Urinalysis

How to Cite This Chapter: Solnica B. Urinalysis. McMaster Textbook of Internal Medicine. Kraków: Medycyna Praktyczna. https://empendium.com/mcmtextbook/chapter/B31.1269.3.205.3. Accessed May 24, 2024.
Last Updated: February 4, 2022
Last Reviewed: February 4, 2022
Chapter Information

Table 1

Table 20.4-1. Urinalysis

Analyte

Reference range

Result interpretation

Dipstick test

pH

4.5-8.0, usually 5.0-6.0

↓ High-protein diet, fever

↑ Low-protein diet, renal tubular acidosis

Specific gravity

1.023-1.035 g/mL

↓ Impaired renal function, diabetes insipidus, electrolyte disorders (hypercalcemia, hypokalemia), hypothyroidism/hyperthyroidism

↑ Significant glycosuria, medication (mannitol, dextran), contrast media

Protein

Absenta

↑ Overflow, glomerular, tubular, or mixed proteinuria

Glucose

Absenta

↑ Uncontrolled diabetes, tubular glycosuria

Ketone bodies (acetoacetate)

Absenta

↑ Ketosis/ketoacidosis

Bilirubin

Absenta

↑ Hepatic/obstructive jaundice, hemolytic states

Urobilinogen

<1 mg/dL

↑ Hemolytic states

↓ Obstructive jaundice

RBCs/Hb

Absenta

↑ Erythrocyturia/hematuria

Leukocyte esterase

Absenta

↑ Leukocyturia, UTI

Nitrites

Absenta

↑ Bacteriuria, UTI

Microscopic examination

RBCs

<3/HPF

↑ Erythrocyturia/hematuria: glomerular (dysmorphic RBCs), extraglomerular (isomorphic RBCs)

WBCs

<4/HPF

↑ Leukocyturia, UTI

Bacteria

Absent

↑ Asymptomatic bacteriuria, UTI

Note: Culture should be performed for qualitative and quantitative analysis of bacteriuria; bacteria in the urine sediment are found mostly due to sample contamination

Squamous epithelial cells

3-5/HPF

↑ UTI

Tubular epithelial cells

Absent

↑ Tubular damage

Casts

Hyaline

≤3/HPF

Nonspecific

Granular

Absent

↑ Renal parenchymal damage

WBC

Absent

↑ Possible pyelonephritis or interstitial nephritis

RBC

Absent

↑ Possible glomerulonephritis

Epithelial cell

Absent

↑ Tubular damage

a Concentration or cell count other than physiologic is considered abnormal.

↑, increase; ↓, decrease; HPF, high-power field; RBC, red blood cell; UTI, urinary tract infection; WBC, white blood cell.

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