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A urinalysis test measures several different components of urine, a waste product made by the kidneys. A routine urine screening test may be done to help find the cause for many types of symptoms. The test can provide information about your overall health and clues to many conditions.

The kidneys remove waste material, minerals, fluids, and other substances from the blood for elimination in the urine. Therefore, urine can contain hundreds of different bodily waste products. Many factors, such as diet, fluid intake, exercise, and kidney function, affect what is in your urine.

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

Color. Many factors affect urine color, including fluid balance, diet, medications, and disease.

Clarity. Urine is normally clear. This test determines the cloudiness of urine, also called opacity or turbidity. Bacteria, blood, sperm, crystals, or mucus can make urine appear cloudy.

Odor. Urine usually does not smell very strong, but has a slightly "nutty" (aromatic) odor. Some diseases can cause a change in the normal odor of urine.

Specific gravity. This measures the amount of substances dissolved in the urine. It also indicates how well the kidneys are able to adjust the amount of water in urine. The higher the specific gravity, the more solid material is dissolved in the urine. When you drink a lot of liquid, your kidneys should produce greater-than-normal amounts of dilute urine (low specific gravity). When you drink very little liquid, your kidneys should make only small amounts of concentrated urine (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.

Protein. Protein is normally not detected in the urine. Fever, strenuous exercise, normal pregnancy, and some diseases, especially kidney disease, may also cause protein in the urine.

Glucose. Glucose is the type of sugar usually found in blood. Normally there is very little or no glucose in urine. However, when the blood sugar level is very high, as in uncontrolled diabetes, it spills over into the urine. Glucose can also be present in urine when the kidneys are damaged or diseased.

Nitrites. Bacteria that cause a urinary tract infection (UTI) produce an enzyme that converts urinary nitrates to nitrites. The presence of nitrites in urine indicates a UTI.

Leukocyte esterase (WBC esterase). Leukocyte esterase detects leukocytes (white blood cells) in the urine. The presence of WBCs in the urine may indicate a urinary tract infection.

Ketones. When fat is broken down for energy, the body produces by-products called ketones (or ketone bodies) and releases them into the urine. Large amounts of ketones in the urine may signal a dangerous condition known as diabetic ketoacidosis.

Microscopic analysis. In this test, urine is spun in a centrifuge so the solid materials settle out. The sediment is spread on a slide and examined under a microscope. Types of materials that may be found include:
Red or white blood cells. Normally blood cells are not found in urine. Inflammation, disease, or injury to the kidneys, ureters, bladder, or urethra can cause blood in urine. White blood cells are often a sign of infection, cancer, 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 can then get flushed out into the urine. The type of cast can provide clues about the type of kidney disease that may be present.

Crystals. Healthy people often have only a few crystals in their urine. However, a large number of crystals, or the presence of certain types of crystals, may indicate kidney stones or a problem with how the body’s metabolism.

Bacteria and yeast cells. Normally there are no bacteria, yeast cells, or parasites in urine. Their presence can indicate an infection.

Urinalysis Testing

Total Urinary Analysis (UA) involves multiple routine tests on a urine specimen. A UA will routinely include color, appearance, and odor; pH; and presence of proteins, glucose, ketones, and blood. It is also examined microscopically for RBCs, WBCs, casts, crystals, and bacteria.

Both a urinalysis and a complete blood count provides an excellent indication of a person’s overall health. It is very rare that something can be going on in the body and it does not show up in the blood or the urine.

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