Urinalysis (complete, with microscopy)

What it measures

The dipstick part reports specific gravity (how concentrated the urine is), pH, protein, glucose, ketones, blood, bilirubin, urobilinogen, nitrite, and leukocyte esterase (an enzyme from white blood cells). The microscopy part counts red cells, white cells, and skin-type (epithelial) cells, and looks for casts, crystals, bacteria, and yeast. Hydration, recent exercise, diet, periods, and some medicines can all shift the results.

Who should consider it

• Adults who want a baseline check of kidneys and urine
• People with diabetes or high blood pressure tracking kidney health
• Anyone with mild urinary symptoms who also plans to see a clinician
• People whose earlier test showed blood or protein in the urine

How to read your result

• Many skin-type (squamous epithelial) cells suggest the sample picked up skin contamination. A repeat clean-catch sample often gives a clearer answer.
• Positive leukocyte esterase or nitrite fits with a urinary infection, but a urine culture confirms it and names the germ. A negative dipstick does not fully rule out infection when symptoms are strong.
• A positive dipstick for blood needs a microscope check. The American Urological Association defines microscopic blood as 3 or more red cells per high-power field, and recommends follow-up when no harmless cause (such as a period or infection) explains it.
• Glucose in urine can come from high blood sugar or from SGLT2 inhibitor medicines, which work by sending sugar into the urine. Trace protein can follow exercise, fever, or dehydration.

Reference ranges differ between labs. Use the range printed on your own report.

When to get care right away. Fever with back or side pain, vomiting, visible blood clots in the urine, or being unable to pee need same-day medical care. Severe pain, confusion, or feeling faint: go to an emergency room or call 911.

What to do next

Repeat an abnormal urinalysis on a clean sample before drawing conclusions, since contamination and timing explain many odd results. Persistent protein, blood, or glucose needs a visit with a clinician, who may add a urine albumin-to-creatinine ratio, a urine culture, or blood tests for kidney function.