Urinalysis: Interpretation of Results and Normal Ranges

A complete urinalysis is a routine test performed at checkups, before surgery, during pregnancy, and when a urinary tract infection, kidney disease, or diabetes is suspected. The report has many lines, and an unclear number often frightens more than it should. Let's break down what each parameter means and where normal ends.

Complete urinalysis (CAU): what it shows

A CAU is a physical, chemical, and microscopic examination of urine. The doctor assesses color and clarity, relative density, pH, the presence of protein, glucose, ketones, bilirubin, blood, and nitrites, and under a microscope—cells, crystals, casts, mucus, and bacteria. The composition of urine is related to the composition of blood and reflects kidney function and the condition of the urinary tract. Some medications change urine color, but this is not a sign of disease.

Physical properties: color, clarity, relative density

Normal color ranges from almost colorless to deep yellow: intensity depends on the concentration of urochromes. Beets and blackberries can turn urine red, carrots and rifampicin orange. Red urine the color of meat washings indicates blood, dark brown occurs with jaundice, and grayish-white with pus. Persistent abundant foam appears with protein. Relative density shows urine concentration: deep yellow usually means high density, pale urine low density.

Chemical parameters: protein, glucose, ketones, bilirubin

Normally, glucose, ketones, protein, and bilirubin are not detected in urine. Their appearance is a reason to investigate: abnormalities occur in kidney disease and poorly controlled diabetes; an acetone odor is associated with ketonuria, and dark brown urine occurs with jaundice. A test strip (dipstick) changes color on contact with these substances.

Sediment microscopy: leukocytes, erythrocytes, epithelium, casts

Under a microscope, cells, crystals, casts, mucus, and bacteria are sought. Normally, hemoglobin, nitrites, erythrocytes, and leukocytes are not detected in urine. Erythrocytes mean blood in the urine; leukocytes and nitrites are normally absent, and when they appear the doctor looks for a cause, such as a urinary tract infection. Casts are tubular protein formations, crystals are salts; their presence is assessed together with the other parameters.

Collection rules and dependence of normal ranges on the laboratory

Morning urine is used for the test: overnight it accumulates in the bladder, so the results are more objective. Before collection, the genitals should be washed, a sterile container used, and the urine delivered to the laboratory within 1.5 hours; a frozen sample has to be collected again. Normal values may differ slightly between laboratories because methods and samples differ, so specific numbers are best discussed with a doctor.

What a bad urinalysis means and when to see a doctor

Abnormalities occur in kidney disease, urinary tract infection, kidney stones, poorly controlled diabetes, and bladder or kidney cancer. You should see the doctor who ordered the test if the report shows blood, protein, leukocytes, nitrites, or persistent glucose, as well as with pain during urination and frequent urges.

• Blood (erythrocytes) in urine
• Protein and persistent foam
• Leukocytes and nitrites are normally absent
• Glucose and ketones
• Bilirubin is normally not detected

An abnormality in a urinalysis alone is not a reason to call an ambulance; 103/112 — for a life-threatening condition, regardless of test results.

The material is for reference: a test report is not a diagnosis, and a doctor should interpret your numbers together with you.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer