A small amount of urine can tell you a lot about your body as a prominent biomarker. Urine test, which includes urinalysis, is a key diagnostic technique used to detect a suspected infection (mostly in the urinary tract and kidneys) and other metabolic conditions like diabetes.
Sunanda Keshav (37), a home maker from Bengaluru, met a dermatologist when she had skin rashes with itching. Along with blood tests, she was also asked to go for a urine test. She was told that a bacterial infection in the urinary tract could also trigger chronic hives. While the blood report was normal, the urinalysis report showed plenty of pus cells, indicating a urinary tract infection (UTI). She was then put on antibiotics to clear the infection.
Happiest Health spoke to experts who decode such indicators in a urine report that can detect a possible infection in the urinary tract or kidneys.
What are the indicators in a urinalysis report?
Dr Pradeep Arumugam, a pathologist in SRL Diagnostics, Bengaluru, explains some of the indicators in a urinalysis report that indicate an infection in urinary tract or kidneys:
- Blood cells: The presence of red blood cell (RBC) or white blood cell (WBC) in a urine sample is a marker of infection. RBCs determine whether an infection is caused in the kidneys or urinary tract. WBC cast indicates certain metabolic changes that can occur in the body.
- Pus cells: It refers to the presence of WBCs in urine. If pus cells are more than 5 HPF (High-power field), it indicates an infection. HPF is a microscopic parameter that aids in analysing an infection.
- Crystals: Urine microscopic exam can show different crystals (like uric acid, oxalate or triple phosphate crystals) which indicate metabolic disorders like kidney stones and gout (indicated by formation of uric acid crystals in urine).
- Sugar: Presence of sugar in urine might be an indicator of diabetes mellitus.
- pH value: Urine is alkaline in nature and has a pH value around 4.5-8. When the pH value goes below 6.5, it indicates acidic urine. If it is more than 8, urine is more alkaline and might indicate an infection.
- Urine Specific gravity: It determines the concentration of urine. Low concentration indicates an infection in the urinary tract or dehydration, whereas excess amount of urine might indicate diabetes insipidus, a hormonal disorder where the amount of fluid produced cannot be regulated by the body.
- Bilirubin: Excess bilirubin in urine can indicate jaundice.
- Urine albumin: The presence of albumin (a protein in blood) in urine can indicate serious renal disorders characterised by inflammation of the kidney.
- Ketone bodies: Excess production of ketone bodies indicate diabetes ketoacidosis, a serious diabetic complication where excess amount of sugar is converted into ketone bodies. Presence of ketone bodies can also indicate dehydration.
Dr Arumugam adds that the presence of these indicators confirms a possible infection or a disorder in a person only if corroborative symptoms are present in the clinical examination. “If one’s urine report shows indicators of an infection like presence of pus cells or alkaline urine, then symptoms like fever, urinary frequency, etc. need to be present in order to suspect a possible infection.”
Once an infection is indicated in urinalysis, the urine sample is further sent for a urine culture and sensitivity test, if required, says Dr Preeti Kabra, chief of lab, Neuberg Diagnostics, Chennai. “The presence of certain bacteria and their sensitivity to certain antibiotics in a urine culture test confirm an infection in the urinary tract or kidneys.”
Types of urine tests to detect infection
Experts Happiest Health spoke to explain the following types of urine tests:
•Urinalysis: There are three components to it:
→Visual: Examines physical characteristics like colour, volume, appearance and specific gravity
→Chemical: Detects elements like sugar, ketone bodies and bilirubin
→Microscopic examination: Detects RBCs, crystals and pus cells
•Urine culture: It is recommended for people showing UTI symptoms like burning sensation while urinating and frequent urination. Bacterial growth in urine culture test can indicate a UTI whereas fungal growth can be seen in people with diabetes.
•24-hour urine test: This is done to check kidney health by measuring the volume and contents of urine. A person should collect urine for 24 hours and thereafter submit the sample for examination.
How to prepare yourself for urine tests?
Dr Kabra advises the following instructions before submitting your urine sample to get an accurate diagnosis of an infection:
- Clean the labia (in case of females) or the tip of the penis (in case of males) before collecting a urine sample.
- Collect midstream urine into the container, after passing the initial amount of urine in the toilet.
- At least 30-60 ml of urine needs to be collected.
Pre-requisites for urinalysis
Knowing the medical history, medication record and lifestyle of an individual is imperative for an accurate urine test report, says Dr Kabra. She also mentions that consuming blackberries and certain medications such as multivitamins or vitamin C can alter the colour of urine. “Exercise can alter your urine test report as it produces concentrated urine due to dehydration in the form of dark yellow urine. Certain medications taken for a long time like rifampicin (taken for tuberculosis) can turn urine reddish orange,” Dr Kabra added.
Takeaways
- A urinalysis contains various indicators for detecting an infection in the urinary tract or kidneys along with other metabolic disorders. A suspected infection is further confirmed by a urine culture test.
- Knowledge of medical history, medication record and lifestyle of an individual is vital for an accurate urinalysis report.
