Hereditary Syndromes Associated With Kidney Cancer
Kidney cancer is a disease in which malignant cancer cells form in tubules of the kidney. Having certain hereditary syndromes, such as Von Hippel-Lindau disease or Birt-Hogg-Dubé syndrome, can increase the risk of kidney cancer. Learn more about hereditary kidney cancer syndromes and how hereditary and non-inherited kidney cancers differ.
Kidney Cross Section With DNA Helix
Image by StoryMD
What Is Kidney Cancer?
Kidney Cancer
Image by BruceBlaus
Kidney Cancer
Kidney Cancer
Image by BruceBlaus
What Is Kidney Cancer?
Key Points
Kidney cancer is a disease in which malignant (cancer) cells form in tubules of the kidney.
Kidney cancer is a disease in which malignant (cancer) cells form in tubules of the kidney.
Kidney cancer (also called renal cell cancer) is a disease in which malignant (cancer) cells are found in the lining of tubules (very small tubes) in the kidney. There are 2 kidneys, one on each side of the backbone, above the waist. Tiny tubules in the kidneys filter and clean the blood. They take out waste products and make urine. The urine passes from each kidney through a long tube called a ureter into the bladder. The bladder holds the urine until it passes through the urethra and leaves the body.
Anatomy of the male urinary system (left panel) and female urinary system (right panel) showing the kidneys, ureters, bladder, and urethra. Urine is made in the renal tubules and collects in the renal pelvis of each kidney. The urine flows from the kidneys through the ureters to the bladder. The urine is stored in the bladder until it leaves the body through the urethra.
Cancer that starts in the ureters or the renal pelvis (the part of the kidney that collects urine and drains it to the ureters) is different from renal cell cancer and is not associated with the hereditary syndromes described in this summary. Cancer of the renal pelvis may be associated with another hereditary condition called Lynch syndrome.
Source: PDQ® Cancer Genetics Editorial Board. PDQ Hereditary Kidney Cancer Syndromes. Bethesda, MD: National Cancer Institute.
What Is Hereditary Cancer?
We’re Not Kidneyin Around: Renal Cancer Runs in Families and Makes up Between 5–8% Of Total Cases.
Image by StoryMD
We’re Not Kidneyin Around: Renal Cancer Runs in Families and Makes up Between 5–8% Of Total Cases.
We inherit all sorts of genes from mom and dad, and sometimes undesirables hitch along for the ride. Kidney cancer can run in the family, so it’s important to be aware of the signs and symptoms.
Image by StoryMD
What Is Hereditary Kidney Cancer?
Key Points
Having certain hereditary syndromes can increase the risk of kidney cancer.
Hereditary and non-inherited kidney cancers differ in several ways.
Having certain hereditary syndromes can increase the risk of kidney cancer.
Most of the time, kidney cancer is not passed down from parent to child. Kidney cancer that affects multiple generations of a family is called hereditary kidney cancer. Hereditary kidney cancer is rare and accounts for only 5% to 8% of all kidney cancers. It is usually linked to a hereditary syndrome. A hereditary syndrome is a set of signs and symptoms or conditions that occur together and is caused by certain changes in the genes that can be passed down from a parent to a child. Hereditary syndromes are sometimes called genetic syndromes or family cancer syndromes. People with the hereditary syndromes described in this summary have an increased risk of getting kidney cancer.
The four hereditary syndromes described in this summary are:
von Hippel-Lindau disease (VHL).
Hereditary leiomyomatosis and renal cell cancer (HLRCC).
Birt-Hogg-Dubé syndrome (BHD).
Hereditary papillary renal cancer (HPRC).
Hereditary and non-inherited kidney cancers differ in several ways.
Hereditary kidney cancer is often diagnosed at an earlier age than sporadic kidney cancer.
Some types of hereditary kidney cancer can be more or less aggressive than sporadic kidney cancer.
The treatments for hereditary kidney cancer may differ from treatments for sporadic kidney cancer.
People with hereditary kidney cancer may have a higher risk of other conditions or types of cancer.
Source: PDQ® Cancer Genetics Editorial Board. PDQ Hereditary Kidney Cancer Syndromes. Bethesda, MD: National Cancer Institute.
Additional Materials (4)
Should I get genetic testing for kidney cancer?
Video by Kidney Cancer Association/YouTube
Renal Cell Carcinoma: Everything You Need To Know
Video by Medical Centric/YouTube
Understanding Kidney Cancer Risk Factors
Video by Roswell Park Comprehensive Cancer Center/YouTube
Mayo Clinic Explains Kidney Cancer
Video by Mayo Clinic/YouTube
3:46
Should I get genetic testing for kidney cancer?
Kidney Cancer Association/YouTube
4:48
Renal Cell Carcinoma: Everything You Need To Know
Medical Centric/YouTube
0:47
Understanding Kidney Cancer Risk Factors
Roswell Park Comprehensive Cancer Center/YouTube
5:44
Mayo Clinic Explains Kidney Cancer
Mayo Clinic/YouTube
Who Should Get Genetic Gesting?
BRCA1 and BRCA2 are genes that produce proteins that help repair damaged DNA.
Image by TheVisualMD
BRCA1 and BRCA2 are genes that produce proteins that help repair damaged DNA.
The breast cancer susceptibility genes BRCA-1 and BRCA-2 normally help prevent cancer by repairing damaged DNA. Certain inherited mutations in these genes, however, can impair this function and result in a greatly increased risk of breast cancer or ovarian cancer (there are hundreds of different BRCA mutations, but are very rare or not linked with an increased risk of cancer). Of 200,000 women diagnosed each year with breast cancer and 20,000 diagnosed with ovarian cancer, 5-10% are due to BRCA mutations.
Image by TheVisualMD
Who Should Consider Genetic Testing for Cancer Risk?
People who are concerned about whether their family history puts them at risk for cancer should consult with a genetic counselor.
The features of a person’s personal or family medical history that, particularly in combination, may suggest a hereditary cancer syndrome include:
Cancer was diagnosed at an unusually young age
Several different types of cancer occurred in the same person
Cancer in both organs in a set of paired organs, such as both kidneys or both breasts
Several first-degree relatives (the parents, siblings, or children of an individual) have the same type of cancer (for example, a mother, daughter, and sisters with breast cancer); family members with breast or ovarian cancer; family members with colon cancer and endometrial cancer
Unusual cases of a specific cancer type (for example, breast cancer in a man)
The presence of birth defects that are known to be associated with inherited cancer syndromes, such as certain noncancerous (benign) skin growths and skeletal abnormalities associated with neurofibromatosis type 1.
Being a member of a racial or ethnic group that is known to have an increased risk of having a certain inherited cancer susceptibility syndrome and having one or more of the above features as well
Several family members with cancer
If a person is concerned that they may have an inherited cancer susceptibility syndrome in their family, it is generally recommended that, when possible, a family member with cancer have genetic counseling and testing first, to identify with more certainty if the cancer in the family is due to an inherited genetic variant. Genetic testing is often more informative if it can begin in a family member with a previous or current cancer diagnosis than in someone who has never had cancer.
If a person in the family has already been found to have an inherited cancer susceptibility syndrome, then any family members who could have inherited the variant should consider genetic testing, even if they have not (yet) had a cancer. Knowing about their risks may help them to prevent a future cancer.
Source: National Cancer Institute (NCI)
Additional Materials (1)
Genetic counseling for hereditary cancer syndromes
Video by MD Anderson Cancer Center/YouTube
6:58
Genetic counseling for hereditary cancer syndromes
MD Anderson Cancer Center/YouTube
What Is Genetic Counseling?
Genetic counseling session
Image by United States National Institutes for Health, Center for Hearing and Communication Disorders
Genetic counseling session
Genetic counseling session
Image by United States National Institutes for Health, Center for Hearing and Communication Disorders
What Is Genetic Counseling and Who Should Receive It for Hereditary Kidney Cancer?
Key Points
Genetic counseling is a communication process between a specially trained health professional and a person concerned about the genetic risk of disease.
Whether a person should get tested for hereditary kidney cancer depends on certain factors.
Genetic counseling is a communication process between a specially trained health professional and a person concerned about the genetic risk of disease.
The person's family and personal medical history may be discussed, and counseling may lead to genetic testing. Genetic counselors and other specially trained health professionals can help patients make an informed decision about whether to get genetic testing.
It is not always easy to determine whether a condition in a family is inherited. Genetic counselors and other specially trained health professionals can help patients understand their family medical history, their options for genetic testing, and the risks and benefits of learning genetic information. If a patient chooses to get genetic testing, it may be done using a sample of blood, saliva, or skin. Genetic test results can reveal information about other family members and can create tension in the family. Genetic counselors can help people cope with their genetic testing results, including how to discuss the results with family members.
Whether a person should get tested for hereditary kidney cancer depends on certain factors.
Certain clues in a person's medical history or family history may lead health professionals to think that an individual may have a hereditary syndrome. These individuals may benefit from genetic counseling and genetic testing. With kidney cancer, individuals who have one or more of the following criteria may be referred for genetic testing:
Multiple family members have had kidney cancer.
Cancer developed at a young age.
Multiple tumors in one kidney or cancer in both kidneys.
Diagnosis of a type of kidney cancer that is known to be commonly inherited.
Source: PDQ® Cancer Genetics Editorial Board. PDQ Hereditary Kidney Cancer Syndromes. Bethesda, MD: National Cancer Institute.
What Are the Major Syndromes?
inheritance
Image by Mark v1.0
inheritance
A cartoon image of two humans, male and female with the expected chances of their children's gene inheritance.
Image by Mark v1.0
What Are the Major Hereditary Kidney Cancer Syndromes?
Key Points
Four hereditary kidney cancer syndromes and the genes that cause them have been identified.
Mutations (changes) in several different genes can cause hereditary syndromes that increase the risk of kidney cancer. Genes are pieces of DNA that contain information needed to define traits and genetic conditions.
Structure of DNA. Most DNA is found inside the nucleus of a cell, where it forms the chromosomes. Chromosomes have proteins called histones that bind to DNA. DNA has two strands that twist into the shape of a spiral ladder called a helix. DNA is made up of four building blocks called nucleotides: adenine (A), thymine (T), guanine (G), and cytosine (C). The nucleotides attach to each other (A with T, and G with C) to form chemical bonds called base pairs, which connect the two DNA strands. Genes are short pieces of DNA that carry specific genetic information.
Genes are passed from parents to children. For each of the hereditary syndromes described below, a child only needs to inherit a single mutated copy of a gene from one parent to have the disease. This is called autosomal dominant inheritance.
Autosomal dominant inheritance is a way a genetic trait or condition can be passed down from parent to child. One copy of a mutated (changed) gene from one parent can cause the genetic condition. A child who has a parent with the mutated gene has a 50% chance of inheriting that mutated gene. Men and women are equally likely to have these mutations and sons and daughters are equally likely to inherit them.
Four hereditary kidney cancer syndromes and the genes that cause them have been identified.
Von Hippel-Lindau Disease (VHL)
VHL is a hereditary syndrome that increases the risk of kidney cancer and renal cysts. VHL is associated with a clear-cell type kidney cancer, which is typically slow growing. People with VHL can also develop other malignant (cancer) and benign (noncancer) tumors in the central nervous system, retina, pancreas, adrenal glands, endolymphatic sac, epididymis (in males), and broad ligament (in females).
Areas of the body affected by von Hippel-Lindau (VHL) disease. VHL disease is an inherited disorder that causes tumors and cysts to grow in certain areas of the body, including the central nervous system (including the brainstem, cerebellum, and spinal cord), retina, endolymphatic sac in the ear, adrenal glands, pancreas, kidneys, epididymis (in males), and broad ligament (in females). VHL disease also causes an increased risk of certain types of cancer, especially kidney cancer and pancreatic cancer.
VHL is caused by mutations in the VHL gene. The VHL gene is a type of gene called tumor suppressor gene. Normally, the VHL gene prevents cells from growing and dividing too quickly. When the VHL gene is mutated in certain ways and loses its protective function, uncontrolled cell growth results that may lead to cancer. Mutated copies of the VHL gene are passed from parents to children. The syndrome caused by these mutations is inherited in an autosomal dominant fashion. If one parent has VHL, there is a 50% (1 in 2) chance for a child to inherit the mutation.
Hereditary Leiomyomatosis and Renal Cell Cancer (HLRCC)
HLRCC is a hereditary syndrome that increases the risk of kidney cancer. HLRCC is associated with a unique type of kidney cancer that can be fast growing and may lead to different treatment decisions. People with HLRCC can also develop skin lesions known as leiomyomas and uterine fibroids (in females).
Areas of the body affected by hereditary leiomyomatosis and renal cell cancer (HLRCC). HLRCC is an inherited disorder that causes an increased risk of kidney cancer. It can also cause lesions in the skin and uterus (in females).
HLRCC is caused by mutations in the FH gene. The FH gene makes a protein called fumarase. Fumarase helps cells use oxygen and produce energy. When the FH gene is mutated, cells are not able to use oxygen, which may lead to cancer. These mutations are passed from parents to children. The syndrome caused by these mutations is inherited in an autosomal dominant fashion. If one parent has HLRCC, there is a 50% (1 in 2) chance for a child to inherit the mutation.
Birt-Hogg-Dubé Syndrome (BHD)
BHD is a hereditary syndrome that increases the risk of multiple types of kidney cancer that are typically slow growing. People with BHD can also develop skin lesions known as fibrofolliculomas, lung cysts, and spontaneous pneumothorax (collapsed lung).
Areas of the body affected by Birt-Hogg-Dube (BHD) syndrome. BHD syndrome is an inherited disorder that causes an increased risk of kidney cancer, benign (not cancer) skin lesions, collapsed lungs, and lung cysts.
BHD is caused by mutations in the FLCN gene. The FLCN gene is a tumor suppressor gene. Normally, the FLCN gene prevents cells from growing and dividing too quickly. When the FLCN gene is mutated, uncontrolled cell growth may result that leads to cancer. Mutated copies of the FLCN gene are passed from parents to children. The syndrome caused by these mutations is inherited in an autosomal dominant fashion. If one parent has BHD, there is a 50% (1 in 2) chance for a child to inherit the mutation.
Hereditary Papillary Renal Cancer (HPRC)
HPRC is a hereditary syndrome that increases the risk of a type of kidney cancer known as papillary type 1 kidney cancer, which is typically slow growing. Papillary kidney cancer forms in the cells lining the renal tubules.
Papillary renal cancer forms in cells that line the renal tubules in the kidney. The renal tubules remove waste from the blood and make urine. Urine moves through the renal tubules into the renal pelvis and ureter, which carries urine from the kidney to the bladder.
HPRC is caused by mutations in the MET gene. The MET gene makes a protein called MET that is involved in cell signaling and growth. When the MET gene is mutated, cells may not respond to signals that normally prevent them from growing, causing cancer to develop. Mutations in the MET gene are passed from parents to children. The syndrome caused by these mutations is inherited in an autosomal dominant fashion. If one parent has HPRC, there is a 50% (1 in 2) chance for a child to inherit the mutation.
Source: PDQ® Cancer Genetics Editorial Board. PDQ Hereditary Kidney Cancer Syndromes. Bethesda, MD: National Cancer Institute.
Von Hippel-Lindau Disease
Hippel angiogram
Image by AFIP Atlas of Tumor Pathology / Dr. Stephen C. Pollack, Durham, NC.
Hippel angiogram
CNS: OCULAR HEMANGIOBLASTOMA IN VON HIPPEL-LINDAU SYNDROME As seen in this retinal angiogram, ocular hemangioblastomas are a common component of this multiorgan disorder.
Image by AFIP Atlas of Tumor Pathology / Dr. Stephen C. Pollack, Durham, NC.
Von Hippel-Lindau Disease
What is Von Hippel-Lindau disease (VHL)?
Von Hippel-Lindau disease (VHL) is a rare disease that causes tumors and cysts to grow in your body. They can grow in your brain and spinal cord, kidneys, pancreas, adrenal glands, and reproductive tract. The tumors are usually benign (non-cancerous). But some tumors, such as those in the kidney and pancreas, can become cancerous.
What causes Von Hippel-Lindau disease (VHL)?
Von Hippel-Lindau disease (VHL) is a genetic disease. It is inherited, which means that it is passed down from parent to child.
What are the symptoms of Von Hippel-Lindau disease (VHL)?
Symptoms of VHL depend on the size and location of the tumors. They may include
Headaches
Problems with balance and walking
Dizziness
Weakness of the limbs
Vision problems
High blood pressure
How is Von Hippel-Lindau disease (VHL) diagnosed?
Detecting and treating VHL early is important. Your health care provider may suspect that you have VHL if you have certain patterns of cysts and tumors. There is a genetic test for VHL. If you have it, you will need other tests, including imaging tests, to look for tumors and cysts.
What are the treatments for Von Hippel-Lindau disease (VHL)?
Treatment can vary, depending on the location and size of the tumors and cysts. It usually involves surgery. Certain tumors may be treated with radiation therapy. The goal is to treat growths while they are small and before they do permanent damage. You will need to have careful monitoring by a doctor and/or medical team familiar with the disorder.
Source: National Institute of Neurological Disorders and Stroke (NINDS)
What Is Hereditary Leiomyomatosis and Renal Cell Cancer?
Hereditary leiomyomatosis and renal cell cancer (HLRCC) is a disorder in which affected individuals tend to develop benign tumors containing smooth muscle tissue (leiomyomas) in the skin and, in females, the uterus. This condition also increases the risk of kidney cancer.
In this disorder, growths on the skin (cutaneous leiomyomas) typically develop in the third decade of life. Most of these growths arise from the tiny muscles around the hair follicles that cause "goosebumps". They appear as bumps or nodules on the trunk, arms, legs, and occasionally on the face. Cutaneous leiomyomas may be the same color as the surrounding skin, or they may be darker. Some affected individuals have no cutaneous leiomyomas or only a few, but the growths tend to increase in size and number over time. Cutaneous leiomyomas are often more sensitive than the surrounding skin to cold or light touch, and may be painful.
Most women with HLRCC also develop uterine leiomyomas (fibroids). While uterine fibroids are very common in the general population, women with HLRCC tend to have numerous large fibroids that appear earlier than in the general population.
Approximately 10 percent to 16 percent of people with HLRCC develop a type of kidney cancer called renal cell cancer. The signs and symptoms of renal cell cancer may include lower back pain, blood in the urine, or a mass in the kidney that can be felt upon physical examination. Some people with renal cell cancer have no symptoms until the disease is advanced. People with HLRCC are commonly diagnosed with kidney cancer in their forties.
This disorder, especially if it appears in individuals or families without renal cell cancer, is also sometimes called multiple cutaneous leiomyomatosis (MCL) or multiple cutaneous and uterine leiomyomatosis (MCUL).
Source: MedlinePlus Genetics
Additional Materials (1)
Male Figure with Urinary System, kidneys and bladder
Male Figure with Urinary System, kidneys and bladder
Image by TheVisualMD
Male Figure with Urinary System, kidneys and bladder
TheVisualMD
Birt-Hogg-Dubé Syndrome
What Is Birt-Hogg-Dube Syndrome?
Birt-Hogg-Dube syndrome (BHDS) is a rare, complex, genetic disorder with three main clinical findings: non-cancerous (benign) skin tumors; lung cysts and/or history of pneumothorax (collapsed lung); and various types of renal tumors. Fibrofolliculomas are a type of benign skin tumor specific to BHDS. They typically occur on the face, neck, and upper torso. Most people with BHDS also have multiple cysts in both lungs that can be seen on high-resolution chest CT scan. While these cysts usually do not cause any symptoms, they put people at increased risk for spontaneous pneumothorax. BHDS is caused by mutations in the FLCN gene. The condition is inherited in an autosomal dominant fashion.
Source: Genetic and Rare Diseases (GARD) Information Center
Hereditary Papillary Renal Cancer
What Is Hereditary Papillary Renal Cancer?
Hereditary papillary renal cancer is a rare, inherited disorder that increases the risk of a type of kidney cancer called type 1 papillary kidney cancer. This cancer forms in cells that line the small tubes in the kidney that filter waste from the blood and make urine. Hereditary papillary renal cancer often affects both kidneys, and often there is more than one tumor in each kidney. It is caused by mutations (changes) in a gene called MET. Hereditary papillary renal cancer is a type of hereditary cancer syndrome. Also called hereditary papillary renal carcinoma and HPRC.
Papillary renal cancer forms in cells that line the renal tubules in the kidney. The renal tubules remove waste from the blood and make urine. Urine moves through the renal tubules into the renal pelvis and ureter, which carries urine from the kidney to the bladder.
Source: National Cancer Institute (NCI)
How Is It Diagnosed?
Renal parenchymal phase CT of transitional cell carcinoma
Image by Kristie Guite, Louis Hinshaw and Fred Lee/Wikimedia
Renal parenchymal phase CT of transitional cell carcinoma
Renal parenchymal phase CT of transitional cell carcinoma. For context, see en:Computed tomography of the abdomen and pelvis.
Image by Kristie Guite, Louis Hinshaw and Fred Lee/Wikimedia
Diagnosis of Kidney Cancer
Tests that examine the abdomen and kidneys are used to diagnose renal cell cancer.
The following tests and procedures may be used:
Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.
Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
Urinalysis: A test to check the color of urine and its contents, such as sugar, protein, red blood cells, and white blood cells.
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the abdomen and pelvis, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. To do a biopsy for renal cell cancer, a thin needle is inserted into the tumor and a sample of tissue is withdrawn.
Source: National Cancer Institute (NCI)
Additional Materials (4)
How is Kidney Cancer Diagnosed? | National Kidney Foundation
Video by National Kidney Foundation/YouTube
Diagnosing and Treating Kidney Cancer
Video by Howard County General Hospital/YouTube
Urinalysis - OSCE Guide
Video by Geeky Medics/YouTube
Urinalysis
Video by University of Dundee Clinical Skills/YouTube
2:12
How is Kidney Cancer Diagnosed? | National Kidney Foundation
National Kidney Foundation/YouTube
3:31
Diagnosing and Treating Kidney Cancer
Howard County General Hospital/YouTube
2:21
Urinalysis - OSCE Guide
Geeky Medics/YouTube
3:37
Urinalysis
University of Dundee Clinical Skills/YouTube
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;
Clean your genitals
Start to urinate in the toilet
Stop halfway through
Collect about two ounces of midstream urine in the container
Stop again and close the container
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.
No preparation is required. Your healthcare provider may want to know of any medication you are currently taking.
No risks are associated with this test.
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.
Several factors can compromise the urinalysis results, including the method used for collecting the sample, the method used for testing by the laboratory, intake of certain drugs, and the time elapsed between the urine collection and its evaluation in the laboratory.
Mayo Clinic: Urinalysis [accessed on Aug 19, 2018]
Urinalysis: A Comprehensive Review; Am Fam Physician. 2005 Mar 15;71(6):1153-1162. [accessed on Aug 19, 2018]
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
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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
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
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mg/dL
15
Your result is Negative.
Glucose is not usually found in urine. If it is, further testing is needed.
Related conditions
A glucose in urine test measures the amount of glucose in your urine. Glucose is a type of sugar. It is your body's main source of energy. A hormone called insulin helps move glucose from your bloodstream into your cells. If too much glucose gets into the blood, the extra glucose will be eliminated through your urine. A urine glucose test can be used to help determine if blood glucose levels are too high, which may be a sign of diabetes.
A glucose in urine test may be part of a urinalysis, a test that measures different cells, chemicals, and other substances in your urine. Urinalysis is often included as part of a routine exam. A glucose in urine test may also be used to screen for diabetes. However, a urine glucose test is not as accurate as a blood glucose test. It may be ordered if blood glucose testing is difficult or not possible. Some people can't get blood drawn because their veins are too small or too scarred from repeated punctures. Other people avoid blood tests due to extreme anxiety or fear of needles.
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:
Wash your hands.
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.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amount.
Finish urinating into the toilet.
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.
You don't need any special preparations for this test.
There is no known risk to having a glucose in urine test.
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.
https://medlineplus.gov/lab-tests/glucose-in-urine-test/ [accessed on Sep 15, 2019]
https://medlineplus.gov/ency/article/003581.htm [accessed on Sep 15, 2019]
https://www.labcorp.com/test-menu/26061/glucose-quantitative-urine [accessed on Sep 15, 2019]
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.
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Use the slider below to see how your results affect your
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Your result is Negative.
Bilirubin is not normally found in the urine.
Related conditions
A bilirubin in urine test measures the levels of bilirubin in your urine. Bilirubin is a yellowish substance made during the body's normal process of breaking down red blood cells. Bilirubin is found in bile, a fluid in your liver that helps you digest food. If your liver is healthy, it will remove most of the bilirubin from your body. If your liver is damaged, bilirubin can leak into the blood and urine. Bilirubin in urine may be a sign of liver disease.
A bilirubin in urine test is often part of a urinalysis, a test that measures different cells, chemicals, and other substances in your urine. Urinalysis is often included as part of a routine exam. This test may also be used to check for liver problems.
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:
Wash your hands.
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.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
Finish urinating into the toilet.
Return the sample container to your health care provider.
You don't need any special preparations to test for bilirubin in urine. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having a urinalysis or a bilirubin in urine test.
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.
Bilirubin in Urine: MedlinePlus Lab Test Information [accessed on Aug 22, 2021]
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 measures ketone levels in your urine. Normally, your body burns glucose (sugar) for energy. If your cells don't get enough glucose, your body burns fat for energy instead. This produces a substance called ketones, which can show up in your blood and urine. High ketone levels in urine may indicate diabetic ketoacidosis (DKA), a complication of diabetes that can lead to a coma or even death. A ketones in urine test can prompt you to get treatment before a medical emergency occurs.
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:
Wash your hands.
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.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amount.
Finish urinating into the toilet.
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.
You may have to fast (not eat or drink) for a certain period of time before taking a ketones in urine test. Ask your health care provider if you need to fast or do any other type of preparation before your test.
There is no known risk to having a ketones in urine test.
Your test results may be a specific number or listed as a "small," "moderate," or "large" amount of ketones. Normal results can vary, depending on your on your diet, activity level, and other factors. Because high ketone levels can be dangerous, be sure to talk to your health care provider about what is normal for you and what your results mean.
Ketone test kits are available at most pharmacies without a prescription. If you are planning to test for ketones at home, ask your health care provider for recommendations on which kit would be best for you. At-home urine tests are easy to perform and can provide accurate results as long as you carefully follow all instructions.
Ketones in Urine: MedlinePlus Lab Test Information [accessed on Sep 15, 2019]
https://medlineplus.gov/ency/article/003585.htm [accessed on Sep 15, 2019]
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.
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Use the slider below to see how your results affect your
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1.002
1.03
Your result is Normal.
Normal results can slightly vary from laboratory to laboratory.
Related conditions
In the kidneys, most of the water, ions, and nutrients are returned to the body while waste products and excess ions are excreted through the urine.
Normally, the color of urine is straw-yellow but it may be affected by several situations, including infections, intake of certain foods or medications, or insufficient or excessive fluid intake. Your urine color may reflect how concentrated or diluted is your urine.
A urine specific gravity (SG) test is used to compare the density of your urine to the normal density of water. The result gives an overview of the concentration of the solutes (particles) in your urine. In other words, it shows how well your kidneys are diluting urine.
A shift in the urine SG test result may give the first indication that your kidneys are not working properly. However, if a kidney disorder is suspected, further tests should be taken to confirm or exclude certain disease.
A urine specific gravity test is mainly used as a partial analysis to assess the kidney’s ability to concentrate and dilute urine. Thus, it can be used to help detect certain disorders or diseases of the urinary tract.
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
Testing for urine specific gravity starts with mid-stream urine sample collection. It is recommended that the sample is collected in the morning when the urine concentration is the highest.
To collect the urine sample, you need to clean your genitals and then discard the first stream of urine into the toilet (this is done to “clean” your urethra), proceeding then to collect about two ounces of midstream urine in the container. You need to be careful not to touch your genitals with the container to avoid possible contamination with external germs. Once you have collected enough urine, put the container cap on and then you can finish emptying your bladder into the toilet.
After the collection, the sample is transported to the laboratory.
Your doctor may ask you to stop taking certain medications and foods before the test.
There are no risks related to a urine gravity test.
The normal value for urine specific gravity is 1.002-1.030.
Lower-than-normal values of urine gravity may indicate:
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
Certain foods may affect the color of your urine; therefore, it's advised not to eat foods such as beet, rhubarb, blackberries, carrots or lava beans before giving a urine sample.
Sometimes doctors may choose a urine osmolality test instead of a urine specific gravity test. The urine osmolarity test is more specific and could help your doctor to diagnose certain disorders more accurately.
https://medlineplus.gov/ency/article/003587.htm [accessed on Oct 09, 2021]
Urine Specific Gravity Test: Overview, Tests, and Procedure [accessed on Oct 29, 2018]
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,
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Use the slider below to see how your results affect your
health.
Your result is Negative.
Related conditions
A test called a urinalysis can detect whether there is blood in your urine. A urinalysis checks a sample of your urine for different cells, chemicals, and other substances, including blood. 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, or liver disease.
A urinalysis, which includes a test for blood in urine, may be done as part of a regular checkup or to check for disorders of the urinary tract, kidney, or liver.
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:
Wash your hands.
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.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the needed amounts.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
You don't need any special preparations before getting a test for blood in your urine. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having a urinalysis or a blood in urine test.
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.
A blood in urine test is usually part of a typical urinalysis. In addition to checking for blood, a urinalysis measures other substances in the urine, including proteins, acid and sugar levels, cell fragments, and crystals.
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.
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pH
4.5
8
Your result is Normal.
A normal urine pH range is between 4.5 and 8.0.
Related conditions
A urine pH test is the analysis of the acidity/alkalinity of the urine. It is part of the chemical examination in a urinalysis. 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.
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
You will need to provide a urine sample.
No preparations are required. Your healthcare provider may want to know of any medication you are currently taking.
No risks are associated with this test.
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
Several factors can compromise the urinalysis results, including the method used for collecting the sample, the method used for testing by the laboratory, intake of certain drugs, and the time elapsed between the urine collection and its evaluation in the laboratory.
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.
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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
A protein in urine test measures how much protein is in your urine. Proteins are substances that are essential for your body to function properly. Protein is normally found in the blood. If there is a problem with your kidneys, protein can leak into your urine. While a small amount is normal, a large amount of protein in urine may indicate kidney disease.
A protein in urine test is often part of a urinalysis, a test that measures different cells, chemicals, and substances in your urine. Urinalysis is often included as part of a routine exam. This test may also be used to look for or to monitor kidney disease.
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:
Wash your hands.
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.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
Finish urinating into the toilet.
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.
You don't need any special preparations to test for protein in urine. If your health care provider has ordered a 24-hour urine sample, you will get specific instructions on how to provide and store your samples.
There is no known risk to having a urinalysis or a urine in protein test.
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.
If you will be doing your urine test at home, ask your health care provider for recommendations on which test kit would be best for you. At-home urine tests are easy to do and provide accurate results as long as you carefully follow all instructions.
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
A urobilinogen in urine test measures the amount of urobilinogen in a urine sample. Urobilinogen is formed from the reduction of bilirubin. Bilirubin is a yellowish substance found in your liver that helps break down red blood cells. Normal urine contains some urobilinogen. If there is little or no urobilinogen in urine, it can mean your liver isn't working correctly. Too much urobilinogen in urine can indicate a liver disease such as hepatitis or cirrhosis.
A urobilinogen test may part of a urinalysis, a test that measures different cells, chemicals, and other substances in your urine. A urinalysis is often part of a routine exam.
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:
Wash your hands.
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.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
You don't need any special preparations. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having this test.
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.
This test is only one measure of liver function. If your health care provider thinks you might have a liver disease, additional urine and blood tests may be ordered.
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.
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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
A urinalysis, also called a urine test, can detect the presence of nitrites in the urine. Normal urine contains chemicals called nitrates. If bacteria enter the urinary tract, nitrates can turn into different, similarly named chemicals called nitrites. Nitrites in urine may be a sign of a urinary tract infection (UTI).
UTIs are one of the most common types of infections, especially in women. Fortunately, most UTIs are not serious and are usually treated with antibiotics. It's important to see your health care provider if you have symptoms of a UTI so you can start treatment right away.
Other names: urine test, urine analysis, microscopic urine analysis, microscopic examination of urine, UA
A urinalysis, which includes a test for nitrites in urine, may be part of a regular exam. It may also be used to check for a UTI.
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:
Wash your hands.
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.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container, which should have markings to indicate the amounts.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider
You don't need any special preparations to test for nitrites in urine. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having a urinalysis or a nitrites in urine test.
If there are nitrites in your urine, it may mean that you have a UTI. However, even if no nitrites are found, you still may have an infection, because bacteria don't always change nitrates into nitrites. If you have symptoms of a UTI, your health care provider will also look at other results of your urinalysis, especially the white blood cell count. A high white blood cell count in urine is another possible sign of an infection. To learn what your results mean, talk to your health care provider.
If a urinalysis is part of your regular checkup, your urine will be tested for a variety of substances along with nitrites. These include red and white blood cells, proteins, acid and sugar levels, cell fragments, and crystals in your urine.
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.
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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
Red blood cells (RBCs), also known as erythrocytes, are cells that can be found circulating in the blood. They are produced in the bone marrow (the spongy tissue inside some of your bones), and their function is to carry a protein called hemoglobin through the body, which in turn delivers oxygen to the tissues and organs.
This test is part of the microscopic characteristics evaluated in a urinalysis, or urine test. This means that RBCs are invisible to the naked eye, and can only be seen through a microscope.
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;
Clean your genitals
Start to urinate in the toilet
Stop halfway through
Collect about two ounces of midstream urine in the container
Stop again and close the container
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.
No preparation is required. Your healthcare provider may want to know of any medication you are currently taking.
No risks are associated with this test.
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
Several factors can compromise the urinalysis results, including the method used for collecting the sample, the method used for testing by the laboratory, intake of certain drugs, menstruation traces, and the time elapsed between the urine collection and its evaluation in the laboratory.
Urinalysis: Reference Range, Interpretation, Collection and Panels [accessed on Jan 10, 2019]
Urinalysis [accessed on Jan 10, 2019]
Urinalysis: A Comprehensive Review - - American Family Physician [accessed on Jan 10, 2019]
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).
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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
White blood cells (WBCs), also known as leukocytes, are part of the immune system. These cells protect your body against viruses, bacteria, parasites, fungus, and any other strange organism or substance that may want to enter into your system.
This test is part of the microscopic characteristics evaluated in a urinalysis, or urine test. This means that WBCs are invisible to the naked eye, and can only be seen through a microscope.
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;
Clean your genitals
Start to urinate in the toilet
Stop halfway through
Collect about two ounces of midstream urine in the container
Stop again and close the container
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.
No preparation is required. Your healthcare provider may want to know of any medication you are currently taking.
No risks are associated with this test.
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.
Several factors can compromise the urinalysis results, including the method used for collecting the sample, the method used for testing by the laboratory, intake of certain drugs, and the time elapsed between the urine collection and its evaluation in the laboratory.
Urinalysis: Reference Range, Interpretation, Collection and Panels [accessed on Jan 10, 2019]
Urinalysis [accessed on Jan 10, 2019]
Urinalysis: A Comprehensive Review - - American Family Physician [accessed on Jan 10, 2019]
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.
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Use the slider below to see how your results affect your
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Your result is Few.
"Few" cells are generally considered in the normal range.
Related conditions
Epithelial cells are a type of cell that lines the surfaces of your body. They are found on your skin, blood vessels, urinary tract, and organs. An epithelial cells in urine test looks at urine under a microscope to see if the number of your epithelial cells is in the normal range. It's normal to have a small amount of epithelial cells in your urine. A large amount may indicate an infection, kidney disease, or other serious medical condition.
An epithelial cells in urine test is a part of a urinalysis, a test that measures different substances in your urine. A urinalysis may include a visual examination of your urine sample, tests for certain chemicals, and an examination of urine cells under a microscope. An epithelial cells in urine test is part of a microscopic exam of urine.
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:
Wash your hands.
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.
Start to urinate into the toilet.
Move the collection container under your urine stream.
Collect at least an ounce or two of urine into the container. The container will have markings to indicate the amounts.
Finish urinating into the toilet.
Return the sample container as instructed by your health care provider.
You don't need any special preparations for the test. If your health care provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.
There is no known risk to having the test.
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.
There are three types of epithelial cells that line the urinary tract. They are called transitional cells, renal tubular cells, and squamous cells. If there are squamous epithelial cells in your urine, it may mean your sample was contaminated. This means that the sample contains cells from the urethra (in men) or the vaginal opening (in women). It can happen if you do not clean well enough when using the clean catch method.
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.
Use the slider below to see how your results affect your
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Your result is Negative.
Related conditions
Urinary casts are tiny cylindrical, tube-shaped structures that are produced by the kidneys and may be found in a urinalysis test when certain diseases or conditions are present.
This test usually forms part of a urine test (urinalysis), which can be ordered as part of a normal routine check-up, or when kidney diseases are suspected.
You will be asked to provide a urine sample by urinating into a sterile urine container.
To adequately do this, you need to clean your genitals, and then discard the first stream of urine into the toilet (this is done to “clean” your urethra), proceeding then to collect about two ounces of midstream urine in the container.
No fasting or other preparations are necessary for this test. Follow the instructions provided by your healthcare professional.
There are no known risks associated with this test.
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."
Kidney Biopsy
Kidney Biopsy
Also called: Renal Biopsy, Biopsy - Kidney
A kidney biopsy is a procedure that involves taking a small piece of kidney tissue for examination with a microscope. The tissue is examined for signs of kidney disease or infection. It can also be used to check for cancer or other abnormalities.
Kidney Biopsy
Also called: Renal Biopsy, Biopsy - Kidney
A kidney biopsy is a procedure that involves taking a small piece of kidney tissue for examination with a microscope. The tissue is examined for signs of kidney disease or infection. It can also be used to check for cancer or other abnormalities.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result is when the kidney tissue shows normal structure.
Related conditions
A kidney biopsy is a procedure that involves taking a small piece of kidney tissue for examination with a microscope. A pathologist—a doctor who specializes in diagnosing diseases—examines the kidney tissue sample in a lab. The pathologist looks for signs of kidney disease or infection. If the kidney has been transplanted and is not working, a kidney biopsy may help identify the cause.
A health care provider will perform a kidney biopsy to evaluate any of the following conditions:
hematuria—blood in the urine, which can be a sign of kidney disease or other urinary problems.
albuminuria—a condition in which the urine has more-than-normal amounts of a protein called albumin. Albuminuria may be a sign of kidney disease.
changes in kidney function, which can cause the buildup of waste products in the blood.
Health care providers may use a kidney biopsy to diagnose cancer. If cancer is present, there is a small chance that the biopsy needle will spread the cancer. In addition, the biopsy specimen is very small and may miss the cancer and, therefore, may not provide the right diagnosis.
A kidney biopsy is usually done in a hospital. An overnight stay may be needed to watch for any problems. You may be awake with only light sedation, or asleep under general anesthesia. You will be lying face down with a pillow under your rib cage. If the biopsy is done on a transplanted kidney, you will be lying on your back.
To prepare for a kidney biopsy talk with your doctor, have blood and imaging tests if needed, arrange for a ride home after the procedure, and follow your doctor’s instructions about about food or medication restrictions.
The risks of a kidney biopsy include
bleeding—the most common complication of a kidney biopsy. Bleeding may come from the kidney or the puncture site. Bleeding from the kidney rarely requires a blood transfusion.
infection—a rare complication of a kidney biopsy. Health care providers prescribe bacteria-fighting medications called antibiotics to treat infections.
The kidney tissue sample can show inflammation, scarring, infection, or unusual deposits of a protein called immunoglobulin. If a person has chronic kidney disease—any condition that causes reduced kidney function over a period of time—the biopsy may show how quickly the disease is advancing. A biopsy can also help explain why a transplanted kidney is not working properly.
https://www.niddk.nih.gov/health-information/diagnostic-tests/kidney-biopsy [accessed on Feb 19, 2019]
https://medlineplus.gov/ency/article/003907.htm [accessed on Feb 19, 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 (17)
Pyelonephritis (Kidney Infection)
Pain caused by Pyelonephritis
Image by Grook Da Oger
Drawing of the urinary tract showing simple kidney cysts (male figure)
Drawing of the urinary tract in the outline of a male figure. The kidneys, ureters, and bladder are labeled. An inset image from one of the kidneys shows simple cysts as raised bumps on the kidney. The simple cysts and ureter are labeled. Simple kidney cysts are abnormal, fluid-filled sacs that form in the kidneys.
Image by NIDDK Image Library
Kidney with ACKD
Drawing of a male torso with kidneys, ureters, bladder, and urethra labeled, and a drawing below of a kidney with sacs of fluid labeled as cysts. Acquired cystic kidney disease happens when a person's kidneys develop fluid-filled sacs called cysts.
Image by National Institute of Diabetes and Digestive and Kidney Diseases
Diagram of two kidneys (healthy vs polycystic)
The healthy kidney on the lower right is smooth. The polycystic kidney on the upper left has many fluid-filled sacs on the surface. Labels point to the ureter and cysts on the polycystic kidney. The polycystic kidney roughly retains the same shape as the healthy kidney.
Image by NIDDK Image Library
Peritoneal dialysis
Outline of a male figure receiving peritoneal dialysis. Labels point to the dialysis solution, catheter, space inside the belly, lining of the belly and tube to drain bag.
Image by NIDDK Image Library
Kidneys and urinary tract within the outline of a young boy
Drawing of the kidneys and urinary tract within the outline of a young boy. The kidneys, ureters, and bladder are labeled. The kidneys remove wastes and extra water from the blood to form urine.Urine flows from the kidneys to the bladder through the ureters.
Image by NIDDK Image Library
Front-view drawing of a normal urinary tract in an infant
Front-view drawing of a normal urinary tract in an infant. The kidneys, ureters, bladder, and urethra are labeled. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra.
Image by NIDDK Image Library
Drawing of a pelvic ectopic kidney labeled
Drawing of a pelvic ectopic kidney labeled, showing the pelvis, bladder, ureters, and kidneys. The kidney on the right is in the normal position, several inches above the bladder. The kidney on the left is an ectopic kidney, just a couple of inches above the bladder. An ectopic kidney may remain in the pelvis, near the bladder.
Image by NIDDK Image Library
Drawing of a fused ectopic kidney, labeled
Drawing of a fused ectopic kidney, showing the pelvis, bladder, ureters, and fused kidneys. The kidney that would normally be on the left has crossed over and fused with the kidney on the right. An ectopic kidney may cross over and become fused with the other kidney.
Image by NIDDK Image Library
Drawing of pelvic ectopic kidney
An ectopic kidney may remain in the pelvis, close to the bladder.
Image by NIDDK Image Library
Drawing of urinary tract in an outline of the top half of a human body. Inset of one kidney and the bladder and one kidney, nonworking kidney, and the bladder
When a person has only one kidney or one working kidney, this kidney is called a solitary kidney. People born with kidney dysplasia have both kidneys; however, one kidney does not function (top right). When a kidney is removed surgically due to disease or for donation, both the kidney and ureter are removed (bottom right).
Image by NIDDK Image Library
Solitary Kidney
Drawing of one kidney and the bladder.
Image by NIDDK Image Library
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
Kidney and Urinary System
3D visualization reconstructed from scanned human data of the urinary system revealing anterior view of the kidneys, ureters and bladder. The urinary system is responsible for fluid balance and waste excretion. Blood enters the kidneys where waste products are excreted to form a fluid called filtrate. Filtrate continues to collect additional waste products and minerals as it travels through the winding tubules of the kidney. Eventually the filtrate becomes urine as it is channeled out of the kidney, into the ureters, down to the bladder and eventually out through the urethra to the external body.
Image by TheVisualMD
Right Kidney and Ureter
3D visualization based on scanned human data of the right kidney.
Image by TheVisualMD
Kidney with Blood Vessel
This 3D visualization reveals the vasculature of a kidney. Kidneys help to remove excess water and salts from the body and lower the volume of blood by producing the waste product, urine.
Image by TheVisualMD
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
Pyelonephritis (Kidney Infection)
Grook Da Oger
Drawing of the urinary tract showing simple kidney cysts (male figure)
NIDDK Image Library
Kidney with ACKD
National Institute of Diabetes and Digestive and Kidney Diseases
Diagram of two kidneys (healthy vs polycystic)
NIDDK Image Library
Peritoneal dialysis
NIDDK Image Library
Kidneys and urinary tract within the outline of a young boy
NIDDK Image Library
Front-view drawing of a normal urinary tract in an infant
NIDDK Image Library
Drawing of a pelvic ectopic kidney labeled
NIDDK Image Library
Drawing of a fused ectopic kidney, labeled
NIDDK Image Library
Drawing of pelvic ectopic kidney
NIDDK Image Library
Drawing of urinary tract in an outline of the top half of a human body. Inset of one kidney and the bladder and one kidney, nonworking kidney, and the bladder
NIDDK Image Library
Solitary Kidney
NIDDK Image Library
Healthy vs Damaged Kidney
The National Institute of Diabetes and Digestive and Kidney Diseases/NIH
Kidney and Urinary System
TheVisualMD
Right Kidney and Ureter
TheVisualMD
Kidney with Blood Vessel
TheVisualMD
Drawing of a kidney with an inset of a nephron
NIDDK Image Library
What Happens After Diagnosis?
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What Happens After a Hereditary Kidney Cancer Syndrome Diagnosis?
Most recommendations for screening and treating people with kidney cancer are based on evidence obtained from clinical trials. Because families with these hereditary kidney cancer syndromes are rare, many of these studies did not include these types of hereditary kidney cancer. When studies of families with hereditary syndromes are not available, guidelines on how to monitor and care for patients with inherited kidney cancer are based on the expert opinion and consensus of healthcare professionals who have experience in treating families with these syndromes.
Families with these hereditary syndromes are watched closely for signs of disease in the kidneys and in other organs. Most kidney tumors that occur can be removed by surgery, but they may recur (come back). Other treatment options may be available.
Source: PDQ® Cancer Genetics Editorial Board. PDQ Hereditary Kidney Cancer Syndromes. Bethesda, MD: National Cancer Institute.
How Is It Treated?
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Diagram showing laparoscopic surgery for kidney cancer
Image by Cancer Research UK / Wikimedia Commons
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Diagram showing laparoscopic surgery for kidney cancer
Diagram showing laparoscopic surgery for kidney cancer
Image by Cancer Research UK / Wikimedia Commons
Treatment of Kidney Cancer
Treatment Option Overview
KEY POINTS
There are different types of treatment for patients with renal cell cancer.
Five types of standard treatment are used:
Surgery
Radiation therapy
Chemotherapy
Immunotherapy
Targeted therapy
New types of treatment are being tested in clinical trials.
Treatment for renal cell cancer may cause side effects.
Patients may want to think about taking part in a clinical trial.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Follow-up tests may be needed.
There are different types of treatment for patients with renal cell cancer.
Different types of treatments are available for patients with renal cell cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Five types of standard treatment:
Surgery
Surgery to remove part or all of the kidney is often used to treat renal cell cancer. The following types of surgery may be used:
Partial nephrectomy: A surgical procedure to remove the cancer within the kidney and some of the tissue around it. A partial nephrectomy may be done to prevent loss of kidney function when the other kidney is damaged or has already been removed.
Simple nephrectomy: A surgical procedure to remove the kidney only.
Radical nephrectomy: A surgical procedure to remove the kidney, the adrenal gland, surrounding tissue, and, usually, nearby lymph nodes.
A person can live with part of 1 working kidney, but if both kidneys are removed or not working, the person will need dialysis (a procedure to clean the blood using a machine outside of the body) or a kidney transplant (replacement with a healthy donated kidney). A kidney transplant may be done when the disease is in the kidney only and a donated kidney can be found. If the patient has to wait for a donated kidney, other treatment is given as needed.
When surgery to remove the cancer is not possible, a treatment called arterial embolization may be used to shrink the tumor. A small incision is made and a catheter(thin tube) is inserted into the main blood vessel that flows to the kidney. Small pieces of a special gelatin sponge are injected through the catheter into the blood vessel. The sponges block the blood flow to the kidney and prevent the cancer cells from getting oxygen and other substances they need to grow.
After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer. External radiation therapy is used to treat renal cell cancer, and may also be used as palliative therapy to relieve symptoms and improve quality of life.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy).
Immunotherapy
Immunotherapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This cancer treatment is a type of biologic therapy.
The following types of immunotherapy are being used in the treatment of renal cell cancer:
Immune checkpoint inhibitor therapy: Some types of immune cells, such as T cells, and some cancer cells have certain proteins, called checkpoint proteins, on their surface that keep immune responses in check. When cancer cells have large amounts of these proteins, they will not be attacked and killed by T cells. Immune checkpoint inhibitors block these proteins and the ability of T cells to kill cancer cells is increased. They are used to treat some patients with advanced renal cell cancer that cannot be removed by surgery.
There are two types of immune checkpoint inhibitor therapy:
CTLA-4 inhibitor therapy: CTLA-4 is a protein on the surface of T cells that helps keep the body’s immune responses in check. When CTLA-4 attaches to another protein called B7 on a cancer cell, it stops the T cell from killing the cancer cell. CTLA-4 inhibitors attach to CTLA-4 and allow the T cells to kill cancer cells. Ipilimumab is a type of CTLA-4 inhibitor.
Immune checkpoint inhibitor. Checkpoint proteins, such as B7-1/B7-2 on antigen-presenting cells (APC) and CTLA-4 on T cells, help keep the body’s immune responses in check. When the T-cell receptor (TCR) binds to antigen and major histocompatibility complex (MHC) proteins on the APC and CD28 binds to B7-1/B7-2 on the APC, the T cell can be activated. However, the binding of B7-1/B7-2 to CTLA-4 keeps the T cells in the inactive state so they are not able to kill tumor cells in the body (left panel). Blocking the binding of B7-1/B7-2 to CTLA-4 with an immune checkpoint inhibitor (anti-CTLA-4 antibody) allows the T cells to be active and to kill tumor cells (right panel).
PD-1 and PD-L1 inhibitor therapy: PD-1 is a protein on the surface of T cells that helps keep the body’s immune responses in check. PD-L1 is a protein found on some types of cancer cells. When PD-1 attaches to PD-L1, it stops the T cell from killing the cancer cell. PD-1 and PD-L1 inhibitors keep PD-1 and PD-L1 proteins from attaching to each other. This allows the T cells to kill cancer cells. Nivolumab and pembrolizumab are types of PD-1 inhibitors. Avelumab is a type of PD-L1 inhibitor.
Immune checkpoint inhibitor. Checkpoint proteins, such as PD-L1 on tumor cells and PD-1 on T cells, help keep immune responses in check. The binding of PD-L1 to PD-1 keeps T cells from killing tumor cells in the body (left panel). Blocking the binding of PD-L1 to PD-1 with an immune checkpoint inhibitor (anti-PD-L1 or anti-PD-1) allows the T cells to kill tumor cells (right panel).
Interferon: Interferon affects the division of cancer cells and can slow tumor growth.
Interleukin-2 (IL-2): IL-2 boosts the growth and activity of many immune cells, especially lymphocytes (a type of white blood cell). Lymphocytes can attack and kill cancer cells.
Targeted therapy
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy do. Targeted therapy with antiangiogenic agents are used to treat advanced renal cell cancer. Antiangiogenic agents keep blood vessels from forming in a tumor, causing the tumor to starve and stop growing or to shrink.
Monoclonal antibodies and kinase inhibitors are two types of antiangiogenic agents used to treat renal cell cancer.
Monoclonal antibodies are immune system proteins made in the laboratory to treat many diseases, including cancer.. As a cancer treatment, these antibodies can attach to a specific target on cancer cells or other cells that may help cancer cells grow. The antibodies are able to then kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells. Monoclonal antibodies used to treat renal cell cancer attach to and block substances that cause new blood vessels to form in tumors. Bevacizumab is a monoclonal antibody.
Kinase inhibitors stop cells from dividing and may prevent the growth of new blood vessels that tumors need to grow.
Vascular endothelial growth factor (VEGF) inhibitors and mTOR inhibitors are kinase inhibitors used to treat renal cell cancer.
VEGF inhibitors: Cancer cells make a substance called VEGF, which causes new blood vessels to form (angiogenesis) and helps the cancer grow. VEGF inhibitors block VEGF and stop new blood vessels from forming. This may kill cancer cells because they need new blood vessels to grow. Sunitinib, pazopanib, cabozantinib, axitinib, sorafenib, and lenvatinib are VEGF inhibitors.
mTOR inhibitors: mTOR is a protein that helps cells divide and survive. mTOR inhibitors block mTOR and may keep cancer cells from growing and prevent the growth of new blood vessels that tumors need to grow. Everolimus and temsirolimus are mTOR inhibitors.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
Source: National Cancer Institute (NIH)
Additional Materials (11)
Kidney Cancer Surgeries & Procedures | National Kidney Foundation
Video by National Kidney Foundation/YouTube
Precision Medicine & Kidney Cancer | National Kidney Foundation
Video by National Kidney Foundation/YouTube
Immunotherapy & Kidney Cancer | National Kidney Foundation
Video by National Kidney Foundation/YouTube
Targeted Therapy & Kidney Cancer | Angiogenesis and Kinase Inhibitors | National Kidney Foundation
Video by National Kidney Foundation/YouTube
Treating Kidney Cancer
Video by Hartford HealthCare/YouTube
Kidney Cancer Treatment Options
Video by Roswell Park Comprehensive Cancer Center/YouTube
Immune Checkpoint Inhibitors
Video by National Cancer Institute/YouTube
Is Cancer Immunotherapy Given in Combination with Other Treatments? Ask a Scientist
Video by Cancer Research Institute/YouTube
Immunotherapy Fights Cancer
Video by The Cancer Immunotherapy Channel/YouTube
IMMUNOTHERAPY: The Path to a Cancer Cure (For Clinicians)
Video by Society for Immunotherapy of Cancer/YouTube
Monoclonal Antibodies: Making Cancer a Target
Video by Cancer Research Institute/YouTube
2:24
Kidney Cancer Surgeries & Procedures | National Kidney Foundation
National Kidney Foundation/YouTube
1:40
Precision Medicine & Kidney Cancer | National Kidney Foundation
National Kidney Foundation/YouTube
1:51
Immunotherapy & Kidney Cancer | National Kidney Foundation
National Kidney Foundation/YouTube
1:36
Targeted Therapy & Kidney Cancer | Angiogenesis and Kinase Inhibitors | National Kidney Foundation
National Kidney Foundation/YouTube
5:09
Treating Kidney Cancer
Hartford HealthCare/YouTube
2:08
Kidney Cancer Treatment Options
Roswell Park Comprehensive Cancer Center/YouTube
1:49
Immune Checkpoint Inhibitors
National Cancer Institute/YouTube
2:54
Is Cancer Immunotherapy Given in Combination with Other Treatments? Ask a Scientist
Cancer Research Institute/YouTube
2:26
Immunotherapy Fights Cancer
The Cancer Immunotherapy Channel/YouTube
8:42
IMMUNOTHERAPY: The Path to a Cancer Cure (For Clinicians)
Society for Immunotherapy of Cancer/YouTube
1:43
Monoclonal Antibodies: Making Cancer a Target
Cancer Research Institute/YouTube
Drugs Approved for Kidney Cancer
Kidneys and medication
Image by TheVisualMD/Gordon Johnson
Kidneys and medication
The next time you pick up a prescription or buy an OTC medicine or supplement, ask your pharmacist how the product may affect your kidneys or react with other medicines you take.
Image by TheVisualMD/Gordon Johnson
Drugs Approved for Kidney Cancer
This page lists cancer drugs approved by the Food and Drug Administration (FDA) for kidney cancer. The list includes generic names and brand names. The drug names link to NCI’s Cancer Drug Information summaries. There may be drugs used in kidney cancer that are not listed here.
Drugs Approved for Renal Cell Cancer (RCC)
Afinitor (Everolimus)
Afinitor Disperz (Everolimus)
Aldesleukin
Alymsys (Bevacizumab)
Avastin (Bevacizumab)
Avelumab
Axitinib
Bavencio (Avelumab)
Belzutifan
Bevacizumab
Cabometyx (Cabozantinib-S-Malate)
Cabozantinib-S-Malate
Everolimus
Fotivda (Tivozanib Hydrochloride)
IL-2 (Aldesleukin)
Inlyta (Axitinib)
Interleukin-2 (Aldesleukin)
Ipilimumab
Keytruda (Pembrolizumab)
Lenvatinib Mesylate
Lenvima (Lenvatinib Mesylate)
Mvasi (Bevacizumab)
Nexavar (Sorafenib Tosylate)
Nivolumab
Opdivo (Nivolumab)
Pazopanib Hydrochloride
Pembrolizumab
Proleukin (Aldesleukin)
Sorafenib Tosylate
Sunitinib Malate
Sutent (Sunitinib Malate)
Temsirolimus
Tivozanib Hydrochloride
Torisel (Temsirolimus)
Votrient (Pazopanib Hydrochloride)
Welireg (Belzutifan)
Yervoy (Ipilimumab)
Zirabev (Bevacizumab)
Drugs Approved for Upper Tract Urothelial Cancer (UTUC)
Enfortumab Vedotin-ejfv
Jelmyto (Mitomycin)
Mitomycin
Padcev (Enfortumab Vedotin-ejfv)
Drugs Approved for Wilms Tumor and other Childhood Kidney Cancers
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Hereditary Kidney Cancer Syndromes
Kidney cancer is a disease in which malignant cancer cells form in tubules of the kidney. Having certain hereditary syndromes, such as Von Hippel-Lindau disease or Birt-Hogg-Dubé syndrome, can increase the risk of kidney cancer. Learn more about hereditary kidney cancer syndromes and how hereditary and non-inherited kidney cancers differ.