Complete Urinalysis (Urine Test)

What is a complete urinalysis?

A complete urinalysis, commonly known as a urine test, is a basic laboratory test in which many properties of the urine are examined at the same time. The kidneys filter the blood and remove waste products and excess fluid in the urine; the composition of the urine therefore holds important clues about the state of the kidneys, the urinary tract and metabolism. The test provides results quickly and is frequently used in routine health checks.

The analysis consists of three stages. In the physical examination, the color, clarity and specific gravity of the urine are assessed; in the chemical examination, pH, protein, glucose, ketones, bilirubin, urobilinogen, blood, nitrite and leukocyte esterase are tested using a urine dipstick or automated analyzers. In the microscopic examination, red and white blood cells, epithelial cells, casts, crystals, bacteria and yeasts in the urine sediment are evaluated. When all this information is interpreted together, a much more meaningful picture emerges than from any single parameter.

When is a complete urinalysis ordered?

A complete urinalysis is ordered both to help with diagnosis in people who have complaints and to catch problems that cause no symptoms at an early stage. It is also among the tests frequently used in preparation for surgery, during pregnancy follow-up and in regular check-ups. Your doctor may also use this test to monitor the effect of certain medicines on the kidneys.

• Burning when urinating, frequent urination or a change in urine color
• Flank or lower back pain, suspected kidney stones
• Monitoring of diabetes, hypertension and kidney diseases
• Swelling (edema) in the body or foamy urine
• Pregnancy follow-up and routine health checks

How should you prepare for a complete urinalysis?

You do not need to fast for this test. The first morning urine is preferred because it is more concentrated and better reflects any findings; drinking a lot of water just before the test can dilute the urine. High-dose vitamin C can affect some chemical measurements, while foods such as beets and certain medicines can change the color of the urine. You are advised to mention the medicines and supplements you take and, if you are on your period, to postpone the test for a few days.

After washing your hands and cleaning the genital area, pass the first part of the urine into the toilet, collect the middle part in the sterile container and close the container tightly. Taking care not to touch the inside of the container prevents the result from being affected by cells and bacteria from outside. If you would like to give the sample at home, a sterile container is left with you, you collect the sample yourself, and the nurse picks it up shortly afterwards. Because cells can break down the longer urine stands, the sample should be examined within a few hours.

What does a complete urinalysis result mean?

There is no single reference range for a complete urinalysis; each parameter is reported separately as negative, positive or a numerical value. Positive nitrite and leukocyte esterase, together with many white blood cells and bacteria seen under the microscope, suggest a urinary tract infection, and your doctor may order a culture. Blood or red blood cells in the urine can have various causes, such as stones, infection, intense exercise or kidney disease.

A positive protein result may be temporary, but it may also indicate a problem with the kidneys' filtering function. Glucose in the urine most often suggests high blood sugar, although some diabetes medicines can also increase the amount of sugar passing into the urine; the presence of ketones may be related to prolonged fasting or uncontrolled diabetes. A positive bilirubin result may call for an evaluation of the liver and bile ducts. Because evaluation criteria can vary by laboratory, age and sex, the laboratory's own reference for each parameter is stated separately in the report. A single abnormal finding often does not mean a definite diagnosis; the results should be interpreted by your doctor together with your complaints and other tests.