A urinalysis is a test that checks several components of a urine sample. Visual, chemical, and microscopic tests are all part of a complete urinalysis. It can see cells from your urinary tract, blood cells, crystals, bacteria, parasites, and cells from tumors. This test is often used to confirm the findings of other tests or add information to a diagnosis. Urine chemistry is a group of one or more tests done to check the chemical content of a urine sample. The term macroscopic refers to observations that are visible with the naked eye and do not require examination under a microscope. Macroscopic analysis of the urine is done by inspecting the physical appearance of the urine. Normal urine is light yellow and clear.

Urine sediment preparation is undertaken to identify cells, casts, crystals, and/or microorganisms. Mix the urine sample by gently inverting the container. Using a disposable plastic pipette, transfer 5 ml of urine to a conical tip centrifuge tube. In practice, there may be 1ml or 5ml conical tubes to use.

What does the test measure?

A urinalysis involves a series of assessments of a urine sample. It can measure one or more different components depending on the purpose of the test and the health care provider performing it.

A complete urinalysis will typically include a visual (also called physical) examination, a microscopic examination, and a chemical dipstick test, each of which involves different measurements and evaluations.

Visual examination

During the visual examination, a health care provider assesses the appearance of the urine and evaluates the following aspects:

• Clarity/turbidity: This is a determination of whether the urine is clear or cloudy.
• Color: This is an assessment of the color of the urine, including whether there are any signs of blood in the urine.
• Foam content: This checks how foamy the urine is, which can be related to its protein content.
• Odor: This examination involves checking for any unusual odor from the urine.

Microscopic examination

A microscopic examination is done by looking at drops of concentrated urine under a microscope to see if there are physical traces of the following:

• Bacteria, parasites, or yeast
• Red or white blood cells
• Urinary casts, which are small particles shaped like a tube that may contain different types of cells or substances
• Urinary crystals
• Sperm

Chemical dipstick test

The dipstick test uses a chemical strip that is submerged in the sample that changes color when exposed to different substances. A dipstick test may be used to check various aspects of the urine sample including:

• Acidity (pH): This is the acid-base or pH level of your urine, which is measured on a scale of 1-14 with 1 being the most acidic and 14 being the most basic.
• Bilirubin: Bilirubin is a substance produced when the body breaks down red blood cells. It is not normally found in the urine.
• Concentration/specific gravity: This measures the concentration of particles in your urine and can be related to fluid levels in the body.
• Glucose: Glucose is a type of sugar that is used to provide energy to cells.
• Enzymes: A dipstick test may check for the presence of an enzyme called leukocyte esterase that is found in white blood cells.
• Ketones: Ketones develop when the body uses fat instead of glucose for energy production.
• Nitrites: Nitrites are a type of chemical produced when bacteria are present in the urinary system.
• Protein: Proteins are molecules that help the body carry out vital functions. Proteins are usually found in the blood and only in small amounts in the urine.
• Blood cells: Dipstick tests can be used to look for evidence of blood and blood cells in the urine.

How the Test is Performed

For this test, a clean catch (midstream) urine sample is needed.

Some tests require that you collect all of your urine for 24 hours.

Your doctor will order certain tests, which will be done on the urine sample in a laboratory.

How to Prepare for the Test

For detailed information about how to prepare for the test, how the test will feel, risks with the test, and normal and abnormal values, please see the test your health care provider ordered:

• 24-hour urinary aldosterone excretion rate
• 24-hour urine protein
• Acid loading test (pH)
• Adrenalin – urine test
• Amylase – urine
• Bilirubin – urine
• Calcium – urine
• Citric acid urine test
• Cortisol – urine
• Creatinine – urine
• Cytology exam of urine
• Dopamine – urine test
• Electrolytes – urine
• Epinephrine – urine test
• Glucose – urine
• HCG (qualitative – urine)
• Homovanillic acid (HVA)
• Immunoelectrophoresis – urine
• Immunofixation – urine
• Ketones – urine
• Leucine aminopeptidase – urine
• Myoglobin – urine
• Norepinephrine – urine test
• Normetanephrine
• Osmolality – urine
• Porphyrins – urine
• Potassium – urine
• Protein electrophoresis – urine
• Protein – urine
• RBC – urine
• Sodium – urine
• Urea nitrogen – urine
• Uric acid – urine
• Urinalysis
• Urine Bence-Jones protein
• Urinary casts
• Urine amino acids
• Urine concentration test
• Urine culture (catheterized specimen)
• Urine culture (clean catch)
• Urine dermatan sulfate
• Urine – hemoglobin
• Urine metanephrine
• Urine pH
• Urine specific gravity
• Vanillylmandelic acid (VMA)

Urinalysis

Urine appearance and color; Routine urine test

Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds that pass through the urine.

How the Test is Performed

A urine sample is needed. Your health care provider will tell you what type of urine sample is needed. Two common methods of collecting urine are 24-hour urine collection and clean catch urine specimen .

The sample is sent to a lab, where it is examined for the following:

PHYSICAL COLOR AND APPEARANCE

How the urine sample looks to the naked eye:

• Is it clear or cloudy?
• Is it is pale, or dark yellow, or another color?

MICROSCOPIC APPEARANCE

The urine sample is examined under a microscope to:

• Check if there are any cells, urine crystals, urinary casts , mucus, and other substances.
• Identify any bacteria or other germs.

CHEMICAL APPEARANCE ( urine chemistry )

• A special strip (dipstick) is used to test for substances in the urine sample. The strip has pads of chemicals that change color when they come in contact with substances of interest.

Examples of specific urinalysis tests that may done to check for problems include:

• Red blood cell urine test
• Glucose urine test
• Protein urine test
• Urine pH urine test
• Ketones urine test
• Bilirubin urine test
• Urine specific gravity test

How to Prepare for the Test

Certain medicines change the color of urine, but this is not a sign of disease. Your provider may tell you to stop taking any medicines that can affect test results.

Medicines that can change your urine color include:

• Chloroquine
• Iron supplements
• Levodopa
• Nitrofurantoin
• Phenazopyridine
• Phenothiazine
• Phenytoin
• Riboflavin
• Triamterene

How the Test will Feel

The test involves only normal urination, and there is no discomfort.

Why the Test is Performed

A urinalysis may be done:

• As part of a routine medical exam to screen for early signs of disease
• If you have signs of diabetes or kidney disease, or to monitor you if you are being treated for these conditions
• To check for blood in the urine
• To diagnose a urinary tract infection

Normal Results

Normal urine varies in color from almost colorless to dark yellow. Some foods, such as beets and blackberries, may turn urine red.

Usually, glucose, ketones, protein, and bilirubin are not detectable in urine. The following are not normally found in urine:

• Hemoglobin
• Nitrites
• Red blood cells
• White blood cells

Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test results.

What Abnormal Results Mean

Abnormal results may mean you have an illness, such as:

• Urinary tract infection
• Kidney stones
• Poorly controlled diabetes
• Bladder or kidney cancer

Your provider can discuss the results with you.

Risks

There are no risks.

Considerations

If a home test is used, the person reading the results must be able to see the difference between colors, because the results are interpreted using a color chart.

Clean catch urine sample

Urine culture – clean catch; Urinalysis – clean catch; Clean catch urine specimen; Urine collection – clean catch; UTI – clean catch; Urinary tract infection – clean catch; Cystitis – clean catch

A clean catch is a method of collecting a urine sample to be tested. The clean-catch urine method is used to prevent germs from the penis or vagina from getting into a urine sample.

How the Test is Performed

If possible, collect the sample when urine has been in your bladder for 2 to 3 hours.

You will use a special kit to collect the urine. It will most likely have a cup with a lid and wipes.

Wash your hands with soap and warm water.

GIRLS AND WOMEN

Girls and women need to wash the area between the vagina “lips” (labia). You may be given a special clean-catch kit that contains sterile wipes.

• Sit on the toilet with your legs spread apart. Use two fingers to spread open your labia.
• Use the first wipe to clean the inner folds of the labia. Wipe from the front to the back.
• Use a second wipe to clean over the opening where urine comes out (urethra), just above the opening of the vagina.

To collect the urine sample:

• Keeping your labia spread open, urinate a small amount into the toilet bowl, then stop the flow of urine.
• Hold the urine cup a few inches (or a few centimeters) from the urethra and urinate until the cup is about half full.
• You may finish urinating into the toilet bowl.

BOYS AND MEN

Clean the head of the penis with a sterile wipe. If you are not circumcised, you will need to pull back (retract) the foreskin first.

• Urinate a small amount into the toilet bowl, and then stop the flow of urine.
• Then collect a sample of urine into the clean or sterile cup, until it is half full.
• You may finish urinating into the toilet bowl.

INFANTS

You will be given a special bag to collect the urine. It will be a plastic bag with a sticky strip on one end, made to fit over your baby’s genital area.

If the collection is being taken from an infant, you may need extra collection bags.

Wash the area well with soap and water, and dry. Open and place the bag on your infant.

• For boys, the entire penis can be placed in the bag.
• For girls, place the bag over the labia.

You can put on a diaper over the bag.

Check the baby often and remove the bag after the urine collects in it. Active infants may displace the bag, so you may need to make more than one attempt. Drain the urine into the container you were given and return it to the health care provider as directed.

AFTER COLLECTING THE SAMPLE

Screw the lid tightly on the cup. Do not touch the inside of the cup or the lid.

• Return the sample to the provider.
• If you are at home, place the cup in a plastic bag and put the bag in the refrigerator until you take it to the lab or your provider’s office.

Sodium urine test

Urinary 24 hours sodium; Urine Na+

The sodium urine test measures the amount of sodium in a certain amount of urine.

Sodium can also be measured in a blood sample .

How the Test is Performed

After you provide a urine sample, it is tested in the lab. If needed, the health care provider may ask you to collect your urine at home over 24 hours . Your provider will tell you how to do this. Follow instructions exactly so that the results are accurate.

How to Prepare for the Test

Your health care provider will ask you to temporarily stop taking any medicines that may affect the test result. Tell your provider about all the medicines you take, including:

• Corticosteroids
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Prostaglandins (used to treat conditions such as glaucoma or stomach ulcers)
• Water pills (diuretics)

DO NOT stop taking any medicine before talking to your provider.

How the Test will Feel

The test involves only normal urination. There is no discomfort.

Why the Test is Performed

The test is often used to help determine the cause of an abnormal sodium blood level. It also checks whether your kidneys are removing sodium from the body. It may be used to diagnose or monitor many types of kidney diseases.

Normal Results

For adults, normal urine sodium values are generally 20 mEq/L in a random urine sample and 40 to 220 mEq/L per day (mEq/L/day). Your result depends on how much fluid and salt you take in.

The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test result.

What Abnormal Results Mean

A higher than normal urine sodium level may be due to:

• Certain medicines, such as water pills (diuretics)
• Low function of the adrenal glands
• Inflammation of the kidney that results in salt loss (salt-losing nephropathy)
• Too much salt in the diet

A lower than normal urine sodium level may be a sign of:

• Adrenal glands releasing too much hormone ( hyperaldosteronism )
• Not enough fluid in the body (dehydration)
• Diarrhea and fluid loss
• Heart failure
• Kidney problems, such as chronic kidney disease or kidney failure
• Scarring of the liver ( cirrhosis )

Risks

There are no risks with this test.

Calcium – urine

Urinary Ca+2

This test measures the amount of calcium in urine. All cells need calcium in order to work. Calcium helps build strong bones and teeth. It is important for heart function, and helps with muscle contraction, nerve signaling, and blood clotting.

See also: Calcium – blood

How the Test is Performed

A 24-hour urine sample is most often needed:

• On day 1, urinate into the toilet when you wake up in the morning.
• Collect all urine (in a special container) for the next 24 hours.
• On day 2, urinate into the container in the morning when you wake up.
• Cap the container. Keep it in the refrigerator or a cool place during the collection period. Label the container with your name, the date, and the time you finish it, and return it as instructed.

For an infant, thoroughly wash the area where urine exits the body.

• Open a urine collection bag (a plastic bag with an adhesive paper on one end).
• For males, place the entire penis in the bag and attach the adhesive to the skin.
• For females, place the bag over the labia.
• Diaper as usual over the secured bag.

This procedure may take a few tries. An active baby can move the bag, causing urine to go into the diaper. You may need extra collection bags.

Check the infant often and change the bag after the infant has urinated into it. Drain the urine from the bag into the container provided by your health care provider.

Deliver the sample to the laboratory or to your provider as soon as possible.

How to Prepare for the Test

Many medicines can interfere with blood test results.

• Your provider will tell you if you need to stop taking any medicines before you have this test.
• DO NOT stop or change your medicines without first talking to your provider.

How the Test will Feel

The test involves only normal urination, and there is no discomfort.

Why the Test is Performed

Urine calcium levels can help your doctor:

• Decide on the best treatment for the most common type of kidney stone , which is made of calcium. This type of stone may occur when the kidney leaks too much calcium into the urine.
• Monitor someone who has a problem with the parathyroid gland , which helps control calcium levels in the blood and urine.
• Help diagnose the cause of problems with your blood calcium level or bones.

Normal Results

If you are eating a normal diet, the expected amount of calcium in the urine is 100 to 300 milligrams per day (mg/day) or 2.50 to 7.50 millimoles per 24 hours (mmol/24 hours). If you are eating a diet low in calcium, the amount of calcium in the urine will be 50 to 150 mg/day or 1.25 to 3.75 mmol/24 hours.

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

Note: mg/day = milligrams per day

What Abnormal Results Mean

High levels of urine calcium (above 300 mg/day) may be due to:

• Chronic kidney disease
• High vitamin D levels
• Leaking of calcium from the kidneys into the urine, which causes calcium kidney stones
• Sarcoidosis
• Taking too much calcium
• Too much production of parathyroid hormone (PTH) by the parathyroid glands in the neck (hyperparathyroidism)
• Use of loop diuretics

Low levels of urine calcium may be due to:

• Disorders in which the body does not absorb nutrients from food well
• Disorders in which the kidney handles calcium abnormally
• Parathyroid glands in the neck do not produce enough PTH (hypoparathyroidism)
• Use of a thiazide diuretic
• Very low levels of vitamin D

Urinary casts

Hyaline casts; Granular casts; Renal tubular epithelial casts; Waxy casts; Casts in the urine; Fatty casts; Red blood cell casts; White blood cell casts

Urinary casts are tiny tube-shaped particles that can be found when urine is examined under the microscope during a test called urinalysis .

Urinary casts may be made up of white blood cells, red blood cells, kidney cells, or substances such as protein or fat. The content of a cast can help tell your health care provider whether your kidney is healthy or abnormal.

How the Test is Performed

The urine sample you provide may need to be from your first morning urine. The sample needs to be taken to the lab within 1 hour.

A clean-catch urine sample is needed. The clean-catch method is used to prevent germs from the penis or vagina from getting into a urine sample. To collect your urine, the provider may give you a special clean-catch kit that contains a cleansing solution and sterile wipes. Follow instructions exactly so that the results are accurate.

How to Prepare for the Test

No special preparation is needed.

How the Test will Feel

The test involves only normal urination. There is no discomfort.

Why the Test is Performed

Your provider may order this test to see if your kidneys are working properly. It may also be ordered to check for certain conditions, such as:

• Glomerular disease
• Interstitial kidney disease
• Kidney infections

Normal Results

The absence of cellular casts or presence of a few hyaline casts is normal. The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.

What Abnormal Results Mean

Abnormal results may include:

• Fatty casts are seen in people who have lipids in urine. This is most often a complication of nephrotic syndrome .
• Granular casts are a sign of many types of kidney diseases.
• Red blood cell casts mean there is a microscopic amount of bleeding from the kidney. They are seen in many kidney diseases.
• Renal tubular epithelial cell casts reflect damage to tubule cells in the kidney. These casts are seen in conditions such as renal tubular necrosis , viral disease (such as CMV nephritis ), and kidney transplant rejection .
• Waxy casts can be found in people with advanced kidney disease and chronic kidney failure .
• White blood cell (WBC) casts are more common with acute kidney infections.

Your provider will tell you more about your results.

Risks

There are no risks with this test.

Chloride – urine test

Urinary chloride

The urine chloride test measures the amount of chloride in a certain volume of urine.

How the Test is Performed

After you provide a urine sample, it is tested in the lab. If needed, the health care provider may ask you to collect your urine at home over a period of 24 hours . Your provider will tell you how to do this. Follow instructions exactly so that the results are accurate.

How to Prepare for the Test

Your provider will ask you to temporarily stop taking any medicines that may affect the test result. Tell your provider about all the medicines you take, including:

• Acetazolamide
• Corticosteroids
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Water pills (diuretic medicines)

DO NOT stop taking any medicine before talking to your provider.

How the Test will Feel

The test involves only normal urination. There is no discomfort.

Why the Test is Performed

Your provider may order this test if you have signs of a condition that affects body fluids or acid-base balance.

Normal Results

The normal range is 110 to 250 mEq/L per day. This range depends on the amount of salt and fluid you take in.

The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test result.

What Abnormal Results Mean

A higher than normal urine chloride level may be due to:

• Low function of the adrenal glands
• Inflammation of the kidney that results in salt loss (salt-losing nephropathy)
• Production of an unusually large amount of urine (polyuria)
• Too much salt in the diet

Decreased urine chloride level may be due to:

• Body holding in too much salt (sodium retention)
• Cushing syndrome
• Decreased salt intake
• Fluid loss that occurs with diarrhea, vomiting, sweating, and gastric suction

Risks

There are no risks with this test.

Clean catch urine sample

Urine culture – clean catch; Urinalysis – clean catch; Clean catch urine specimen; Urine collection – clean catch; UTI – clean catch; Urinary tract infection – clean catch; Cystitis – clean catch

A clean catch is a method of collecting a urine sample to be tested. The clean-catch urine method is used to prevent germs from the penis or vagina from getting into a urine sample.

How the Test is Performed

If possible, collect the sample when urine has been in your bladder for 2 to 3 hours.

You will use a special kit to collect the urine. It will most likely have a cup with a lid and wipes.

Wash your hands with soap and warm water.

GIRLS AND WOMEN

Girls and women need to wash the area between the vagina “lips” (labia). You may be given a special clean-catch kit that contains sterile wipes.

• Sit on the toilet with your legs spread apart. Use two fingers to spread open your labia.
• Use the first wipe to clean the inner folds of the labia. Wipe from the front to the back.
• Use a second wipe to clean over the opening where urine comes out (urethra), just above the opening of the vagina.

To collect the urine sample:

• Keeping your labia spread open, urinate a small amount into the toilet bowl, then stop the flow of urine.
• Hold the urine cup a few inches (or a few centimeters) from the urethra and urinate until the cup is about half full.
• You may finish urinating into the toilet bowl.

BOYS AND MEN

Clean the head of the penis with a sterile wipe. If you are not circumcised, you will need to pull back (retract) the foreskin first.

• Urinate a small amount into the toilet bowl, and then stop the flow of urine.
• Then collect a sample of urine into the clean or sterile cup, until it is half full.
• You may finish urinating into the toilet bowl.

INFANTS

You will be given a special bag to collect the urine. It will be a plastic bag with a sticky strip on one end, made to fit over your baby’s genital area.

If the collection is being taken from an infant, you may need extra collection bags.

Wash the area well with soap and water, and dry. Open and place the bag on your infant.

• For boys, the entire penis can be placed in the bag.
• For girls, place the bag over the labia.

You can put on a diaper over the bag.

Check the baby often and remove the bag after the urine collects in it. Active infants may displace the bag, so you may need to make more than one attempt. Drain the urine into the container you were given and return it to the health care provider as directed.

AFTER COLLECTING THE SAMPLE

Screw the lid tightly on the cup. Do not touch the inside of the cup or the lid.

• Return the sample to the provider.
• If you are at home, place the cup in a plastic bag and put the bag in the refrigerator until you take it to the lab or your provider’s office.

Citric acid urine test

Urine – citric acid test

Citric acid urine test measures the level of citric acid in urine.

How the Test is Performed

You will need to collect your urine at home over 24 hours . Your health care provider will tell you how to do this. Follow instructions exactly so that the results are accurate.

How to Prepare for the Test

No special preparation is necessary for this test. But the results are affected by your diet, and this test is usually done while you are on a normal diet. Ask your provider for more information.

How the Test will Feel

The test involves only normal urination, and there is no discomfort.

Why the Test is Performed

The test is used to diagnose renal tubular acidosis and evaluate kidney stone disease.

Normal Results

The normal range is 320 to 1,240 mg per 24 hours.

Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test results.

What Abnormal Results Mean

A low level of citric acid may mean renal tubular acidosis and a tendency to form calcium kidney stones.

The following may decrease urine citric acid levels:

• Chronic kidney failure
• Diabetes
• Excessive muscle activity
• Medicines called angiotensin converting enzyme inhibitors (ACE inhibitors)
• Parathyroid glands do not produce enough of its hormone ( hypoparathyroidism )
• Too much acid in the body fluids ( acidosis )

The following may increase urine citric acid levels:

• A high carbohydrate diet
• Estrogen therapy
• Vitamin D

Risks

There are no risks with this test.

Hemoglobinuria test

Urine – hemoglobin

Hemoglobinuria test is a urine test that checks for hemoglobin in the urine.

How the Test is Performed

A clean-catch (midstream) urine sample is needed. The clean-catch method is used to prevent germs from the penis or vagina from getting into a urine sample. To collect your urine, you may get a special clean-catch kit from your health care provider that contains a cleansing solution and sterile wipes. Follow instructions exactly so that the results are accurate.

How to Prepare for the Test

No special preparation is necessary for this test. If the collection is being taken from an infant, a couple of extra collection bags may be necessary.

How the Test will Feel

The test involves only normal urination. There is no discomfort.

Why the Test is Performed

Hemoglobin is a molecule attached to red blood cells. Hemoglobin helps move oxygen and carbon dioxide through the body.

Red blood cells have an average life span of 120 days. After this time, they are broken down into parts that can make a new red blood cell. This breakdown takes place in the spleen, bone marrow, and liver. If the red blood cells break down in the blood vessels, their parts move freely in the bloodstream.

If the level of hemoglobin in the blood rises too high, then hemoglobin begins to appear in the urine. This is called hemoglobinuria.

This test may be used to help diagnose causes of hemoglobinuria, such as those listed in the “What Abnormal Results Mean” section.

Normal Results

Normally, hemoglobin does not appear in the urine.

What Abnormal Results Mean

Hemoglobinuria may be a result of any of the following:

• A kidney disorder called acute glomerulonephritis
• Burns
• Crushing injury
• Hemoglobin C disease
• Hemoglobin SC disease
• Hemolytic uremic syndrome (HUS)
• Kidney infection
• Kidney tumor
• Malaria
• Paroxysmal nocturnal hemoglobinuria
• Paroxysmal cold hemoglobinuria
• Sickle cell anemia
• Thalassemia
• Thrombotic thrombocytopenic purpura (TTP)
• Transfusion reaction
• Tuberculosis

RBC urine test

Red blood cells in urine; Hematuria test; Urine – red blood cells

The RBC urine test measures the number of red blood cells in a urine sample.

How the Test is Performed

A random sample of urine is collected. Random means that the sample is collected at any time either at the lab or at home. If needed, the health care provider may ask you to collect your urine at home over 24 hours . Your provider will tell you how to do this.

A clean-catch urine sample is needed. The clean-catch method is used to prevent germs from the penis or vagina from getting into a urine sample. To collect your urine, the provider may give you a special clean-catch kit that contains a cleansing solution and sterile wipes. Follow instructions exactly so that the results are accurate.

How to Prepare for the Test

No special preparation is necessary for this test.

How the Test will Feel

The test involves only normal urination. There is no discomfort.

Why the Test is Performed

This test is done as part of a urinalysis test .

Normal Results

A normal result is 4 red blood cells per high power field (RBC/HPF) or less when the sample is examined under a microscope.

The example above is a common measurement for a result of this test. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test result.

What Abnormal Results Mean

A higher than normal number of RBCs in the urine may be due to:

• Kidney and other urinary tract problems, such as infection, tumor , or stones
• Kidney injury
• Prostate problems
• Bladder or kidney cancer

Risks

There are no risks with this test.

Urine 24-hour volume

Urine volume; 24-hour urine collection; Urine protein – 24 hour

The urine 24-hour volume test measures the amount of urine produced in a day. The amount of creatinine, protein, and other chemicals released into the urine during this period is often tested.

How the Test is Performed

For this test, you must urinate into a special bag or container every time you use the bathroom for a 24-hour period.

• On day 1, urinate into the toilet when you get up in the morning.
• Afterwards, collect all urine in a special container for the next 24 hours.
• On day 2, urinate into the container when you get up in the morning.
• Cap the container. Keep it in the refrigerator or a cool place during the collection period.
• Label the container with your name, the date, the time of completion, and return it as instructed.

For an infant:

Thoroughly wash the area around the urethra (the hole where urine flows out). Open a urine collection bag (a plastic bag with an adhesive paper on one end).

• For males, place the entire penis in the bag and attach the adhesive to the skin.
• For females, place the bag over the two folds of skin on either side of the vagina (labia). Put a diaper on the baby (over the bag).

Check the infant often, and change the bag after the infant has urinated. Empty the urine from the bag into the container provided by your health care provider.

An active infant can cause the bag to move. It may take more than 1 try to collect the sample.

When finished, label the container and return it as instructed.

How to Prepare for the Test

Certain drugs can also affect the test results. Your provider may tell you to stop taking certain medicines before the test. Never stop taking medicine without first talking to your provider.

The following may also affect test results:

• Dehydration
• Any type of x-ray exam with dye (contrast material) within 3 days before the urine test
• Fluid from the vagina that gets into the urine
• Emotional stress
• Heavy exercise
• Urinary tract infection

How the Test will Feel

The test involves only normal urination, and there is no discomfort.

Why the Test is Performed

You may have this test if there are signs of damage to your kidney function on blood, urine, or imaging tests.

Urine volume is normally measured as part of a test that measures the amount of a substances passed in your urine in a day, such as:

• Creatinine
• Sodium
• Potassium
• Nitrogen
• Protein

This test may also be done if you have polyuria (abnormally large volumes of urine), such as is seen in people with diabetes insipidus .

Normal Results

The normal range for 24-hour urine volume is 800 to 2000 milliliters per day (with a normal fluid intake of about 2 liters per day).

The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test results.

What Abnormal Results Mean

Disorders that cause reduced urine volume include dehydration, not enough fluid intake, or some types of chronic kidney disease.

Some of the conditions that cause increased urine volume include:

• Diabetes insipidus – renal
• Diabetes insipidus – central
• Diabetes
• High fluid intake
• Some forms of kidney disease
• Use of diuretic medicines

Protein urine test

Urine protein; Albumin – urine; Urine albumin; Proteinuria; Albuminuria

The protein urine dipstick test measures the presence of proteins, such as albumin, in a urine sample.

Albumin and protein can also be measured using a blood test .

How the Test is Performed

After you provide a urine sample, it is tested. The health care provider uses a dipstick made with a color-sensitive pad. The color change on the dipstick tells the provider the level of acid in your urine.

If needed, your provider may ask you to collect your urine at home over 24 hours . Your provider will tell you how to do this. Follow instructions exactly so that the results are accurate.

How to Prepare for the Test

Different medicines can change the result of this test. Before the test, tell your provider which medicines you are taking. DO NOT stop taking any medicine before talking to your provider.

The following may also interfere with test results:

• Dehydration
• Dye (contrast media) if you have a radiology scan within 3 days before the urine test
• Strenuous exercise
• Urinary tract infection
• Urine contaminated with fluids from the vagina

How the Test Will Feel

The test only involves normal urination. There is no discomfort.

Why the Test is Performed

This test is most often done when your provider suspects you have kidney disease. It may be used as a screening test.

Although small amounts of protein are normally in urine, a routine dipstick test may not detect them. A urine microalbumin test can be performed to detect small amounts of albumin in the urine that may not be detected on dipstick testing. If the kidney is diseased, proteins may be detected on a dipstick test, even if blood protein levels are normal.

Normal Results

For a random urine sample, normal values are 0 to 20 mg/dL.

For a 24-hour urine collection, the normal value is less than 80 mg per 24 hours.

The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test results.

What Abnormal Results Mean

Larger amounts of protein in the urine may be due to:

• Heart failure
• Kidney problems, such as kidney damage , diabetic kidney disease , and kidney cysts
• Loss of body fluids (dehydration)
• Problems during pregnancy, such as seizures due to eclampsia or high blood pressure caused by preeclampsia
• Urinary tract problems, such as a bladder tumor or infection
• Multiple myeloma

Risks

There are no risks with this test.

Aminoaciduria

Amino acids – urine; Urine amino acids

Aminoaciduria is an abnormal amount of amino acids in the urine. Amino acids are the building blocks for proteins in the body.

How the Test is Performed

A clean-catch urine sample is needed. This is often done at your doctor’s office or health clinic.

How to Prepare for the Test

Most of the time you do not need to take special steps before this test. Make sure your doctor knows all of the medicines you recently used. If this test is being done on an infant who is breast-feeding, make sure the health care provider knows what medicines the nursing mother is taking.

How the Test will Feel

The test involves only normal urination.

Why the Test is Performed

This test is done to measure amino acid levels in the urine. There are many different types of amino acids. It is common for some of each kind to be found in the urine. Increased levels of individual amino acids can be a sign of a problem with metabolism.

Normal Results

The specific value is measured in micromoles per deciliter (micromol/dL) or micromoles per liter (micromol/l).

Alanine

• Children: 65 to 190 micromol/dL or 650 to 1,900 micromol/L
• Adults: 160 to 690 micromol/dL or 1600 to 6,900 micromol/L

Alpha-aminoadipic acid

• Children: 25 to 78 micromol/dL or 250 to 780 micromol/L
• Adults: 0 to 165 micromol/dL or 0 to 1,650 micromol/L

Alpha-amino-N-butyric acid

• Children: 7 to 25 micromol/dL or 70 to 250 micromol/L
• Adults: 0 to 28 micromol/dL or 0 to 280 micromol/L

Arginine

• Children: 10 to 25 micromol/dL or 100 to 250 micromol/L
• Adults: 13 to 64 micromol/dL or 130 to 640 micromol/L

Asparagine

• Children: 15 to 40 micromol/dL or 150 to 400 micromol/L
• Adults: 34 to 100 micromol/dL or 340 to 1,000 micromol/L

Aspartic acid

• Children: 10 to 26 micromol/dL or 100 to 260 micromol/L
• Adults: 14 to 89 micromol/dL or 140 to 890 micromol/L

Beta-alanine

• Children: 0 to 42 micromol/dL or 0 to 420 micromol/L
• Adults: 0 to 93 micromol/dL or 0 to 930 micromol/L

Beta-amino-isobutyric acid

• Children: 25 to 96 micromol/dL or 250 to 960 micromol/L
• Adults: 10 to 235 micromol/dL or 100 to 2,350 micromol/L

Carnosine

• Children: 34 to 220 micromol/dL or 340 to 2,200 micromol/L
• Adults: 16 to 125 micromol/dL or 160 to 1,250 micromol/L

Citrulline

• Children: 0 to 13 micromol/dL or 0 to 130 micromol/L
• Adults: 0 to 11 micromol/dL or 0 to 110 micromol/L

Cystine

• Children: 11 to 53 micromol/dL or 110 to 530 micromol/L
• Adults: 28 to 115 micromol/dL or 280 to 1,150 micromol/L

Glutamic acid

• Children: 13 to 22 micromol/dL or 130 to 220 micromol/L
• Adults: 27 to 105 micromol/dL or 270 to 1,050 micromol/L

Glutamine

• Children: 150 to 400 micromol/dL or 1,500 to 4,000 micromol/L
• Adults: 300 to 1,040 micromol/dL or 3,000 to 10,400 micromol/L

Glycine

• Children: 195 to 855 micromol/dL or 1,950 to 8,550 micromol/L
• Adults: 750 to 2,400 micromol/dL or 7,500 to 24,000 micromol/L

Histidine

• Children: 46 to 725 micromol/dL or 460 to 7,250 micromol/L
• Adults: 500 to 1500 micromol/dL or 5,000 to 15,000 micromol/L

Hydroxyproline

• Children: not measured
• Adults: not measured

Isoleucine

• Children: 3 to 15 micromol/dL or 30 to 150 micromol/L
• Adults: 4 to 23 micromol/dL or 40 to 230 micromol/L

Leucine

• Children: 9 to 23 micromol/dL or 90 to 230 micromol/L
• Adults: 20 to 77 micromol/dL or 200 to 770 micromol/L

Lysine

• Children: 19 to 140 micromol/dL or 190 to 1,400 micromol/L
• Adults: 32 to 290 micromol/dL or 320 to 2,900 micromol/L

Methionine

• Children: 7 to 20 micromol/dL or 70 to 200 micromol/L
• Adults: 5 to 30 micromol/dL or 50 to 300 micromol/L

1-methylhistidine

• Children: 41 to 300 micromol/dL or 410 to 3,000 micromol/L
• Adults: 68 to 855 micromol/dL or 680 to 8,550 micromol/L

3-methylhistidine

• Children: 42 to 135 micromol/dL or 420 to 1,350 micromol/L
• Adults: 64 to 320 micromol/dL or 640 to 3,200 micromol/L

Ornithine

• Children: 3 to 16 micromol/dL or 30 to 160 micromol/L
• Adults: 5 to 70 micromol/dL or 50 to 700 micromol/L

Phenylalanine

• Children: 20 to 61 micromol/dL or 200 to 610 micromol/L
• Adults: 36 to 90 micromol/dL or 360 to 900 micromol/L

Phosphoserine

• Children: 16 to 34 micromol/dL or 160 to 340 micromol/L
• Adults: 28 to 95 micromol/dL or 280 to 950 micromol/L

Phosphoethanolamine

• Children: 24 to 66 micromol/dL or 240 to 660 micromol/L
• Adults: 17 to 95 micromol/dL or 170 to 950 micromol/L

Proline

• Children: not measured
• Adults: not measured

Serine

• Children: 93 to 210 micromol/dL or 930 to 2,100 micromol/L
• Adults: 200 to 695 micromol/dL or 2,000 to 6,950 micromol/L

Taurine

• Children: 62 to 970 micromol/dL or 620 to 9,700 micromol/L
• Adults: 267 to 1290 micromol/dL or 2,670 to 12,900 micromol/L

Threonine

• Children: 25 to 100 micromol/dL or 250 to 1,000 micromol/L
• Adults: 80 to 320 micromol/dL or 800 to 3,200 micromol/L

Tyrosine

• Children: 30 to 83 micromol/dL or 300 to 830 micromol/L
• Adults: 38 to 145 micromol/dL or 380 1,450 micromol/L

Valine

• Children: 17 to 37 micromol/dL or 170 to 370 micromol/L
• Adults: 19 to 74 micromol/dL or 190 to 740 micromol/

Normal value ranges may vary slightly among different laboratories. Talk to your health care provider about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

What Abnormal Results Mean

Increased total urine amino acids may be due to:

• Alkaptonuria
• Canavan disease
• Cystinosis
• Cystathioninuria
• Fructose intolerance
• Galactosemia
• Hartnup disease
• Homocystinuria
• Hyperammonemia
• Hyperparathyroidism
• Maple syrup urine disease
• Methylmalonic acidemia
• Multiple myeloma
• Ornithine transcarbamylase deficiency
• Osteomalacia
• Propionic acidemia
• Rickets
• Tyrosinemia type 1
• Tyrosinemia type 2
• Viral hepatitis
• Wilson disease

Considerations

Screening infants for increased levels of amino acids can help detect problems with metabolism. Early treatment for these conditions may prevent complications in the future.

Quantitative Bence-Jones protein test

Immunoglobulin light chains – urine; Urine Bence-Jones protein

This test measures the level of abnormal proteins called Bence-Jones proteins in the urine.

How the Test is Performed

A clean-catch urine sample is needed. The clean-catch method is used to prevent germs from the penis or vagina from getting into a urine sample. To collect your urine, the health care provider may give you a special clean-catch kit that contains a cleansing solution and sterile wipes. Follow instructions exactly so that the results are accurate.

The sample is sent to the lab. There, one of many methods is used to detect Bence-Jones proteins. One method, called immunoelectrophoresis , is the most accurate.

How the Test will Feel

The test involves only normal urination, and there is no discomfort.

Why the Test is Performed

Bence-Jones proteins are a part of regular antibodies called light chains. These proteins are not normally in urine. Sometimes, when your body makes too many antibodies, the level of light chains also rises. Bence-Jones proteins are small enough to be filtered out by the kidneys. The proteins then spill into the urine.

Your provider may order this test:

• To diagnose conditions that lead to protein in the urine
• If you have a lot of protein in your urine
• If you have signs of a blood cancer called multiple myeloma

Normal Results

A normal result means no Bence-Jones proteins are found in your urine.

What Abnormal Results Mean

Bence-Jones proteins are rarely found in urine. If they are, it is usually associated with multiple myeloma .

An abnormal result may also be due to:

• An abnormal buildup of proteins in tissues and organs ( amyloidosis )
• Blood cancer called chronic lymphocytic leukemia
• Lymph system cancer (lymphoma)
• Buildup in the blood of a protein called M-protein (monoclonal gammopathy of unknown significance; MGUS)
• White blood cell cancer called Waldenström macroglobulinemia

Risks

There are no risks with this test.

Catecholamines – urine

Dopamine-urine test; Epinephrine-urine test; Adrenalin-urine test; Urine metanephrine; Normetanephrine; Norepinephrine-urine test; Urine catecholamines; VMA; HVA; Metanephrine; Homovanillic acid (HVA)

Catecholamines are chemicals made by nerve tissue (including the brain) and the adrenal gland.

The main types of catecholamines are dopamine, norepinephrine, and epinephrine. These chemicals break down into other components, which leave your body through your urine.

A urine test can be done to measure the level of catecholamines in your body. Separate urine tests may be done to measure related substances.

Catecholamines can also be measured with a blood test .

How the Test is Performed

For this test, you must collect your urine in a special bag or container every time you urinate for 24-hour period.

• On day 1, urinate over the toilet when you wake up in the morning and discard that urine.
• Urinate into the special container every time you use the bathroom for the next 24 hours. Keep it in the refrigerator or a cool place during the collection period.
• On day 2, urinate into the container in the morning again when you wake up.
• Label the container with your name, the date, the time of completion, and return it as instructed.

For an infant, thoroughly wash the area where urine exits the body.

• Open a urine collection bag (a plastic bag with an adhesive paper on one end).
• For males, place the entire penis in the bag and attach the adhesive to the skin.
• For females, place the bag over the labia.
• Diaper as usual over the secured bag.

This procedure may take a few tries. An active baby can move the bag causing urine to go into the diaper.

Check the infant often and change the bag after the infant has urinated into it. Drain the urine from the bag into the container provided by your health care provider.

Deliver the sample to the laboratory or to your provider as soon as possible.

How to Prepare for the Test

Stress and heavy exercise may affect the test results.

Some foods can increase catacholamines in your urine. You may need to avoid the follow foods for several days before the test:

• Coffee
• Tea
• Bananas
• Chocolate
• Cocoa
• Citrus fruits
• Vanilla

Many medicines can interfere with test results.

• Your provider will tell you if you need to stop taking any medicines before you have this test.
• DO NOT stop or change your medicines without talking to your provider first.

How the Test will Feel

The test involves only normal urination, and there is no discomfort.

Why the Test is Performed

The test is usually done to diagnose an adrenal gland tumor called pheochromocytoma . It may also be used to diagnose neuroblastoma . Urine catecholamine levels are increased in most persons with neuroblastoma.

The urine test for catecholamines may also be used to monitor those who are receiving treatment for these conditions.

Normal Results

All of the catecholamines are broken down into inactive substances that appear in the urine:

• Dopamine becomes homovanillic acid (HVA)
• Norepinephrine becomes normetanephrine and vanillylmandelic acid (VMA)
• Epinephrine becomes metanephrine and VMA

The following normal values are the amount of the substance found in the urine over a 24-hour period:

• Dopamine: 65 to 400 micrograms (mcg)/24 hours (425 to 2610 nmol/24 hours)
• Epinephrine: 0.5 to 20 mcg/24 hours
• Metanephrine: 24 to 96 mcg/24 hours (some laboratories give the range as 140 to 785 mcg/24 hours)
• Norepinephrine: 15 to 80 mcg/24 hours (89 to 473 nmol/24 hours)
• Normetanephrine: 75 to 375 mcg/24 hours
• Total urine catecholamines: 14 to 110 mcg/24 hours
• VMA: 2 to 7 milligrams (mg)/24 hours (10.09 mcmol/24 hours)

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

What Abnormal Results Mean

Elevated levels of urinary catecholamines may indicate:

• Acute anxiety
• Ganglioneuroblastoma (very rare)
• Ganglioneuroma (very rare)
• Neuroblastoma (rare)
• Pheochromocytoma (rare)
• Severe stress

The test may also be performed for:

• Multiple endocrine neoplasia (MEN) II

Risks

There are no risks.

Considerations

Several foods and drugs, as well as physical activity and stress, can affect the accuracy of this test.

Urine concentration test

Water loading test; Water deprivation test

A urine concentration test measures the ability of the kidneys to conserve or excrete water.

How the Test is Performed

For this test, the specific gravity of urine , urine electrolytes , and/or urine osmolality are measured before and after one or more of the following:

• Water loading. Drinking large amounts of water or receiving fluids through a vein.
• Water deprivation. Not drinking fluids for a certain amount of time.
• ADH administration. Receiving antidiuretic hormone (ADH), which should cause the urine to become concentrated.

After you provide a urine sample, it is tested right away. For urine specific gravity, the health care provider uses a dipstick made with a color-sensitive pad. The dipstick color changes and tells the provider the specific gravity of your urine. The dipstick test gives only a rough result. For a more accurate specific gravity result or measurement of urine electrolytes or osmolality, your provider will send your urine sample to a lab.

If needed, your provider may ask you to collect your urine at home over 24 hours . Your provider will tell you how to do this. Follow instructions exactly so that the results are accurate.

How to Prepare for the Test

Eat a normal, balanced diet for several days before the test. Your provider will give you instructions for water loading or water deprivation.

Your provider will ask you to temporarily stop any medicines that may affect the test results. Be sure to tell your provider about all the medicines you take, including dextran and sucrose. DO NOT stop taking any medicine before talking to your provider.

Also tell your provider if you recently received intravenous dye (contrast medium) for an x-ray. The dye can also affect test results.

How the Test will Feel

The test involves only normal urination. There is no discomfort.

Why the Test is Performed

This test is most often done if your doctor suspects central diabetes insipidus . The test can help tell that disease from nephrogenic diabetes insipidus .

This test may also be done if you have signs of syndrome of inappropriate ADH (SIADH).

Normal Results

In general, normal values for specific gravity are as follows:

• 1.000 to 1.030 (normal specific gravity)
• 1.001 after drinking excessive amounts of water
• More than 1.030 after avoiding fluids
• Concentrated after receiving ADH

Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test results.

What Abnormal Results Mean

Increased urine concentration may be due to different conditions, such as:

• Heart failure
• Loss of body fluids (dehydration) from diarrhea or excessive sweating
• Narrowing of the kidney artery (renal arterial stenosis)
• Sugar, or glucose, in the urine
• Syndrome of inappropriate antidiuretic hormone secretion ( SIADH )
• Vomiting

Decreased urine concentration may indicate:

• Diabetes insipidus
• Drinking too much fluid
• Kidney failure (loss of ability to reabsorb water)
• Severe kidney infection (pyelonephritis)

Risks

There are no risks with this test.