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Vesicoureteral Reflux

Table of Contents

Vesicoureteral Reflux

Vesico-ureteral Reflux; VUR

Vesicoureteral reflux (VUR) is a condition in which urine flows backward from the bladder to one or both ureters and sometimes to the kidneys. VUR is most common in infants and young children.

Vesicoureteral-reflux

Image by RadsWiki

Summary

Urinary System Bladder, Kidneys, Ureters and Urethra

Image by TheVisualMD

Urinary System Bladder, Kidneys, Ureters and Urethra

Urinary System _ Bladder, Kidneys, Ureters and Urethra

Image by TheVisualMD

What Is Vesicoureteral Reflux?

Vesicoureteral reflux (VUR) is a condition in which urine flows backward from the bladder to one or both ureters and sometimes to the kidneys. VUR is most common in infants and young children. Most children don’t have long-term problems from VUR.

Normally, urine flows down the urinary tract, from the kidneys, through the ureters, to the bladder. With VUR, some urine will flow back up—or reflux—through one or both ureters and may reach the kidneys.

Doctors usually rank VUR as grade 1 through 5. Grade 1 is the mildest form of the condition, and grade 5 is the most serious.

VUR causes urine to flow back up through the urinary tract, often leading to urinary tract infections.

VUR can cause urinary tract infections (UTI) and, less commonly, kidney damage. The two main types of VUR are primary VUR and secondary VUR. Most children have primary VUR.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Additional Materials (2)

Kidneys and cross section of hip Bone

Kidneys and cross section of hip Bone

Image by TheVisualMD

Vesicoureteral Reflux (VUR) | FAQ with Dr. Heather Di Carlo

Video by Johns Hopkins Medicine/YouTube

Kidneys and cross section of hip Bone

TheVisualMD

3:11

Vesicoureteral Reflux (VUR) | FAQ with Dr. Heather Di Carlo

Johns Hopkins Medicine/YouTube

How Common?

Illustration of rare disease incidence

Image by mcmurryjulie/Pixabay

Illustration of rare disease incidence

Image by mcmurryjulie/Pixabay

How Common Is Vesicoureteral Reflux?

About 1 in 3 children who has a UTI with a fever has VUR. The number of children with VUR may be higher, because some children with VUR who don’t have symptoms or problems are not tested.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Additional Materials (1)

Vesicoureteral Reflux

Video by NationwideChildrens/YouTube

0:22

Vesicoureteral Reflux

NationwideChildrens/YouTube

Risk Factors

Front-view drawing of a normal urinary tract in an infant

Image by NIDDK Image Library

Front-view drawing of a normal urinary tract in an infant

The urinary tract includes two kidneys, two ureters, a bladder, and a urethra.

Image by NIDDK Image Library

Who Is More Likely to Have Vesicoureteral Reflux?

Generally, the younger a child is, the more likely he or she will have VUR. VUR is more common in infants and children ages 2 and under, but it can also be present in older children and even adults.

Children who have abnormal kidneys or urinary tracts are more likely to have VUR. Girls are more likely than boys to have VUR.

A child is more likely to have VUR if a brother, sister, or parent has it. A little more than 1 in 4 siblings of children with VUR will also have the condition. A little more than 1 in 3 children with a parent with VUR will also have the condition.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Additional Materials (1)

1. What is vesicoureteral reflux?

Video by childrenshospgh/YouTube

0:58

1. What is vesicoureteral reflux?

childrenshospgh/YouTube

Causes

Primary VUR due to a shortened ureter

Image by NIDDK Image Library

Primary VUR due to a shortened ureter

Drawing of the urinary tract in the outline of a male figure with an inset of a cross section of the bladder. The cross-section image has arrows and labels that show the normal direction of urine flow in a normal ureter and reflux in a shortened ureter. Other labels point to the valve and bladder.

Image by NIDDK Image Library

What Causes Vesicoureteral Reflux?

Primary vesicoureteral reflux

Most children who have VUR have primary VUR, which means they are born with an abnormal ureter. With primary VUR, the valve between the ureter and the bladder does not close well, so urine comes back up the ureter toward the kidney. If only one ureter and one kidney are affected, doctors call the VUR unilateral reflux.

Primary VUR can get better or go away as a child gets older. As a child grows, the entrance of the ureter into the bladder matures and the valve works better.

In children with primary VUR, the valve between the ureter and the bladder does not close well, so urine comes back up the ureter toward the kidney.

Secondary vesicoureteral reflux

Children can have secondary VUR for many reasons, including a blockage or narrowing in the bladder neck or urethra. For example, a fold of tissue may block the urethra. The blockage stops some of the urine from leaving the body, so the urine goes back up the urinary tract.

A child also can have secondary VUR because the nerves to the bladder may not work well. The nerve problems can prevent the bladder from relaxing and contracting normally to release urine.

Children with secondary VUR often have bilateral reflux, meaning the VUR affects both ureters and both kidneys. Doctors can sometimes diagnose a urine blockage in a fetus in the womb.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Additional Materials (1)

Vesicoureteral Reflux (VUR)

Video by mdconversation/YouTube

12:39

Vesicoureteral Reflux (VUR)

mdconversation/YouTube

Symptoms

Grades 5 Vesico-ureteric reflux shown on right of the diagram. A normal kidney is shown on the left of the diagram.

Image by ColnKurtz

Grades 5 Vesico-ureteric reflux shown on right of the diagram. A normal kidney is shown on the left of the diagram.

Grades 5 Vesico-ureteric reflux shown on right of the diagram. A normal kidney is shown on the left of the diagram.

Image by ColnKurtz

What Are the Symptoms and Complications of Vesicoureteral Reflux?

Sometimes a child with VUR has no symptoms. If a child does have symptoms, the most common is a UTI. When urine flows backward, as it does with VUR, bacteria can grow more easily in the child’s urinary tract, causing a UTI.

Problems with bladder or bowel function can sometimes be related to VUR. A child with VUR is more likely to have

UTIs, including bladder or kidney infections
other bladder problems, such as urinary incontinence, bedwetting, and urinary retention
bowel problems, such as constipation

Most children with VUR who get a UTI recover without other problems. However, in some cases, UTIs can lead to kidney scarring, also called renal scarring, or permanent scars on the kidney. A child is more likely to have kidney scarring if he or she is not treated at all—or not treated fast enough—for a UTI, repeat UTIs, or a high grade of VUR.

Children who have VUR along with bladder or bowel symptoms have a higher risk of UTIs. Doctors use certain tests to find out if a child is at risk for kidney problems.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Additional Materials (1)

Get the Facts About Vesicoureteral Reflux (V.U.R.) - Urology Care Foundation

Video by Urology Care Foundation/YouTube

2:49

Get the Facts About Vesicoureteral Reflux (V.U.R.) - Urology Care Foundation

Urology Care Foundation/YouTube

Diagnosis

Pelvic ultrasound

Image by TheVisualMD

Pelvic ultrasound

Pelvic ultrasound, a procedure that uses sound waves to look at organs and structures inside the pelvic region

Image by TheVisualMD

How Do Doctors Diagnose Vesicoureteral Reflux?

To diagnose the grade of VUR, doctors use imaging tests.

Imaging tests

Before you and your child’s doctor decide to use urinary tract imaging to diagnose VUR in your child, a doctor considers the child’s

age
symptoms
family history of VUR
sexual activity level in an older child

Doctors use the following imaging tests, or tests to see organs inside the body, to help diagnose VUR

Abdominal ultrasound. An ultrasound uses sound waves to look inside the body without exposing your child to x-ray radiation. An ultrasound of the abdomen, called an abdominal ultrasound, can create images of the entire urinary tract, including the kidneys and bladder. An ultrasound can show whether a child’s kidneys or ureters are dilated, or widened. During this painless test, your child lies on a padded table. A technician gently moves a wand called a transducer over your child’s belly and back. No anesthesia is needed. Ultrasound may be used to look for kidney and urinary tract problems after a child has had a UTI.
Voiding cystourethrogram (VCUG). A VCUG uses x-rays of the bladder and urethra to show if urine flows backward into the ureters. To perform the test, a technician uses a small catheter to fill your child’s bladder with a special dye. The technician then takes x-rays before, during, and after your child urinates. A VCUG uses only a small amount of radiation. Anesthesia is not needed, but the doctor may offer your child a calming medicine, called a sedative.

An ultrasound is often the first imaging test used to check for kidney problems caused by VUR.

Lab tests

Health care professionals often test a urine sample, which is called urinalysis, to screen for a UTI. White blood cells and bacteria in the urine can be signs of a UTI. A urine culture is needed to confirm a UTI.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Additional Materials (1)

Treatment of Pediatric Vesicoureteral Reflux (VUR)

Video by BusinessWire/YouTube

0:55

Treatment of Pediatric Vesicoureteral Reflux (VUR)

BusinessWire/YouTube

Abdominal Ultrasound

Abdominal Ultrasound

Also called: Ultrasound - abdomen, Abdominal sonogram, Abdominal sonography, Right upper quadrant sonogram, Ultrasound of the Abdomen, Ultrasound Imaging of the Abdomen

An abdominal ultrasound uses sound waves to look at organs in the abdomen, including the liver, gallbladder, spleen, pancreas, and kidneys. It may also be used to assess blood flow to abdominal organs. An abdominal ultrasound can help find the cause of stomach pain or bloating, check for kidney stones, liver disease, tumors and many other conditions.

Abdominal Ultrasound

Also called: Ultrasound - abdomen, Abdominal sonogram, Abdominal sonography, Right upper quadrant sonogram, Ultrasound of the Abdomen, Ultrasound Imaging of the Abdomen

An abdominal ultrasound uses sound waves to look at organs in the abdomen, including the liver, gallbladder, spleen, pancreas, and kidneys. It may also be used to assess blood flow to abdominal organs. An abdominal ultrasound can help find the cause of stomach pain or bloating, check for kidney stones, liver disease, tumors and many other conditions.

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Use the slider below to see how your results affect your health.
Your result is Normal.
A normal result indicates that the organs examined appear normal.
Related conditions
1. https://www.niddk.nih.gov/health-information/diagnostic-tests/prostate#additional [accessed on Sep 16, 2019]
2. https://www.niddk.nih.gov/health-information/digestive-diseases/appendicitis/diagnosis [accessed on Sep 19, 2019]
3. https://www.niddk.nih.gov/health-information/diagnostic-tests/urinary-tract-imaging [accessed on Sep 16, 2019]
4. https://www.niddk.nih.gov/health-information/urologic-diseases/urine-blockage-newborns/vesicoureteral-reflux [accessed on Sep 16, 2019]
5. https://medlineplus.gov/ency/article/003777.htm [accessed on Oct 09, 2021]
6. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/abdominal-ultrasound [accessed on Oct 09, 2021]
7. https://www.radiologyinfo.org/en/info/abdominus [accessed on Oct 09, 2021]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Voiding Cystourethrogram

Voiding Cystourethrogram

Also called: VCUG

A voiding cystourethrogram (VCUG) is an x-ray exam of the bladder and urethra taken while the bladder is full and during urination (voiding). The test can show abnormalities of the inside of the urethra and bladder and whether urine is backing up toward the kidneys during urination.

Voiding Cystourethrogram

Also called: VCUG

A voiding cystourethrogram (VCUG) is an x-ray exam of the bladder and urethra taken while the bladder is full and during urination (voiding). The test can show abnormalities of the inside of the urethra and bladder and whether urine is backing up toward the kidneys during urination.

A voiding cystourethrogram (VCUG) is an x-ray image of the bladder and urethra taken while the bladder is full and during urination, also called voiding. The bladder and urethra are filled with contrast medium to make the structures clearly visible on the x-ray images. The x-ray machine captures images of the contrast medium while the bladder is full and when the person urinates.
1. https://www.niddk.nih.gov/health-information/diagnostic-tests/urinary-tract-imaging [accessed on Jun 04, 2019]
2. https://www.niddk.nih.gov/health-information/kidney-disease/children/ectopic-kidney [accessed on Jun 04, 2019]
3. https://medlineplus.gov/ency/article/003784.htm [accessed on Jun 04, 2019]
4. https://www.uofmhealth.org/health-library/hw210845 [accessed on Jun 04, 2019]

Additional Materials (1)

X-ray of urinary bladder filled with contrast media.

Image by Lucien Monfils

X-ray of urinary bladder filled with contrast media.

Lucien Monfils

Urinalysis Test

Urinalysis Test

Also called: Urine Test

A urine test is used to help diagnose a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. It evaluates many characteristics, macroscopic (that can be seen with the naked eye) and microscopic (invisible to the naked eye). It is a routine exam for your health check-up, before surgery, or when pregnant.

Urinalysis Test

Also called: Urine Test

A urine test is used to help diagnose a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. It evaluates many characteristics, macroscopic (that can be seen with the naked eye) and microscopic (invisible to the naked eye). It is a routine exam for your health check-up, before surgery, or when pregnant.

A urinalysis test consists in the evaluation of the macroscopic (that can be seen with the naked eye) and microscopic (invisible to the naked eye, can be seen through a microscope) characteristics of a urine sample to detect and measure various substances and compounds that the body filter through the kidneys.
Usually, these characteristics are done as a single panel and are not done separately as it had been before. This test can be used to make an overall health evaluation of the urinary tract, but it also helps diagnose and monitor many other conditions.
The structure of the test includes:
- Macroscopic aspects:
  Color
  Appearance
  Odor
- Chemical examination:
  pH
  Density
  Proteins
  Glucose
  Urobilinogen
  Bilirubin
  Leucocytes
  Nitrites
  Blood
  Ketones
- Microscopic aspects include:
  Blood cells (white and red cells)
  Epithelial cells
  Bacteria
  Crystals or casts
The most common uses of the urine test are:
- Overall check up
- To monitor pregnant women
- If you have signs and symptoms of urinary tract infection (pelvic pain, dark urine, painful urination, blood in urine, frequent urination)
- To monitor a medical condition, such as diabetes or kidney disease
- Drug screening
You will need to give a clean catch urine sample.
This requires following these simple steps;
1. Clean your genitals
2. Start to urinate in the toilet
3. Stop halfway through
4. Collect about two ounces of midstream urine in the container
5. Stop again and close the container
6. Last, finish peeing in the toilet
You also need to be careful not to touch your genitals with the container to avoid possible contamination with external microorganisms.
Macroscopic findings
- Appearance (Clarity): normal urine is typically clear. If the urine seems to be cloudy or with floating particles, it may be indicative of urinary tract infection.
- Color: most often shades of yellow. Unusual colors might be because of certain foods, medications or a specific condition.
- Odor: normally it is relatively mild and not too noticeable.
Chemical examination
- pH: this measures the acidity. Under normal conditions, the urine is acidic with pH levels that range from 4.5 to 8.0
- Density (specific gravity): this measures how diluted or concentrated is your urine. Normal urine density is usually from 1.003 to 1.035.
- Proteins: urine can have small amounts of proteins; however, finding high protein levels may indicate kidney disease or diabetes mellitus.
- Glucose: no glucose should be found in the urine of a healthy individual.
- Urobilinogen: normal results range from 0.1 to 1.0 mg/dL.
- Bilirubin: no bilirubin should be found in the urine of a healthy individual. Positive findings may suggest liver disease.
- Nitrite: no nitrites should be found in the urine of a healthy individual. When positive is highly indicative of urinary tract infection.
- Ketones: normally is not found. However, it can be positive if you have been fasting for long periods of time, or if you have diabetes mellitus.
Microscopic aspects
- Red blood cells (RBC’s): is not unusual to find RBCs in a urine sample; however, 3 or more red blood cells are regarded as a sign of hematuria (blood loss through urine).
- White blood cells (WBC’s): under normal conditions, this parameter should be negative. A positive result is suggestive of urinary tract infection.
- Epithelial cells: from 1 to 5 squamous/hpf is considered to be normal. Higher results may indicate contamination of the urine sample by improper collection methods.
- Bacteria: it is normal to find up to 1+ bacteria; more than this is abnormal and should be analyzed to discern whether is caused by an infection or by improper sample storage.
- Crystals or casts: no crystals or casts should be found in the urine of healthy individuals. When present, it may be indicative of kidney disease or kidney stones.
1. Mayo Clinic: Urinalysis [accessed on Aug 19, 2018]
2. Urinalysis: A Comprehensive Review; Am Fam Physician. 2005 Mar 15;71(6):1153-1162. [accessed on Aug 19, 2018]
3. University of Utah: Urinalysis [accessed on Aug 19, 2018]

Additional Materials (22)

Urine Hydration chart

Image by Aishik Rehman/Wikimedia

Test Tube Containing Urine

Visualization of a test tube containing urine. Urine comprises mainly of water - 96% and the remaining 4% is urea and sodium.

Image by TheVisualMD

Urine in Vial

Urine is tested for a variety of reasons and can reveal a wealth of information about the source individual. More than 100 different tests can be done on urine. In addition to visual characteristics, for example color and clarity, urine may be examined for the presence of glucose, nitrites, or ketones. Microscopic examination may reveal the presence of red or white blood cells, or bacteria, yeast cells, or parasites. Urine samples may contain tumor markers, which can suggest cancer.

Image by TheVisualMD

White blood cells seen under a microscope from a urine sample. Bigger cells are skin cells (epithelial cells)

White blood cells seen under a microscope from a urine sample. Bigger cells are skin cells (epithelial cells)

Image by Bobjgalindo

Abundant uric acid crystals in a human urine sample

Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.

Image by Doruk Salancı

Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample

Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.

Image by Doruk Salancı

Struvite crystals (urine)

Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.

Image by Doruk Salancı

Uric acid crystals (urine)

Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.

Image by Doruk Salancı

Urine samples

Each day our kidneys filter about 200 quarts of blood to extract about 2 quarts of wastes, which are then eliminated as urine. Urine samples are evaluated visually, for color, clarity and concentration; chemically, for various substances, such as glucose and proteins, in solution; and microscopically, for signs of bacteria, crystals and other contaminants.

Image by TheVisualMD

Male Figure with Urinary System

Both the male and the female urinary tracts are made up of the kidneys, ureters, urethra, and bladder.The kidneys filter wastes and water from the blood to produce urine. From the kidneys, urine passes through tubes called ureters to the bladder, which stores urine until it is full. Urine exits the bladder through another tube, the urethra. The male and female urinary tracts are relatively the same except for the length of the urethra: the male urethra is about five times as long as the female urethra.

Image by TheVisualMD

Urine collection container

Image by frolicsomepl/Pixabay

Cancer screening

Screening for Cancer: Urine Tests : Urine samples may contain tumor markers, which can suggest cancer. Urinalysis is commonly a part of routine health screening. It is simply an analysis of the urine that can be performed in many healthcare settings including doctors' offices, urgent care facilities, laboratories, and hospitals. Urinalysis can disclose evidence of diseases, even some that have not caused significant signs or symptoms.

Image by TheVisualMD

Sensitive content

This media may include sensitive content

Male Urinary System

Image of a male showing his urinary system. The urinary system, also known as the excretory system, produces, stores, and eliminates urine. It also helps to maintain the fluid balance in humans. The male urinary system consists of two kidneys, ureters, a urinary bladder, prostate, and urethra.

Image by TheVisualMD

Nephron of Kidney

The nephron is composed of looping and folding tubules that at first glance look like an impossibly tangled knot of highways, side roads and interchanges. But in fact, the nephron directs the traffic flow effortlessly. When stretched out, a nephron would be almost a couple of feet in length and there are about a million nephrons in each kidney. A nephron is composed of two basic parts: the glomerulus and the tubule. The glomerulus, part of the vascular system, is a tuft of capillaries that filters the wastes and fluid from the blood. The tubules then catch, concentrate and excrete the waste into the urine. The walls of the tubules are made of specialized cells, which serve as \"check points\" for the waste flowing by them. Hormonal sensors in these cells determine which substances should be excreted as waste and which substances will be reabsorbed into the blood to nourish the body's cells. The specific materials the cells are assigned to reabsorb or secrete include water and essential nutrients, salts and minerals, depending on where in the tubules the cells are located. From the glomerulus until the collecting duct, intricate and minute calculations are at constant play within the nephron. The production of urine does not just result in a waste product but also protects the fine balance of substances required to keep the body healthy.

Image by TheVisualMD

Fluid Filtration

Each day our kidneys filter about 200 quarts of blood to extract about 2 quarts of waste, which is then eliminated as urine. The kidneys' delicate filtration units are called nephrons; each kidney has about a million nephrons, and within each nephron are dense forests of tiny capillaries called glomeruli. The kidneys also play a key role in maintaining the body's fluid balance within a very narrow range. Even a 1% increase in blood sodium, for example, will make a person thirsty enough to take a drink in order to return the fluid balance to normal.

Image by TheVisualMD

Ammonia, Urine

Ammonia is a waste product generated by intestinal bacteria during the digestion of protein. From the intestine, ammonia is transported to the liver, where it is converted into urea, which is then excreted in the urine by the kidneys. The conversion and elimination of ammonia can be impaired by liver disease or kidney damage, which can result in a dangerous build up of ammonia.

Image by TheVisualMD

Pyuria

Urine may contain pus (a condition known as pyuria) as seen from a person with sepsis due to a urinary tract infection.

Image by James Heilman, MD

Urine

Sample of human urine

Image by Markhamilton

Interpretation of the Urinalysis (Part 1) - Introduction and Inspection

Video by Strong Medicine/YouTube

Interpretation of the Urinalysis (Part 2) - The Dipstick

Video by Strong Medicine/YouTube

How to collect a mid-stream urine sample for a urinary tract infection test

Video by Pathology Tests Explained/YouTube

How to collect a first-void or first-pass urine sample

Video by Pathology Tests Explained/YouTube

Urine Hydration chart

Aishik Rehman/Wikimedia

Test Tube Containing Urine

TheVisualMD

Urine in Vial

TheVisualMD

White blood cells seen under a microscope from a urine sample. Bigger cells are skin cells (epithelial cells)

Bobjgalindo

Abundant uric acid crystals in a human urine sample

Doruk Salancı

Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample

Doruk Salancı

Struvite crystals (urine)

Doruk Salancı

Uric acid crystals (urine)

Doruk Salancı

Urine samples

TheVisualMD

Male Figure with Urinary System

TheVisualMD

Urine collection container

frolicsomepl/Pixabay

Cancer screening

TheVisualMD

Sensitive content

This media may include sensitive content

Male Urinary System

TheVisualMD

Nephron of Kidney

TheVisualMD

Fluid Filtration

TheVisualMD

Ammonia, Urine

TheVisualMD

Pyuria

James Heilman, MD

Urine

Markhamilton

6:10

Interpretation of the Urinalysis (Part 1) - Introduction and Inspection

Strong Medicine/YouTube

16:36

Interpretation of the Urinalysis (Part 2) - The Dipstick

Strong Medicine/YouTube

1:03

How to collect a mid-stream urine sample for a urinary tract infection test

Pathology Tests Explained/YouTube

1:06

How to collect a first-void or first-pass urine sample

Pathology Tests Explained/YouTube

Glucose in Urine Test

Glucose in Urine Test

Also called: Urine sugar test, Urine glucose test, Glucosuria test, Glucose urine dipstick

A glucose in urine test measures the amount of glucose (sugar) in your urine. The test is used to monitor both type 1 and type 2 diabetes.

Glucose in Urine Test

Also called: Urine sugar test, Urine glucose test, Glucosuria test, Glucose urine dipstick

A glucose in urine test measures the amount of glucose (sugar) in your urine. The test is used to monitor both type 1 and type 2 diabetes.

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Use the slider below to see how your results affect your health.
mg/dL
15
Your result is Negative.
Glucose is not usually found in urine. If it is, further testing is needed.
Related conditions
You may get a glucose in urine test as part of your regular checkup or if you have symptoms of diabetes and cannot take a blood glucose test. Symptoms of diabetes include:
- Increased thirst
- More frequent urination
- Blurred vision
- Fatigue
You may also need a urinalysis, which includes a glucose in urine test, if you are pregnant. If high levels of glucose in urine are found, it may indicate gestational diabetes. Gestational diabetes is form of diabetes that happens only during pregnancy. Blood glucose testing can be used to confirm a diagnosis of gestational diabetes. Most pregnant women are tested for gestational diabetes with a blood glucose test, between their 24th and 28th weeks of pregnancy.
If your urine glucose test is part of a urinalysis, you will need to provide a sample of your urine. During your office visit, you will receive a container in which to collect the urine and special instructions to ensure the sample is sterile. These instructions are often referred to as the "clean catch method." The clean catch method includes the following steps:
1. Wash your hands.
2. Clean your genital area with a cleansing pad. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
3. Start to urinate into the toilet.
4. Move the collection container under your urine stream.
5. Collect at least an ounce or two of urine into the container, which should have markings to indicate the amount.
6. Finish urinating into the toilet.
7. Return the sample container as instructed by your health care provider.
Your health care provider may ask you to monitor your urine glucose at home with a test kit. He or she will provide you with either a kit or a recommendation of which kit to buy. Your urine glucose test kit will include instructions on how to perform the test and a package of strips for testing. Be sure to follow the kit instructions carefully, and talk to your health care provider if you have any questions.
Glucose is not normally found in urine. If results show glucose, it may be a sign of:
- Diabetes
- Pregnancy. As many half of all pregnant women have some glucose in their urine during pregnancy. Too much glucose may indicate gestational diabetes.
- A kidney disorder
A urine glucose test is only a screening test. If glucose is found in your urine, your provider will order a blood glucose test to help make a diagnosis.
1. https://medlineplus.gov/lab-tests/glucose-in-urine-test/ [accessed on Sep 15, 2019]
2. https://medlineplus.gov/ency/article/003581.htm [accessed on Sep 15, 2019]
3. https://www.labcorp.com/test-menu/26061/glucose-quantitative-urine [accessed on Sep 15, 2019]
4. https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=glucose_urine [accessed on Sep 15, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (6)

Abdomen Revealing Pancreas and Kidney

Sugar is one of the nutrients your body uses for energy. It is the product of the body's breakdown of complex carbohydrates and is circulated in the blood to all your cells. Although blood sugar levels change depending on whether you just ate or exercised, in general, your body keeps the sugar levels within a narrow range. Not enough sugar - hypoglycemia - and you can get hungry, shaky, sweaty, tired, and even faint. Too much sugar - hyperglycemia - is a cardiovascular risk factor leading to arteriosclerosis (hardening of the arteries). To control blood sugar levels, your body depends on a hormone called insulin.

Image by TheVisualMD

Diabetes Symptoms

(left to right) Fatigue: dehydration, lack of ability to utilize glucose for energy and other factors cause fatigue; weight loss: because it can't use glucose for energy, the body breaks down muscle instead; constant hunger: diabetes prevents glucose from entering cells, leading to constant hunger due to cell starvation; increased thirst: too much urination leaves tissues dehydrated and causes increased thirst; frequent urination: fluids are drawn from tissues and the kidneys constantly filter out glucose, leading to frequent urination.

Image by TheVisualMD

Male Figure with Urinary System

Both the male and the female urinary tracts are made up of the kidneys, ureters, urethra, and bladder.The kidneys filter wastes and water from the blood to produce urine. From the kidneys, urine passes through tubes called ureters to the bladder, which stores urine until it is full. Urine exits the bladder through another tube, the urethra. The male and female urinary tracts are relatively the same except for the length of the urethra: the male urethra is about five times as long as the female urethra.

Image by TheVisualMD

Kidney Glomeruli, Compromised Filtration

Our kidneys are remarkable filters. Each day, they filter about 200 quarts of blood to extract about 2 quarts of wastes, which are then eliminated as urine. Proteins are also normally filtered out of the blood and recycled in the body by the kidneys. When kidneys are diseased or damaged, however, their ability to filter out proteins is compromised, which allows protein to then leak into urine.

Image by TheVisualMD

Diseased and Aging Kidney Tissue Comparisons

As a person ages, the number of nephrons, the kidneys' vital filters, decreases, as does the overall amount of tissue in the kidneys. A healthy aging kidney will not function like a 20-year-old kidney, but it can still do its job. The difference between an aging kidney in a healthy body and a kidney damaged by hypertension or diabetes can be as stark as the difference between someone who is a picture of health and someone who is debilitated by illness.

Image by TheVisualMD

Glomerulonephritis

Our kidneys filter about 200 quarts of blood each day to extract about 2 quarts of waste, which is then eliminated as urine. The kidneys' delicate filtration units are called nephrons; each kidney has about a million nephrons, and within each nephron are dense forests of tiny capillaries called glomeruli. Glomerulonephritis is the inflammation of these tiny filters and can be caused by diabetes and chronic high blood pressure or, in acute cases, infection. When kidney function declines, waste products normally filtered out and excreted into the urine begin instead to accumulate in the blood.

Image by TheVisualMD

Abdomen Revealing Pancreas and Kidney

TheVisualMD

Diabetes Symptoms

TheVisualMD

Male Figure with Urinary System

TheVisualMD

Kidney Glomeruli, Compromised Filtration

TheVisualMD

Diseased and Aging Kidney Tissue Comparisons

TheVisualMD

Glomerulonephritis

TheVisualMD

Bilirubin in Urine Test

Bilirubin in Urine Test

Also called: Total Urine Bilirubin, Bilirubin

Bilirubin is a yellowish pigment found in bile, a fluid produced by the liver. When the liver is damaged, bilirubin can leak into your urine. A bilirubin in urine test can help detect liver disease.

Bilirubin in Urine Test

Also called: Total Urine Bilirubin, Bilirubin

Bilirubin is a yellowish pigment found in bile, a fluid produced by the liver. When the liver is damaged, bilirubin can leak into your urine. A bilirubin in urine test can help detect liver disease.

{"label":"Bilirubin Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"Bilirubin is not normally found in the urine.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"High levels of bilirubin could mean your liver is not functioning correctly. However, high levels can also be due to medications, exercise, or certain foods.","conditions":["Biliary tract disease","Cirrhosis","Gallstones in the biliary tract","Hepatitis","Liver disease","Tumors of the liver or gallbladder"]}],"value":0.5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your health.
Your result is Negative.
Bilirubin is not normally found in the urine.
Related conditions
Your health care provider may have ordered a bilirubin in urine test as part of your regular checkup, or if you have symptoms of liver disease. These symptoms include:
- Jaundice, a condition that causes your skin and eyes to turn yellow
- Dark-colored urine
- Abdominal pain
- Nausea and vomiting
- Fatigue
Because bilirubin in urine can indicate liver damage before other symptoms appear, your health care provider may order a bilirubin in urine test if you are at a higher risk for liver damage. Risk factors for liver disease include:
- Family history of liver disease
- Heavy drinking
- Exposure or possible exposure to hepatitis virus
- Obesity
- Diabetes
- Taking certain medicines that can cause liver damage
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." The clean catch method includes the following steps:
1. Wash your hands.
2. Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
3. Start to urinate into the toilet.
4. Move the collection container under your urine stream.
5. Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
6. Finish urinating into the toilet.
7. Return the sample container to your health care provider.
If bilirubin is found in your urine, it may indicate:
- A liver disease such as hepatitis
- A blockage in the structures that carry bile from your liver
- A problem with liver function
A bilirubin in urine test is only one measure of liver function. If your results are abnormal, your health care provider may order additional blood and urine tests, including a liver panel. A liver panel is a series of blood tests that measure various enzymes, proteins, and substances in the liver. It is often used to detect liver disease.
1. Bilirubin in Urine: MedlinePlus Lab Test Information [accessed on Aug 22, 2021]
2. https://medlineplus.gov/ency/article/003595.htm [accessed on Aug 22, 2021]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Ketones in Urine Test

Ketones in Urine Test

Also called: Urine Ketones, Ketone Bodies (Urine), Ketones Urine Test

Ketones in urine may indicate a problem with the body's ability to burn energy. Diabetics are at a higher risk for developing urine ketones. A ketones in urine test can prompt you to get treatment before a medical emergency occurs.

Ketones in Urine Test

Also called: Urine Ketones, Ketone Bodies (Urine), Ketones Urine Test

Ketones in urine may indicate a problem with the body's ability to burn energy. Diabetics are at a higher risk for developing urine ketones. A ketones in urine test can prompt you to get treatment before a medical emergency occurs.

{"label":"Ketones in Urine Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"normal","label":{"short":"N","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":20},"text":"A negative test result is normal.","conditions":[]},{"flag":"borderline","label":{"short":"S","long":"Small","orientation":"horizontal"},"values":{"min":20,"max":40},"text":"An abnormal result means you have ketones in your urine. The results are usually listed as small, moderate, or large.","conditions":["Fasting or starvation","High protein or low carbohydrate diet","Vomiting over a long period (such as during early pregnancy)","Acute or severe illnesses, such as sepsis or burns","High fevers","Hyperthyroidism","Nursing a baby, if the mother does not eat and drink enough"]},{"flag":"abnormal","label":{"short":"M","long":"Moderate","orientation":"horizontal"},"values":{"min":40,"max":60},"text":"An abnormal result means you have ketones in your urine. The results are usually listed as small, moderate, or large.","conditions":["Fasting or starvation","High protein or low carbohydrate diet","Vomiting over a long period (such as during early pregnancy)","Acute or severe illnesses, such as sepsis or burns","High fevers","Hyperthyroidism","Nursing a baby, if the mother does not eat and drink enough"]},{"flag":"abnormal","label":{"short":"L","long":"Large","orientation":"horizontal"},"values":{"min":60,"max":80},"text":"An abnormal result means you have ketones in your urine. The results are usually listed as small, moderate, or large.","conditions":["Fasting or starvation","High protein or low carbohydrate diet","Vomiting over a long period (such as during early pregnancy)","Acute or severe illnesses, such as sepsis or burns","High fevers","Hyperthyroidism","Nursing a baby, if the mother does not eat and drink enough"]}],"value":10}[{"normal":0},{"borderline":0},{"abnormal":0},{"abnormal":1}]
Use the slider below to see how your results affect your health.
Your result is Normal.
A negative test result is normal.
Related conditions
The test is often used to help monitor people at a higher risk of developing ketones. These include people with type 1 or type 2 diabetes. If you have diabetes, ketones in urine can mean that you are not getting enough insulin. If you don't have diabetes, you may still be at risk for developing ketones if you:
- Experience chronic vomiting and/or diarrhea
- Have a digestive disorder
- Participate in strenuous exercise
- Are on a very low-carbohydrate diet
- Have an eating disorder
- Are pregnant
Your health care provider may order a ketones in urine test if you have diabetes or other risk factors for developing ketones. You may also need this test if you have symptoms of ketoacidosis. These include:
- Nausea or vomiting
- Abdominal pain
- Confusion
- Trouble breathing
- Feeling extremely sleepy
People with type 1 diabetes are at a higher risk for ketoacidosis.
A ketones in urine test can be done in the home as well as in a lab. If in a lab, you will be given instructions to provide a "clean catch" sample. The clean catch method generally includes the following steps:
1. Wash your hands.
2. Clean your genital area with a cleansing pad. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
3. Start to urinate into the toilet.
4. Move the collection container under your urine stream.
5. Collect at least an ounce or two of urine into the container, which should have markings to indicate the amount.
6. Finish urinating into the toilet.
7. Return the sample container as instructed by your health care provider.
If you do the test at home, follow the instructions that are in your test kit. Your kit will include a package of strips for testing. You will either be instructed to provide a clean catch sample in a container as described above or to put the test strip directly in the stream of your urine. Talk to your health care provider about specific instructions.
1. Ketones in Urine: MedlinePlus Lab Test Information [accessed on Sep 15, 2019]
2. https://medlineplus.gov/ency/article/003585.htm [accessed on Sep 15, 2019]
3. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=ketone_bodies_urine [accessed on Sep 15, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (5)

DKA - Diabetic Ketoacidosis

Video by DrER.tv/YouTube

Symptoms of Ketoacidosis

Video by Diabetes.co.uk/YouTube

Diabetes & Associated Complications

Video by Boehringer Ingelheim/YouTube

Acute complications of diabetes - Diabetic ketoacidosis | NCLEX-RN | Khan Academy

Video by khanacademymedicine/YouTube

A medical illustration depicting a ketone urine test

A medical illustration depicting a ketone urine test

Image by BruceBlaus

5:46

DKA - Diabetic Ketoacidosis

DrER.tv/YouTube

1:00

Symptoms of Ketoacidosis

Diabetes.co.uk/YouTube

5:50

Diabetes & Associated Complications

Boehringer Ingelheim/YouTube

11:26

Acute complications of diabetes - Diabetic ketoacidosis | NCLEX-RN | Khan Academy

khanacademymedicine/YouTube

A medical illustration depicting a ketone urine test

BruceBlaus

Urine Specific Gravity Test

Urine Specific Gravity Test

Also called: Urine SG, Specific Gravity of Urine, Urine Density

A urine specific gravity test measures the concentration of solutes in your urine, which shows if your kidneys are properly diluting urine. This test is a partial analysis used in case of suspected kidney disorder.

Urine Specific Gravity Test

Also called: Urine SG, Specific Gravity of Urine, Urine Density

A urine specific gravity test measures the concentration of solutes in your urine, which shows if your kidneys are properly diluting urine. This test is a partial analysis used in case of suspected kidney disorder.

{"label":"Urine Specific Gravity Reference Range","scale":"lin","step":0.01,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0.8,"max":1.002},"text":"Your urine is too diluted.","conditions":["Diabetes","Kidney disorders","Glomerulonephritis","Pyelonephritis","Kidney failure","Overhydration"]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":1.002,"max":1.03},"text":"Normal results can slightly vary from laboratory to laboratory.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":1.03,"max":1.2},"text":"Your urine is too concentrated. ","conditions":["Liver disease","Adrenal glands disorder","Heart disease","Dehydration","Shock"]}],"value":1.02}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
1.002
1.03
Your result is Normal.
Normal results can slightly vary from laboratory to laboratory.
Related conditions
Your doctor may order a urine specific gravity test as part of your routine health checkup, or to help diagnose or monitor the following conditions:
- Urinary tract infection
- Dehydration or overhydration
- Kidney infection (pyelonephritis)
- Kidney failure
- Shifts in sodium levels (hypernatremia or hyponatremia)
- Diabetes
- Shock
- Heart failure
The normal value for urine specific gravity is 1.002-1.030.
Lower-than-normal values of urine gravity may indicate:
- Diabetes
- Kidney disorders (glomerulonephritis, pyelonephritis)
- Kidney failure
- Drinking too much fluid (overhydration)
Higher-than-normal urine gravity test results may refer to an increased level of some substances in your urine, such as proteins, bacteria, glucose, urine crystals, red and white blood cells. These findings may occur in cases of:
- Liver disease
- Adrenal glands disorder
- Heart disease
- Dehydration (not consuming enough water, or losing too much fluid through sweating, vomiting, or diarrhea)
- Shock
1. https://medlineplus.gov/ency/article/003587.htm [accessed on Oct 09, 2021]
2. Urine Specific Gravity Test: Overview, Tests, and Procedure [accessed on Oct 29, 2018]
3. Urine specific gravity test: Procedure and results [accessed on Oct 29, 2018]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (20)

Hematuria

Hematuria Trauma : Gross hematuria due to kidney trauma.

Image by James Heilman, MD

Hematuria by anatomic location

Source of Hematuria by anatomic location

Image by Copene

Phenazopyridine

Pyridiumurine : The characteristic color of urine after taking pyridium.

Image by James Heilman, MD

Drawing of a kidney with an inset of a nephron

The glomeruli are sets of looping blood vessels in nephrons--the tiny working units of the kidneys that filter wastes and remove extra fluid from the blood.

Image by NIDDK Image Library

Urine samples

Each day our kidneys filter about 200 quarts of blood to extract about 2 quarts of wastes, which are then eliminated as urine. Urine samples are evaluated visually, for color, clarity and concentration; chemically, for various substances, such as glucose and proteins, in solution; and microscopically, for signs of bacteria, crystals and other contaminants.

Image by TheVisualMD

Urine in Vial

Urine is tested for a variety of reasons and can reveal a wealth of information about the source individual. More than 100 different tests can be done on urine. In addition to visual characteristics, for example color and clarity, urine may be examined for the presence of glucose, nitrites, or ketones. Microscopic examination may reveal the presence of red or white blood cells, or bacteria, yeast cells, or parasites. Urine samples may contain tumor markers, which can suggest cancer.

Image by TheVisualMD

Ureteropelvic junction obstruction

Drawing of a swollen kidney that results from ureteropelvic junction obstruction. The point of blockage is labeled UPJ obstruction. UPJ obstruction occurs when urine is blocked where the ureter joins the kidney.

Image by NIDDK Image Library

Bilirubin, Jaundice Urine

When damaged or dying red blood cells are broken down, bilirubin, a yellow pigment and component of hemoglobin, is released into the bloodstream. Bilirubin is usually eliminated from the body by the liver as a component of bile, which is released into the small intestine to aid digestion. Under normal circumstances, very little, if any, bilirubin is excreted in the urine, but in cases of liver damage or a blockage of the bile ducts, some bilirubin can leak out and appear in the urine, turning it a darker color.

Image by TheVisualMD

Urine Color Chart

Urine Color Chart - Hydration

Image by OpenStax College

Healthy vs Damaged Kidney

A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. Urine Test for Albumin If you are at risk for kidney disease, your provider may check your urine for albumin. Albumin is a protein found in your blood. A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. The less albumin in your urine, the better. Having albumin in the urine is called albuminuria. A diagram showing a healthy kidney with albumin only found in blood, and a damaged kidney that has albumin in both blood and urine. A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. A health care provider can check for albumin in your urine in two ways: Dipstick test for albumin. A provider uses a urine sample to look for albumin in your urine. You collect the urine sample in a container in a health care provider’s office or lab. For the test, a provider places a strip of chemically treated paper, called a dipstick, into the urine. The dipstick changes color if albumin is present in the urine. Urine albumin-to-creatinine ratio (UACR). This test measures and compares the amount of albumin with the amount of creatinine in your urine sample. Providers use your UACR to estimate how much albumin would pass into your urine over 24 hours. A urine albumin result of 30 mg/g or less is normal more than 30 mg/g may be a sign of kidney disease If you have albumin in your urine, your provider may want you to repeat the urine test one or two more times to confirm the results. Talk with your provider about what your specific numbers mean for you. If you have kidney disease, measuring the albumin in your urine helps your provider know which treatment is best for you. A urine albumin level that stays the same or goes down may mean that treatments are working.

Image by The National Institute of Diabetes and Digestive and Kidney Diseases/NIH

Drawing of a urine sample and dipstick

A strip of chemically treated paper will change color when dipped in urine with too much protein.

Image by NIDDK Image Library

Struvite crystals (urine)

Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.

Image by Doruk Salancı

Uric acid crystals (urine)

Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.

Image by Doruk Salancı

Male Figure with Urinary System

Both the male and the female urinary tracts are made up of the kidneys, ureters, urethra, and bladder.The kidneys filter wastes and water from the blood to produce urine. From the kidneys, urine passes through tubes called ureters to the bladder, which stores urine until it is full. Urine exits the bladder through another tube, the urethra. The male and female urinary tracts are relatively the same except for the length of the urethra: the male urethra is about five times as long as the female urethra.

Image by TheVisualMD

Adequate water intake and kidney health

Adequate water intake and kidney health. Replacing the water lost through sweating and waste elimination is vital to our health. Remaining hydrated is one way to help prevent kidney stones, which can form when certain waste minerals are highly concentrated in the urine. In this 3-D visualization, a clear bottle pours water into a model of a human kidney.

Image by TheVisualMD

Urine

Sample of human urine

Image by Markhamilton

Urine Culture: Preventing UTIs

There are a number of ways you can help to prevent UTIs. Drinking plenty of liquids, especially water, not only aids your kidneys in filtering out wastes, it also dilutes your urine and makes you urinate more frequently. This flushes out bacteria and other pathogens from your urinary tract and helps to prevent infections. Urinating after having sex also helps to flush out bacteria. Women should wipe from front to back when using the toilet and change tampons and pads frequently during their periods.

Image by TheVisualMD

formation of urine

Anatomy and physiology of animals Summary of the processes involved in the formation of urine.

Image by Sunshineconnelly

male's urinary system

Urinary system in the male. Urine flows from the kidneys via the ureters into the bladder where it is stored. When urinating, urine flows through the urethra (longer in males, shorter in females) to exit the body

Image by BruceBlaus

Urine of patient with porphyria

Change in urine color before and after sun exposure Left figure is urine of the first day. Right figure is urine after sun exposure for 3 days. Urine color changed to “port wine” color after sun exposure. This color change is due to increased concentrations of porphyrin intermediates in the urine, indicating an abnormality in production and a partial block within the enzymatic porphyrin chain with metabolite formation. The urine color usually becomes darker with acute illness, even dark reddish or brown after sun exposure.

Image by Chen GL, Yang DH, Wu JY, Kuo CW, Hsu WH

Hematuria

James Heilman, MD

Hematuria by anatomic location

Copene

Phenazopyridine

James Heilman, MD

Drawing of a kidney with an inset of a nephron

NIDDK Image Library

Urine samples

TheVisualMD

Urine in Vial

TheVisualMD

Ureteropelvic junction obstruction

NIDDK Image Library

Bilirubin, Jaundice Urine

TheVisualMD

Urine Color Chart

OpenStax College

Healthy vs Damaged Kidney

The National Institute of Diabetes and Digestive and Kidney Diseases/NIH

Drawing of a urine sample and dipstick

NIDDK Image Library

Struvite crystals (urine)

Doruk Salancı

Uric acid crystals (urine)

Doruk Salancı

Male Figure with Urinary System

TheVisualMD

Adequate water intake and kidney health

TheVisualMD

Urine

Markhamilton

Urine Culture: Preventing UTIs

TheVisualMD

formation of urine

Sunshineconnelly

male's urinary system

BruceBlaus

Urine of patient with porphyria

Chen GL, Yang DH, Wu JY, Kuo CW, Hsu WH

Blood in Urine Test

Blood in Urine Test

Also called: Hematuria, Bloody urine

A blood in urine test is part of a urinalysis, a test that measures different cells, chemicals, and other substances in urine. Most causes of blood in your urine are not serious, but sometimes red or white blood cells in your urine can mean that you have a medical condition that needs treatment, such as a kidney disease, urinary tract infection,

Blood in Urine Test

Also called: Hematuria, Bloody urine

A blood in urine test is part of a urinalysis, a test that measures different cells, chemicals, and other substances in urine. Most causes of blood in your urine are not serious, but sometimes red or white blood cells in your urine can mean that you have a medical condition that needs treatment, such as a kidney disease, urinary tract infection,

{"label":"Blood in Urine Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"","conditions":[]}],"value":0.5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your health.
Your result is Negative.
Related conditions
Your health care provider may have ordered a urinalysis as part of a routine exam. You may also need this test if you have seen blood in your urine or have other symptoms of a urinary disorder. These symptoms include:
- Painful urination
- Frequent urination
- Back pain
- Abdominal pain
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." It includes the following steps:
1. Wash your hands.
2. Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
3. Start to urinate into the toilet.
4. Move the collection container under your urine stream.
5. Collect at least an ounce or two of urine into the container, which should have markings to indicate the needed amounts.
6. Finish urinating into the toilet.
7. Return the sample container as instructed by your health care provider.
There are a variety of factors that can cause red or white blood cells to be present in the urine. Many are not cause for concern. Small amounts of blood in the urine may be due to certain medicines, intense exercise, sexual activity, or menstruation. If larger amounts of blood are found, your health care provider may request further testing.
Increased red blood cells in urine may indicate:
- A viral infection
- Inflammation of the kidney or bladder
- A blood disorder
- Bladder or kidney cancer
Increased white blood cells in urine may indicate:
- A bacterial urinary tract infection. This is the most common cause of a high white blood cell count in urine.
- Inflammation of the urinary tract or kidneys
To learn what your results mean, talk to your health care provider.
1. Lab Tests Online: Blood in Urine (Hematuria) [accessed on Aug 19, 2018]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (12)

Urine Color Chart

Urine Color Chart - Hydration

Image by OpenStax College

Hematuria (Blood in the Urine)

Video by mdconversation/YouTube

Blood in the Urine: What does it mean?

Video by Frederick Memorial Hospital/YouTube

Blood in the Urine

Video by St. Mark's Hospital/YouTube

Hematuria

Microscopic hematuria

Image by Bobjgalindo

Hematuria

Hematuria Trauma : Gross hematuria due to kidney trauma.

Image by James Heilman, MD

Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.

Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.

Image by Bobjgalindo

Hematuria by anatomic location

Source of Hematuria by anatomic location

Image by Copene

Microphotography - sample of urine with hematuria

Microphotography - sample of urine with hematuria

Image by J3D3

This browser does not support the video element.

Bleeding Tissue

Blood continues to flow into tissue after the piercing needle has left the finger. Camera starts off looking at the cut edges of bleeding capillaries in the tissue and then looks down at the cavity where blood is beginning to pool.

Video by TheVisualMD

Microhematuria

Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.

Image by Bobjgalindo

Phenazopyridine

Pyridiumurine : The characteristic color of urine after taking pyridium.

Image by James Heilman, MD

Urine Color Chart

OpenStax College

12:53

Hematuria (Blood in the Urine)

mdconversation/YouTube

0:50

Blood in the Urine: What does it mean?

Frederick Memorial Hospital/YouTube

2:24

Blood in the Urine

St. Mark's Hospital/YouTube

Hematuria

Bobjgalindo

Hematuria

James Heilman, MD

Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.

Bobjgalindo

Hematuria by anatomic location

Copene

Microphotography - sample of urine with hematuria

J3D3

0:08

Bleeding Tissue

TheVisualMD

Microhematuria

Bobjgalindo

Phenazopyridine

James Heilman, MD

PH of Urine Test

PH of Urine Test

Also called: Acid Loading Test, Urine pH, Alkaline Urine Test, Acidic Urine Test

A urine pH test is used to detect a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. Any pH higher than 8 is basic or alkaline, and any under 6 is acidic. A urine pH test is carried out as a part of a urinalysis.

PH of Urine Test

Also called: Acid Loading Test, Urine pH, Alkaline Urine Test, Acidic Urine Test

A urine pH test is used to detect a wide range of conditions such as urinary tract infections, kidney disease, and diabetes. Any pH higher than 8 is basic or alkaline, and any under 6 is acidic. A urine pH test is carried out as a part of a urinalysis.

{"label":"Urine pH reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":1,"max":4.5},"text":"This means that your urine is acidic. This can be seen in people who eat large quantities of meat, and it's also related to other health issues. ","conditions":["Metabolic acidosis","Respiratory acidosis","Xanthine kidney stones","Cystine kidney stones","Uric acid kidney stones","Diabetes","Diarrhea","Starvation","Fanconi syndrome","Milkman syndrome"]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":4.5,"max":8},"text":"A normal urine pH range is between 4.5 and 8.0.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":8,"max":14},"text":"This means that your urine is alkaline. This can be seen in people who eat large quantities of citrus fruit and vegetables, and it's also related to other health issues. ","conditions":["Kidney failure","Urinary tract infection","Calcium carbonate kidney stones","Calcium phosphate kidney stones","Struvite kidney stones","Respiratory alkalosis","Metabolic alkalosis"]}],"units":[{"printSymbol":"pH","code":"[pH]","name":"pH"}],"value":6.3,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
pH
4.5
8
Your result is Normal.
A normal urine pH range is between 4.5 and 8.0.
Related conditions
Some of the most common uses of the urine pH test are:
- Evaluate the risk of developing kidney stones (nephrolithiasis)
- Assessment of metabolic acidosis
- Monitor treatment of uric acid kidney stones
- Help identify crystals in the urine
Under normal conditions, the urine is acidic with pH levels that range from 4.5 to 8.0
A high urine pH (alkaline urine) can be found in people who eat large quantities of citrus fruit and vegetables. Other causes include:
- Kidney failure
- Urinary tract infection
- Kidney stones made up from calcium carbonate, calcium phosphate, and struvite (magnesium ammonium phosphate)
- Respiratory alkalosis
- Metabolic alkalosis
A low urine pH (acid urine) can be found in people who eat large quantities of meat. Other causes include:
- Metabolic acidosis
- Respiratory acidosis
- Kidney stones made up from xanthine, cystine, and uric acid
- Diabetes
- Diarrhea
- Starvation
- Fanconi syndrome
- Milkman syndrome
1. 013037: pH, Urine | LabCorp [accessed on Jan 04, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Protein in Urine Test

Protein in Urine Test

Also called: Urine Protein

A protein in urine test measures how much protein is in your urine. A large amount of protein can indicate a problem with your kidneys.

Protein in Urine Test

Also called: Urine Protein

A protein in urine test measures how much protein is in your urine. A large amount of protein can indicate a problem with your kidneys.

{"label":"Protein in Urine Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"Normal results vary based on the laboratory and the method used.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"If a large amount of protein is found in your urine sample, it doesn't necessarily mean that you have a medical problem needing treatment. Strenuous exercise, diet, stress, pregnancy, and other factors can cause a temporary rise in urine protein levels.<br \/>\n<br \/>\nIf your urine protein levels are consistently high, it may indicate kidney damage or other medical condition.","conditions":["Urinary tract infection","Lupus","High blood pressure","Preeclampsia","Diabetes","Certain types of cancer"]}],"value":0.5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your health.
Your result is Negative.
Normal results vary based on the laboratory and the method used.
Related conditions
Your health care provider may have ordered a protein test as part of your regular checkup, or if you have symptoms of kidney disease. These symptoms include:
- Difficulty urinating
- Frequent urination, especially at night
- Nausea and vomiting
- Loss of appetite
- Swelling in the hands and feet
- Fatigue
- Itching
A protein in urine test can be done in the home as well as in a lab. If in a lab, you will receive instructions to provide a "clean catch" sample. The clean catch method includes the following steps:
1. Wash your hands.
2. Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
3. Start to urinate into the toilet.
4. Move the collection container under your urine stream.
5. Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
6. Finish urinating into the toilet.
7. Return the sample container as instructed by your health care provider.
If at home, you will use a test kit. The kit will include a package of strips for testing and instructions on how to provide a clean catch sample. Talk to your health care provider if you have any questions.
Your health care provider may also request you collect all your urine during a 24-hour period. This "24-hour urine sample test" is used because the amounts of substances in urine, including protein, can vary throughout the day. Collecting several samples in a day may provide a more accurate picture of your urine content.
If a large amount of protein is found in your urine sample, it doesn't necessarily mean that you have a medical problem needing treatment. Strenuous exercise, diet, stress, pregnancy, and other factors can cause a temporary rise in urine protein levels. Your health care provider may recommend additional urinalysis tests if a high level of protein is found. This testing may include a 24-hour urine sample test.
If your urine protein levels are consistently high, it may indicate kidney damage or other medical condition. These include:
- Urinary tract infection
- Lupus
- High blood pressure
- Preeclampsia, a serious complication of pregnancy, marked by high blood pressure. If it is not treated, preeclampsia can be life-threatening to the mother and baby.
- Diabetes
- Certain types of cancer
To learn what your results mean, talk to your health care provider.

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (2)

Urine Color Chart

Urine Color Chart - Hydration

Image by OpenStax College

When kidneys are diseased or damaged, their ability to filter out proteins is compromised, which allows protein to then leak into urine.

Urine Total Protein Test for Diseased Glomerulus : The kidneys' delicate filtration units are called nephrons; each kidney has about a million nephrons, and within each nephron are dense forests of tiny capillaries called glomeruli, which remove waste products from the blood while preventing the loss of other components, including proteins, which are recycled in the body. When kidneys are diseased or damaged, however, their ability to filter out proteins is compromised, which allows protein to then leak into urine.

Image by TheVisualMD

Urine Color Chart

OpenStax College

When kidneys are diseased or damaged, their ability to filter out proteins is compromised, which allows protein to then leak into urine.

TheVisualMD

Urobilinogen Test

Urobilinogen Test

Also called: Urinary Urobilinogen

A urobilinogen in urine test looks for liver disease or damage. It may be included in a routine exam or if a liver problem is suspected.

Urobilinogen Test

Also called: Urinary Urobilinogen

A urobilinogen in urine test looks for liver disease or damage. It may be included in a routine exam or if a liver problem is suspected.

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Use the slider below to see how your results affect your health.
Your result is Normal.
Normal results vary based on the laboratory and the method used.
Related conditions
Your health care provider may have ordered this test as part of your regular checkup, to monitor an existing liver condition, or if you have symptoms of a liver disease. These include:
- Jaundice, a condition that causes your skin and eyes to turn yellow
- Nausea and/or vomiting
- Dark colored urine
- Pain and swelling in the abdomen
- Itchy skin
Your health care provider will need to collect a sample of your urine. He or she will provide you with special instructions to ensure the sample is sterile. These instructions are often called as the "clean catch method." The clean catch method includes the following steps:
1. Wash your hands.
2. Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
3. Start to urinate into the toilet.
4. Move the collection container under your urine stream.
5. Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
6. Finish urinating into the toilet.
7. Return the sample container as instructed by your health care provider.
If your test results show too little or no urobilinogen in your urine, it may indicate:
- A blockage in the structures that carry bile from your liver
- A blockage in the blood flow of the liver
- A problem with liver function
If your test results show a higher-than-normal level of urobilinogen, it may indicate:
- Hepatitis
- Cirrhosis
- Liver damage due to drugs
- Hemolytic anemia, a condition in which red blood cells are destroyed before they can be replaced. This leaves the body without enough healthy red blood cells
If your results are abnormal, it does not necessarily indicate you have a medical condition requiring treatment. Be sure to tell your health care provider about any medicines and supplements you are taking, as these can affect your results. If you are a woman, you should tell your health care provider if you are menstruating.

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (4)

Bilirubin Metabolism

Video by Armando Hasudungan/YouTube

Urinalysis

Kidneys and Related Conditions : The value of routine urinalysis is that abnormal levels of substances such as protein or glucose, for example, will often appear in the urine before patients are aware they may have a problem. It is also used to detect disorders of the urinary tract, most commonly infections. Abnormal urine screens are typically followed up by more specific diagnostic tests.

Image by TheVisualMD

Alkaline Phosphatase, Liver

The liver is the body's central chemical plant, filtering blood and removing toxins, storing sugars, lipids, and vitamins, and producing important blood proteins. Liver function is typically evaluated by a panel of tests, including one for alkaline phosphatase (ALP), an enzyme made in liver cells, that help doctors distinguish among the many different possible causes of liver damage. Many types of liver damage, including hepatitis, cirrhosis, liver cancer or drug toxicity, can elevate ALP levels.

Image by TheVisualMD

Liver and Gallbladder with Associated Vessel

The liver is the body's central chemical plant, filtering blood and removing toxins, storing sugars, lipids, and vitamins, and producing important blood proteins such as albumin as well as those involved in blood clotting. The liver also produces most of body's cholesterol (the rest comes from food) as well as a quart of bile each day, a greenish-brown, alkaline fluid that aids digestion. The gallbladder stores bile for release into the small intestine; bile contains cholesterol, bile salts, and bilirubin, a yellowish pigment produced by the breakdown of red blood cells.

Image by TheVisualMD

8:44

Bilirubin Metabolism

Armando Hasudungan/YouTube

Urinalysis

TheVisualMD

Alkaline Phosphatase, Liver

TheVisualMD

Liver and Gallbladder with Associated Vessel

TheVisualMD

Nitrites in Urine Test

Nitrites in Urine Test

Also called: Urine Nitrite

A nitrites in urine test is part of a urinalysis, a test that measures different substances in urine. If nitrites are present, it may indicate an infection.

Nitrites in Urine Test

Also called: Urine Nitrite

A nitrites in urine test is part of a urinalysis, a test that measures different substances in urine. If nitrites are present, it may indicate an infection.

{"label":"Nitrites in Urine Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"Even if no nitrites are found, you still may have an infection, because bacteria don't always change nitrates into nitrites.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"If there are nitrites in your urine, it may mean that you have a urinary tract infection.","conditions":["UTI"]}],"value":0.5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your health.
Your result is Negative.
Even if no nitrites are found, you still may have an infection, because bacteria don't always change nitrates into nitrites.
Related conditions
Your health care provider may have ordered a urinalysis as part of a routine checkup or if you have symptoms of a UTI. Symptoms of a UTI may include:
- Frequent urge to urinate, but little urine comes out
- Painful urination
- Dark, cloudy, or reddish colored urine
- Bad smelling urine
- Weakness and fatigue, particularly in older women and men
- Fever
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." The clean catch method includes the following steps:
1. Wash your hands.
2. Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
3. Start to urinate into the toilet.
4. Move the collection container under your urine stream.
5. Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
6. Finish urinating into the toilet.
7. Return the sample container as instructed by your health care provider

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (2)

Urine Color Chart

Urine Color Chart - Hydration

Image by OpenStax College

Lower urinary tract infection (cystitis) - an Osmosis preview

Video by Osmosis/YouTube

Urine Color Chart

OpenStax College

0:45

Lower urinary tract infection (cystitis) - an Osmosis preview

Osmosis/YouTube

Red Blood Cells in Urine Test

Red Blood Cells in Urine Test

Also called: RBC urine

Red blood cells (RBCs), also known as erythrocytes, may also be found in a urinalysis, or a urine test. High levels of RBCs in your urine indicates that you have hematuria.

Red Blood Cells in Urine Test

Also called: RBC urine

Red blood cells (RBCs), also known as erythrocytes, may also be found in a urinalysis, or a urine test. High levels of RBCs in your urine indicates that you have hematuria.

{"label":"Red Blood Cells in Urine Reference Range","scale":"lin","step":0.1,"hideunits":false,"units":[{"printSymbol":"{cells}\/uL","code":"{cells}\/uL","name":"cells per microliter"}],"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":5},"text":"This indicates that only small traces of blood was found in your urine. It is considered normal and does not require further investigation.","conditions":[]},{"flag":"abnormal","label":{"short":"One cross (+)","long":"One cross (+)","orientation":"horizontal"},"values":{"min":5,"max":25},"text":"This indicates that small but significant traces of blood was found in your urine. Repeat test may be necessary and should be looked at in clinical setting.","conditions":["Persistent microscopic haematuria","Glomerular disorders","Glomerulonephritis","Systemic lupus erythematosus","Renal disorders","Polycystic kidney disease","Benign prostatic hyperplasia","Cancer","Cystitis","Pyelonephritis","Nephrolithiasis","Prostatitis","Intake or certain drugs","Trauma"]},{"flag":"abnormal","label":{"short":"Two crosses (++)","long":"Two crosses (++)","orientation":"horizontal"},"values":{"min":25,"max":100},"text":"This indicates that significant traces of blood was found in your urine. Further testing is necessary.","conditions":["Glomerular disorders","Glomerulonephritis","Systemic lupus erythematosus","Renal disorders","Polycystic kidney disease","Benign prostatic hyperplasia","Cancer","Cystitis","Pyelonephritis","Nephrolithiasis","Prostatitis","Intake or certain drugs","Trauma"]}],"value":2.5}[{"normal":0},{"abnormal":0},{"abnormal":1}]
Use the slider below to see how your results affect your health.
{cells}/uL
5
25
Your result is Normal.
This indicates that only small traces of blood was found in your urine. It is considered normal and does not require further investigation.
Related conditions
This test is not usually ordered alone but rather as part of a urinalysis. It can be helpful in the following cases:
- Overall check up
- To monitor pregnant women
- If you have signs and symptoms of urinary tract infection (pelvic pain, dark urine, painful urination, blood in urine, frequent urination)
- To monitor a medical condition, such as diabetes or kidney disease
You will need to give a clean catch urine sample.
This requires following these simple steps;
1. Clean your genitals
2. Start to urinate in the toilet
3. Stop halfway through
4. Collect about two ounces of midstream urine in the container
5. Stop again and close the container
6. Last, finish peeing in the toilet
You also need to be careful not to touch your genitals with the container to avoid possible contamination with external microorganisms.
Is not unusual to find RBCs in a urine sample; however, 3 or more red blood cells per high-powered field are regarded as a sign of hematuria (blood loss through urine).; further information should be gathered to make a diagnose.
Presence of RBC’s in urine may be due to:
- Glomerular disorders
- Glomerulonephritis
- Systemic lupus erythematosus
- Renal disorders
- Polycystic kidney disease
- Benign prostatic hyperplasia
- Cancer
- Cystitis
- Pyelonephritis
- Nephrolithiasis
- Prostatitis
- Intake or certain drugs
- Trauma
1. Urinalysis: Reference Range, Interpretation, Collection and Panels [accessed on Jan 10, 2019]
2. Urinalysis [accessed on Jan 10, 2019]
3. Urinalysis: A Comprehensive Review - - American Family Physician [accessed on Jan 10, 2019]
4. https://www.cambridgeshireandpeterboroughccg.nhs.uk/EasySiteWeb/GatewayLink.aspx?alId=7479 [accessed on Jan 10, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (5)

Hematuria

Hematuria Trauma : Gross hematuria due to kidney trauma.

Image by James Heilman, MD

Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.

Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.

Image by Bobjgalindo

Hematuria by anatomic location

Source of Hematuria by anatomic location

Image by Copene

Microhematuria

Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.

Image by Bobjgalindo

Phenazopyridine

Pyridiumurine : The characteristic color of urine after taking pyridium.

Image by James Heilman, MD

Hematuria

James Heilman, MD

Microscopic hematuria: Red blood cells in a urine sample seen under the microscope.

Bobjgalindo

Hematuria by anatomic location

Copene

Microhematuria

Bobjgalindo

Phenazopyridine

James Heilman, MD

White Blood Cells, Urine Test

White Blood Cells, Urine Test

Also called: Leukocytes in Urine

White blood cells (WBCs), also known as leukocytes, may also be found in a urinalysis, or a urine test. High levels of WBCs in your urine suggest that you have a urinary tract infection (UTI).

White Blood Cells, Urine Test

Also called: Leukocytes in Urine

White blood cells (WBCs), also known as leukocytes, may also be found in a urinalysis, or a urine test. High levels of WBCs in your urine suggest that you have a urinary tract infection (UTI).

{"label":"White Blood Cells, Urine Reference Range","scale":"lin","step":0.1,"hideunits":false,"units":[{"printSymbol":"{cells}\/uL","code":"{cells}\/uL","name":"cells per microliter"}],"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":10},"text":"Normal reference ranges can slightly vary depending on the laboratory and the method used for testing.","conditions":[]},{"flag":"borderline","label":{"short":"Borderline","long":"Borderline","orientation":"horizontal"},"values":{"min":10,"max":100},"text":"This is usually not significant but still requires further clinical assessment. Discuss your result with your doctor. ","conditions":["Urinary tract infection","Vaginal infection"]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":100,"max":200},"text":"A high number of WBCs may indicate a urinary tract infection or inflammation, especially if bacteria is also present.","conditions":["Urinary tract infection","Urinary tract inflammation","Pyelonephritis","Glomerulonephritis","Interstitial nephritis","Renal inflammatory processes"]}],"value":5}[{"normal":0},{"borderline":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
{cells}/uL
10
100
Your result is Normal.
Normal reference ranges can slightly vary depending on the laboratory and the method used for testing.
Related conditions
This test is not ordered alone but rather as part of a urinalysis. It can be helpful in the following cases:
- Overall check up
- To monitor pregnant women
- If you have signs and symptoms of urinary tract infection (pelvic pain, dark urine, painful urination, blood in urine, frequent urination)
You will need to give a clean catch urine sample.
This requires following these simple steps;
1. Clean your genitals
2. Start to urinate in the toilet
3. Stop halfway through
4. Collect about two ounces of midstream urine in the container
5. Stop again and close the container
6. Last, finish peeing in the toilet
You also need to be careful not to touch your genitals with the container to avoid possible contamination with external microorganisms.
The normal range for WBCs in urine is:
- <10 WBC/µl: not significant
- 10-100 WBC/µl: usually not significant but still requires further clinical assessment
- >100 WBC/µl: suggestive of infection
It is also considered normal to have less than 5 WBCs/hpf. A high number of WBCs may indicate a urinary tract infection or inflammation, especially if bacteria is also present.
1. Urinalysis: Reference Range, Interpretation, Collection and Panels [accessed on Jan 10, 2019]
2. Urinalysis [accessed on Jan 10, 2019]
3. Urinalysis: A Comprehensive Review - - American Family Physician [accessed on Jan 10, 2019]
4. https://www.cambridgeshireandpeterboroughccg.nhs.uk/EasySiteWeb/GatewayLink.aspx?alId=7479 [accessed on Jan 10, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (1)

Pyuria

Pyuria : White blood cells seen under a microscope from a urine sample.

Image by Bobjgalindo

Pyuria

Bobjgalindo

Epithelial Cells in Urine Test

Epithelial Cells in Urine Test

The test measures the amount of epithelial cells in urine. A large amount may indicate an infection, kidney disease, or other serious medical condition. This test is part of a urinalysis, a test that measures different substances in your urine.

Epithelial Cells in Urine Test

The test measures the amount of epithelial cells in urine. A large amount may indicate an infection, kidney disease, or other serious medical condition. This test is part of a urinalysis, a test that measures different substances in your urine.

{"label":"Epithelial Cells in Urine Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"normal","label":{"short":"Few","long":"Few","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"\"Few\" cells are generally considered in the normal range.","conditions":[]},{"flag":"borderline","label":{"short":"Moderate","long":"Moderate","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"\"Moderate\" cells may indicate a medical condition, however it doesn't necessarily mean that you have a medical condition that requires treatment.","conditions":["Urinary tract infection","Yeast infection","Kidney disease","Liver disease","Certain types of\u00a0cancer"]},{"flag":"abnormal","label":{"short":"Many","long":"Many","orientation":"horizontal"},"values":{"min":2,"max":3},"text":"\"Many\" cells may indicate a medical condition, however it doesn't necessarily mean that you have a medical condition that requires treatment.","conditions":["Urinary tract infection","Yeast infection","Kidney disease","Liver disease","Certain types of\u00a0cancer"]}],"value":0.5}[{"normal":0},{"borderline":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
Your result is Few.
"Few" cells are generally considered in the normal range.
Related conditions
Your health care provider may have ordered an epithelial cells in urine test as part of your regular checkup or if your visual or chemical urine tests showed abnormal results. You may also need this test if you have symptoms of a urinary or kidney disorder. These symptoms may include:
- Frequent and/or painful urination
- Abdominal pain
- Back pain
Your health care provider will need to collect a sample of your urine. During your office visit, you will receive a container to collect the urine and special instructions to make sure that the sample is sterile. These instructions are often called the "clean catch method." The clean catch method includes the following steps:
1. Wash your hands.
2. Clean your genital area with a cleansing pad given to you by your provider. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
3. Start to urinate into the toilet.
4. Move the collection container under your urine stream.
5. Collect at least an ounce or two of urine into the container. The container will have markings to indicate the amounts.
6. Finish urinating into the toilet.
7. Return the sample container as instructed by your health care provider.
Results are often reported as an approximate amount, such as "few," moderate," or "many" cells. "Few" cells are generally considered in the normal range. "Moderate" or "many" cells may indicate a medical condition such as:
- Urinary tract infection
- Yeast infection
- Kidney disease
- Liver disease
- Certain types of cancer
If your results are not in the normal range, it doesn't necessarily mean that you have a medical condition that requires treatment. You may need more tests before you can get a diagnosis. To learn what your results mean, talk to your health care provider.

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (5)

Uric acid crystals (urine)

Abundant uric acid crystals in a human urine sample with a pH of 5, as detected by an automated urinalysis system. Along with them, some amorphous urate crystals that are either clumped or dispersed can be observed.

Image by Doruk Salancı

Struvite crystals (urine)

Struvite (magnesium ammonium phosphate / triple phosphate) crystals in a human urine sample with a pH of 9, as detected by an automated urinalysis system. Along with them; abundant amorphous phosphate crystals, several squamous and non-squamous epithelial cells and a few leukocytes can be observed.

Image by Doruk Salancı

Urine Test

Image by frolicsomepl/Pixabay

Urine

Sample of human urine

Image by Markhamilton

Cancer screening

Screening for Cancer: Urine Tests : Urine samples may contain tumor markers, which can suggest cancer. Urinalysis is commonly a part of routine health screening. It is simply an analysis of the urine that can be performed in many healthcare settings including doctors' offices, urgent care facilities, laboratories, and hospitals. Urinalysis can disclose evidence of diseases, even some that have not caused significant signs or symptoms.

Image by TheVisualMD

Uric acid crystals (urine)

Doruk Salancı

Struvite crystals (urine)

Doruk Salancı

Urine Test

frolicsomepl/Pixabay

Urine

Markhamilton

Cancer screening

TheVisualMD

Urinary Casts Test

Urinary Casts Test

Also called: Urine Casts

Urinary casts are tiny structures that can be seen in a urine test (urinalysis) when certain kidney diseases or conditions are present.

Urinary Casts Test

Also called: Urine Casts

Urinary casts are tiny structures that can be seen in a urine test (urinalysis) when certain kidney diseases or conditions are present.

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Use the slider below to see how your results affect your health.
Your result is Negative.
Related conditions
- Hyaline casts: the presence of a few of these casts is usually normal and can occur in physiologic states (e.g., after exercise).
- Fatty casts: these casts can be found in people who have lipids (fat) in the urine and are usually related to a kidney disease complication, such as nephrotic syndrome, glomerulonephritis, or other forms of chronic renal diseases.
- Granular casts: these casts might be found after exercise, but also when certain kidney diseases are present.
- Red blood cell casts: these casts are related to a very small amount of bleeding from the kidney. Red blood cell casts are seen in many kidney diseases.
- Epithelial cell casts: the apparition of these casts implies damage to cells in the kidneys. These casts are seen in conditions such as heavy metal poisoning, and kidney transplant rejection, among others.
- Waxy casts: these casts can be found in people with long-term (chronic) kidney disease and chronic kidney failure.
- White blood cell (WBC) casts: these casts can be found when acute kidney infections are present.

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Treatment

Antibiotics

Image by Memed_Nurrohmad

Antibiotics

Image by Memed_Nurrohmad

How Do Doctors Treat Vesicoureteral Reflux?

Doctors treat VUR based on the child’s age, symptoms, and type and grade of VUR.

Primary vesicoureteral reflux

Primary VUR will often get better and will go away as a child gets older.

Until VUR goes away on its own, doctors treat any UTIs that develop with antibiotics, a type of medicine that fights bacteria. Treating UTIs quickly and preventing UTIs from developing will make it less likely your child will have a kidney infection.

Your child’s doctor also may consider the use of a long-term, low-dose antibiotic to prevent UTIs. Researchers have found that daily use of a low-dose antibiotic may help many children with VUR. Talk with your child’s doctor about using antibiotics. The bacteria that cause these infections can become harder to fight when antibiotics are used long term.

Sometimes doctors will consider surgery for a child who has VUR with repeat UTIs, particularly if the child has renal scarring or severe reflux that is not improving. Doctors can use surgery to correct your child’s reflux and prevent urine from flowing back to the kidney.

In certain cases, treatment may include the use of bulking injections. Doctors inject a small amount of gel-like liquid into the bladder wall near the opening of the ureter. The gel makes a bulge in the bladder wall, which acts like a valve to the ureter if a child’s valve doesn’t work properly. The doctor provides the treatment using general anesthesia and a child can usually go home the same day.

Secondary vesicoureteral reflux

Doctors treat secondary VUR after finding the exact cause of the condition. Treatment may include

surgery to remove a blockage
antibiotics to prevent or treat UTIs
surgery to correct an abnormal bladder or ureter
intermittent urinary catheterization—draining the bladder by inserting a catheter through the urethra to the bladder. You can do this at home if your child’s bladder does not empty properly.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Additional Materials (1)

What is a urinary reflux and how is it managed?

Video by Top Doctors UK/YouTube

3:19

What is a urinary reflux and how is it managed?

Top Doctors UK/YouTube

Prevention

Glass of Water, Water Glass, Water

Image by moritz320/Pixabay

Glass of Water, Water Glass, Water

Image by moritz320/Pixabay

Can I Prevent Vesicoureteral Reflux?

You can’t prevent VUR, but good habits may help keep your child’s urinary tract as healthy as possible. To prevent some bladder infections and bladder control problems, have your child

drink enough liquids based on the doctor’s advice.
follow good bathroom habits, such as urinating regularly and wiping front to back.
changed as soon as possible after his or her diaper becomes dirty, if he or she is not potty trained.
get treated for constipation if necessary. Try to prevent your child’s constipation if possible.
treated for related health problems such as urinary incontinence or fecal incontinence.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Additional Materials (1)

Don’t Freak Out About Vesicoureteral Reflux | Connecticut Children's

Video by Connecticut Children's/YouTube

2:08

Don’t Freak Out About Vesicoureteral Reflux | Connecticut Children's

Connecticut Children's/YouTube

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Vesicoureteral Reflux

Vesicoureteral reflux (VUR) is a condition in which urine flows backward from the bladder to one or both ureters and sometimes to the kidneys. VUR is most common in infants and young children.

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