What is being tested?

Urinalysis involves checking the appearance, concentration and content of urine.
This can be done by

1. Chemical examination, which tests chemically for a number of substances such as sugar (glucose), protein and nitrites that provide valuable information about health and disease; and
2. Microscopic examination, which identifies and counts the type of cells and other components (bacteria, casts and crystals) that can be present in urine.

Chemical examination:
Can be evaluated by a dipstick test in the doctor’s surgery or in the laboratory. A dipstick is a thin plastic strip with bands of chemicals on it which change colour if certain substances are present or present in high concentrations.  It often tests for the following:

• Acidity (pH): indicates the acidity of the urine – abnormal levels may be associated with kidney stones or kidney disorders
• Concentration (specific gravity): shows how concentrated the urine isProtein: large amounts may indicate a kidney problem
• Glucose (sugar): any detection of sugar usually calls for diabetes testing
• Ketones: any amount of ketones could signal the possibility of diabetes
• Nitrites/leukocyte esterase:  a product of white blood cells might be a sign of urinary tract infection
• Blood: finding blood in urine may be a sign of urinary tract infection but other conditions such as kidney stones, kidney or bladder cancer or blood disorders can also cause this.

Microscopic examination:
Several drops of urine are viewed with a microscope or with an automated processor. The presence of the following are checked for:

White blood cells (pus cells or leukocytes): increased level may be a sign of infection
Red blood cells (erythrocytes): an increase may indicate kidney disease, blood disorder or another conditions such as bladder cancer
Bacteria or yeasts: may indicate infection (in the presence of symptoms)
Casts: tube shaped proteins that may indicate kidney disorders
Crystals: may be a sign of kidney stones

How is it used?

Urinalysis is used as a screening and/or diagnostic test that can detect urinary tract infections as well as a a number of different metabolic and kidney disorders. In some conditions, it also provides a rapid way to monitor ongoing progress. However, a urinalysis cannot detect all disorders.

When is it requested?

A routine urinalysis may be done when you visit your doctor, attend an outpatient clinic or when you are admitted to hospital. It can also be part of a routine medical examination, a new pregnancy evaluation or preparation for a surgical procedure. It will most likely be performed if you see your doctor complaining of stomach pain, back pain, painful or frequent urination, or blood in the urine. This test can also be useful in monitoring certain conditions. 

What does the result mean?

Urinalysis results can have many interpretations. A urinalysis alone usually doesn’t provide a definite diagnosis and often prompts additional testing to be requested when abnormal results are found. Urinalysis is only one screening test that can provide a general overview of someone's health. Your doctor must correlate the urinalysis results with your symptoms and overall health.

Common questions

• How long does it take to get results for urinalysis?

Urinalysis testing is often carried out by dip-stick testing in the doctor's rooms or clinic and results are instantly available. If there is an abnormal finding, such as excessive protein or the presence of blood, it may be necessary to send the sample on to the laboratory for further analysis. This will take a variable amount of time depending on the tests to be carried out.

• Is the time of day a factor when collecting a urine sample?

Because this is a general screening test, the time of day the urine sample is given is usually not important. However, if your doctor is looking for a specific finding, you may be asked to do this at a specific time. For example, if your doctor is looking for glucose in your urine, the sample is better collected after a meal whereas low levels of protein can be better detected in a concentrated sample collected first thing in the morning.

• Are home test kits available?

Some commercial testing strips can be purchased at a pharmacy to perform part of the chemical examination, such as urine pH, urine glucose, and urine ketones.

More information

RCPA Manual: Urinalysis