Urine Test

URINE ANALYSIS

More than 100 different tests can be done on urine. A regular urinalysis often includes the following tests

• Color. Many things affect urine color, including fluid balance, diet, medicines, and diseases. How dark or light the color is tells you how much water is in it. Vitamin B supplements can turn urine bright yellow. Some medicines, blackberries, beets, rhubarb, or blood in the urine can turn urine red-brown.
• Clarity. Urine is normally clear. Bacteria, blood, sperm, crystals, or mucus can make urine look cloudy.
• Odor. Urine does not smell very strong, but has a slightly "nutty" odor. Some diseases cause a change in the odor of urine. For example, an infection with E. coli bacteria can cause a bad odor, while diabetes or starvation can cause a sweet, fruity odor.
• Specific gravity. This checks the amount of substances in the urine. It also shows how well the kidneys balance the amount of water in urine. The higher the specific gravity, the more solid material is in the urine. When you drink a lot of fluid, your kidneys make urine with a high amount of water in it which has a low specific gravity. When you do not drink fluids, your kidneys make urine with a small amount of water in it which has a high specific gravity.
• pH. The pH is a measure of how acidic or alkaline (basic) the urine is. A urine pH of 4 is strongly acidic, 7 is neutral (neither acidic nor alkaline), and 9 is strongly alkaline. Sometimes the pH of urine is affected by certain treatments. For example, your doctor may instruct you how to keep your urine either acidic or alkaline to prevent some types of kidney stones from forming.
• Protein. Protein is normally not found in the urine. Fever, hard exercise,pregnancy, and some diseases, especially kidney disease, may cause protein to be in the urine.
• Glucose. Glucose is the type of sugar found in blood. Normally there is very little or no glucose in urine. When the blood sugar level is very high, as in uncontrolleddiabetes, the sugar spills over into the urine. Glucose can also be found in urine when the kidneys are damaged or diseased.
• Nitrites. Bacteria that cause a urinary tract infection (UTI) make an enzyme that changes urinary nitrates to nitrites. Nitrites in urine show a UTI is present.
• Leukocyte esterase (WBC esterase). Leukocyte esterase shows leukocytes (white blood cells [WBCs]) in the urine. WBCs in the urine may mean a UTI is present.
• Ketones. When fat is broken down for energy, the body makes substances called ketones (or ketone bodies). These are passed in the urine. Large amounts of ketones in the urine may mean a very serious condition, diabetic ketoacidosis, is present. A diet low in sugars and starches (carbohydrates), starvation, or severe vomiting may also cause ketones to be in the urine.
• Microscopic analysis. In this test, urine is spun in a special machine (centrifuge) so the solid materials (sediment) settle at the bottom. The sediment is spread on a slide and looked at under a microscope. Things that may be seen on the slide include:
• Red or white blood cells. Blood cells are not found in urine normally. Inflammation, disease, or injury to the kidneys, ureters, bladder, or urethra can cause blood in urine. Strenuous exercise, such as running a marathon, can also cause blood in the urine. White blood cells may be a sign of infection or kidney disease.
• Casts. Some types of kidney disease can cause plugs of material (called casts) to form in tiny tubes in the kidneys. The casts then get flushed out in the urine. Casts can be made of red or white blood cells, waxy or fatty substances, or protein. The type of cast in the urine can help show what type of kidney disease may be present.
• Crystals. Healthy people often have only a few crystals in their urine. A large number of crystals, or certain types of crystals, may mean kidney stones are present or there is a problem with how the body is using food (metabolism).
• Bacteria, yeast cells, or parasites. There are no bacteria, yeast cells, orparasites in urine normally. If these are present, it can mean you have an infection.
• Squamous cells. The presence of squamous cells may mean that the sample is not as pure as it needs to be. These cells do not mean there is a medical problem, but your doctor may ask that you give another urine sample.

Urine test results

Color	Normal:	Pale to dark yellow
	Abnormal:	Many foods and medicines can affect the color of the urine. Urine with no color may be caused by long-term kidney disease or uncontrolled diabetes. Dark yellow urine can be caused by dehydration. Red urine can be caused by blood in the urine.
Clarity	Normal:	Clear
	Abnormal:	Cloudy urine can be caused by pus (white blood cells), blood (red blood cells), sperm, bacteria, yeast, crystals, mucus, or a parasite infection, such as trichomoniasis.
Odor	Normal:	Slightly "nutty" odor
	Abnormal:	Some foods (such as asparagus), vitamins, and antibiotics (such as penicillin) can cause urine to have a different odor. A sweet, fruity odor may be caused by uncontrolled diabetes. A urinary tract infection (UTI) can cause a bad odor. Urine that smells like maple syrup can mean maple syrup urine disease, when the body cannot break down certain amino acids.
Specific gravity	Normal:	1.005-1.030
	Abnormal:	A very high specific gravity means very concentrated urine, which may be caused by not drinking enough fluid, loss of too much fluid (excessive vomiting, sweating, or diarrhea), or substances (such as sugar or protein) in the urine. Very low specific gravity means dilute urine, which may be caused by drinking too much fluid, severe kidney disease, or the use of diuretics.
pH	Normal:	4.6-8.0
	Abnormal:	Some foods (such as citrus fruit and dairy products) and medicines (such as antacids) can affect urinepH. A high (alkaline) pH can be caused by severe vomiting, a kidney disease, some urinary tract infections, and asthma. A low (acidic) pH may be caused by severe lung disease (emphysema), uncontrolled diabetes, aspirin overdose, severe diarrhea, dehydration, starvation, drinking too much alcohol, or drinking antifreeze (ethylene glycol).
Protein	Normal:	None
	Abnormal:	Protein in the urine may mean kidney damage, an infection, cancer, high blood pressure, diabetes,systemic lupus erythematosus (SLE), orglomerulonephritis is present. Protein in the urine may also mean that heart failure, leukemia, poison (lead or mercury poisoning), or preeclampsia (if you are pregnant) is present.
Glucose	Normal:	None
	Abnormal:	Intravenous (IV) fluids can cause glucose to be in the urine. Too much glucose in the urine may be caused by uncontrolled diabetes, an adrenal glandproblem, liver damage, brain injury, certain types of poisoning, and some types of kidney diseases. Healthy pregnant women can have glucose in their urine, which is normal during pregnancy.
Ketones	Normal:	None
	Abnormal:	Ketones in the urine can mean uncontrolled diabetes, a very low-carbohydrate diet, starvation or eating disorders (such as anorexia nervosa orbulimia), alcoholism, or poisoning from drinking rubbing alcohol (isopropanol). Ketones are often found in the urine when a person does not eat (fasts) for 18 hours or longer. This may occur when a person is sick and cannot eat or vomits for several days. Low levels of ketones are sometimes found in the urine of healthy pregnant women.
Microscopic analysis	Normal:	Very few or no red or white blood cells or casts are seen. No bacteria, yeast cells, parasites, or squamous cells are present. A few crystals are normally seen.
	Abnormal:	Red blood cells in the urine may be caused by kidney or bladder injury, kidney stones, a urinary tract infection (UTI), inflammation of the kidneys (glomerulonephritis), a kidney or bladder tumor, or systemic lupus erythematosus (SLE). White blood cells (pus) in the urine may be caused by a urinary tract infection, bladder tumor, inflammation of the kidneys, systemic lupus erythematosus (SLE), or inflammation in the vagina or under the foreskin of the penis. Depending on the type, casts can mean inflammation or damage to the tiny tubes in the kidneys, poor blood supply to the kidneys, metal poisoning (such as lead or mercury), heart failure, or a bacterial infection. Large amounts of crystals, or certain types of crystals, can mean kidney stones, damaged kidneys, or problems with metabolism. Some medicines and some types of urinary tract infections can also increase the number of crystals in urine. Bacteria in the urine mean a urinary tract infection (UTI). Yeast cells or parasites (such as the parasite that causes trichomoniasis) can mean an infection of the urinary tract. The presence of squamous cells may mean that the sample is not as pure as it needs to be. These cells do not mean there is a medical problem, but your doctor may ask that you give another urine sample.