Understanding Ranges on Urinalysis
A urinalysis is considered a safe and non-invasive form of testing. The only risk it may pose is for those who require catheterization to obtain a urine sample. The risks of urinary catheterization include infection, bleeding, or pain.
While the preparations for a urinalysis are minimal, there are a few things you should know before delivering a sample.
Timing
An optimal urine sample is usually obtained in the early morning when the concentration is at its highest.If possible, try to schedule the collection for this time and “hold it in” until you get there if you can. The collection itself only takes a couple of minutes.
For a 24-hour urine collection, you should ideally pick a 24-hour period when you can stay at home so that you don’t have to carry the samples with you or miss a collection.
Location
A urinalysis may be performed at your healthcare provider’s office, clinic, or lab, or upon admission to the hospital.In some instances, you may be provided a sterile plastic cup and lid to collect the sample at home, after which you would deliver the sample to the lab within an hour. (If performing a 24-hour urine collection, ask your healthcare provider when samples should be dropped off.)
Food and Drink
Typically, no fasting is required before the collection of a urine sample. The only exception would be if other tests are being performed that do require fasting, such as acholesterol testorfasting plasma glucose test.Check with your healthcare provider if you are unsure about the dietary restrictions. The test is obviously easier with a full bladder, so some like to drink liquids beforehand.
Medications
Most routine medications can be taken before a urinalysis unless your healthcare provider tells you otherwise. It is important, however, to advise your healthcare provider about any and all drugs you may be taking, whether they be prescription, over-the-counter, traditional, homeopathic, or recreational.
Since the test involves a visual, chemical, and microscopic examination of the collected urine, certain substances may throw off the results. Examples include:
Ask your healthcare provider if you need to stop any of these before taking the test.
Cost and Health Insurance
On the day of the test, bring identification and your insurance card to register. You may also be asked to fill out a patient information form if it is your first visit, detailing any health problems or medications you may be taking. If you are taking the test as part of a healthcare provider’s appointment, this may not be necessary.
Collection
You will then be led to a private bathroom and provided a sterile plastic cup and lid, a sanitary cleansing wipe, and instructions on how to obtain a “midstream clean-catch” sample. The clean-catch technique prevents bacteria or fungus from the penis or vagina from accidentally getting into the urine.
How to Obtain a Clean Catch
Once filled, place the lid on the cup, wash your hands, and deliver the sample to the nurse or attendant. Some facilities may ask you to deposit the cup in a designated cabinet.
If you collected the sample at home and cannot bring it to the lab right away, you may be able to refrigerate it. Speak with the lab to ensure this is okay. If it is, place the sealed cup in a sealed plastic bag to prevent contamination.
A urine sample should not be refrigerated for more than 24 hours.It should never be frozen or kept on ice but rather stored at temperatures of around 39 degrees.
Though evaluation of a urinalysis involves three separate steps, you will generally get your results in just a few days.Understanding the process used to come to your results can help you better understand them and what they might mean.
Visual Examination
During the visual exam, the lab technician will characterize the color and clarity of the urine. Any variations may be signs of an abnormality.
Urine coloris considered normal if it is described as yellow, straw color, or nearly colorless.Abnormal colors may be the result of a disease, something you’ve eaten, or something you’ve taken.
Examples include:
Chemical Examination
To perform the chemical exam, the lab uses commercially prepared test strips (called reagent strips) impregnated with reactive chemicals. The technician dips each strip into the urine. Any abnormality in the urine composition triggers a color change within seconds or minutes.There are also machines able to do this all at once and deliver an automated result within minutes.
The 10 most commonly performed reagent tests are:
Microscopic Examination
A drop or two of the sediment is then placed on a slide under the microscope. Cells, crystals, and other substances are counted and reported as either “per low power field” (LPF) or “per high power field” (HPF). Other, smaller substances may be reported as “few,” “moderate,” or “many.”
Some of the substances found either abnormally or in abnormal quantities may include:
Three or more RBCs per high-power field with microscopic urinalysis requires a workup for microhematuria, according to the American Urological Association. This includes urine studies, imaging, and cystoscopy.
Reference Ranges
Your healthcare provider should review the results with you. The lab values can be difficult to decipher but are generally evaluated on a scale called a laboratory reference range (RR).
The RR delineates the numeric values between which a test result is considered normal. The RR differs for each substance being tested and is based on the expected value within a specific population. Those values higher than the RR are often marked “H” for high, while values lower than the RR may be marked “L” for low.
In reviewing your results, your healthcare provider will explain which values are normal, borderline, and/or abnormal. Oftentimes, a healthcare provider can explain an abnormality based on your medical history and offer a treatment plan. In other cases, further testing will be needed.
The same may apply to monitoring gestational diabetes during pregnancy.Routine urinalysis may be ordered to check to see if glucose, not commonly found in urine, is detected. The findings may help direct prenatal treatment and care.
If you have symptoms of a urinary tract infection but the causal agent (pathogen) cannot be identified in the initial urinalysis, abacterial or fungal culturemay be performed along with pathogen-specific blood tests. (Negative urine culture results are sometimes suggestive of a less common viral UTI).
Imaging tests, such as an ultrasound,computed tomography (CT), ormagnetic resonance imaging (MRI), may be also be used to determine whether the problem is located before the kidneys (pre-renal), in the kidneys (renal), or after the kidneys (post-renal).
A flexible fiber-optic tool called acystoscopemay be used to check for benign or malignantbladder tumors.The narrow, tube-like device is fed into the bladder through the urethra, providing direct visualization of injuries that other imaging and blood tests sometimes miss.
A Word From Verywell
A urinalysis with all normal values is generally a strong indication that your kidneys and urinary tract are functioning normally. Beyond that, there are limitations as to what can be interpreted from the test.
The absence of abnormal values is neither the “all clear” sign nor an indication that your symptoms are all in your head. It simply means that the lab was unable to detect any abnormalities based on this one test.
Similarly, a urinalysis with abnormal values could mean any number of things, both consequential and inconsequential. It is only when used with other tests—such as acomplete blood count,liver function, orrenal function test—that a urinalysis can provide fuller insights into what is going on. A urinalysis is almost never used as the sole form of diagnosis.
While a urinalysis is an important tool for diagnosis, remember that the values need to be taken in context. Try not to make assumptions until an experienced clinician is able to review your results in their entirety. If an explanation cannot be found, you canseek a second opinionor ask for a referral to a specialist who may have better insights into a possible cause.
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