A large amount may indicate an infection, kidney disease, or other serious medical condition. Other names: microscopic urine analysis, microscopic examination of urine, urine test, urine analysis, UA.
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:. 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. 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. Results are often reported as an approximate amount, such as "few," moderate," or "many" cells. If your results are not in the normal range, it doesn't necessarily mean that you have a medical condition that requires treatment. The clarity of urine is measured as either clear, slightly clear, cloudy, or turbid.
Urine clarity, like urine color, suggests that substances may be present in the urine; for example, turbid urine suggests the presence of protein or excess cellular material. However, accurate conclusions regarding the origin of the urine clarity cannot be drawn until further chemical and microscopic tests are performed. The physical examination also includes specific gravity, which measures the concentration of the urine sample.
Specific gravity compares the concentration of urine to that of water 1. Usually it is better for the urine given in a sample to be more concentrated; this allows the laboratory to more accurately detect substances being excreted by your body. If your urine is very dilute i. The chemical examination measures several features of the urine. Either the laboratory technician or an automated instrument will then read the reaction color for each test pad to determine the result for each test.
The use of automated instruments helps to eliminate discrepancies that arise with human interpretation. The microscopic examination uses a microscope to identify and count cells, crystals, bacteria, mucous, and other substances that may be present in the urine. All information contained within the Johns Hopkins Lupus Center website is intended for educational purposes only. Physicians and other health care professionals are encouraged to consult other sources and confirm the information contained within this site.
Consumers should never disregard medical advice or delay in seeking it because of something they may have read on this website. Chemical Analysis The chemical examination measures several features of the urine. The kidneys regulate this acid-base chemistry by reabsorbing sodium and secreting hydrogen and ammonium ions.
When the body retains excess sodium or acid, urine becomes more acidic i. Highly acidic urine can occur with uncontrolled diabetes, diarrhea, starvation, dehydration, and certain respiratory diseases. This can occur with urinary tract infections and certain kidney and lung conditions. Certain foods can also alter the pH of your urine. For example, eating excessive protein or cranberries can make your urine more acidic, whereas eating a low-carbohydrate or vegetarian diet can make your urine more basic.
Sometimes people are asked by their doctors to regulate the pH of their urine through diet in order to manage certain diseases or medications. Their presence indicates inflammation of the kidney, because such casts will not form except in the kidney. When cellular casts remain in the nephron for some time before they are flushed into the bladder urine, the cells may degenerate to become a coarsely granular cast, later a finely granular cast, and ultimately, a waxy cast.
Granular and waxy casts are be believed to derive from renal tubular cell casts. Broad casts are believed to emanate from damaged and dilated tubules and are therefore seen in end-stage chronic renal disease. The so-called telescoped urinary sediment is one in which red cells, white cells, oval fat bodies, and all types of casts are found in more or less equal profusion.
The conditions which may lead to a telescoped sediment are: 1 lupus nephritis 2 hypertensive emergency 3 diabetic glomerulosclerosis, and 4 rapidly progressive glomerulonephritis. In end-stage kidney disease of any cause, the urinary sediment often becomes very scant because few remaining nephrons produce dilute urine. Bacteria are common in urine specimens because of the abundant normal microbial flora of the vagina or external urethral meatus and because of their ability to rapidly multiply in urine standing at room temperature.
Therefore, microbial organisms found in all but the most scrupulously collected urines should be interpreted in view of clinical symptoms. Diagnosis of bacteriuria in a case of suspected urinary tract infection requires culture. A colony count may also be done to see if significant numbers of bacteria are present.
Multiple organisms reflect contamination. However, the presence of any organism in catheterized or suprapubic tap specimens should be considered significant. Yeast cells may be contaminants or represent a true yeast infection. They are often difficult to distinguish from red cells and amorphous crystals but are distinguished by their tendency to bud.
Most often they are Candida, which may colonize bladder, urethra, or vagina. Common crystals seen even in healthy patients include calcium oxalate, triple phosphate crystals and amorphous phosphates. Very uncommon crystals include: cystine crystals in urine of neonates with congenital cystinuria or severe liver disease, tyrosine crystals with congenital tyrosinosis or marked liver impairment, or leucine crystals in patients with severe liver disease or with maple syrup urine disease.
General "crud" or unidentifiable objects may find their way into a specimen, particularly those that patients bring from home. Spermatozoa can sometimes be seen. Rarely, pinworm ova may contaminate the urine. In Egypt, ova from bladder infestations with schistosomiasis may be seen.
Random collection taken at any time of day with no precautions regarding contamination. The sample may be dilute, isotonic, or hypertonic and may contain white cells, bacteria, and squamous epithelium as contaminants. In females, the specimen may cont contain vaginal contaminants such as trichomonads, yeast, and during menses, red cells. Early morning collection of the sample before ingestion of any fluid.
This is usually hypertonic and reflects the ability of the kidney to concentrate urine during dehydration which occurs overnight. If all fluid ingestion has been avoided since 6 p. Clean-catch, midstream urine specimen collected after cleansing the external urethral meatus. A cotton sponge soaked with benzalkonium hydrochloride is useful and non-irritating for this purpose.
A midstream urine is one in which the first half of the bladder urine is discarded and the collection vessel is introduced into the urinary stream to catch the last half. The first half of the stream serves to flush contaminating cells and microbes from the outer urethra prior to collection.
This sounds easy, but it isn't try it yourself before criticizing the patient. Catherization of the bladder through the urethra for urine collection is carried out only in special circumstances, i. This procedure risks introducing infection and traumatizing the urethra and bladder, thus producing iatrogenic infection or hematuria. Suprapubic transabdominal needle aspiration of the bladder. When done under ideal conditions, this provides the purest sampling of bladder urine.
Persistent haematuria should be investigated, as it may indicate disease such as malignancy. Epithelial cells - Squamous epithelial cells in urine usually indicate contamination of the specimen from the distal urethra in men and the opening of the vagina in women. It is not uncommon to find transitional epithelial cells in the normal urine sediment; however, if they are present in large numbers or clumps and have an abnormal histology they may indicate malignancy affecting the urothelium the lining of the bladder.
Urine testing is a simple procedure and a valuable tool, which yields important information about diseases ranging from a urinary tract infection to diabetes, cancer of the bladder or renal disease. Effective use of urine testing depends on using the correct procedure to collect the urine sample and the measures adopted to reduce the risk of contamination. Nurses need appropriate knowledge and skills to interpret results.
To give patients the best possible service, nurses must be able to use the results appropriately. It is important to remember that urine testing should not be viewed in isolation and that results should be reviewed as part of an holistic assessment. Sign in or Register a new account to join the discussion. You are here: Archive. Understanding urine testing.
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