Urinalysis

Test Quick Guide

A urinalysis is a test that checks several components of a urine sample. Visual, chemical, and microscopic tests are all part of a complete urinalysis.

Urinalysis is frequently used to screen for urinary tract infections (UTIs), kidney and liver issues, and diabetes. A urinalysis may be performed during a routine check-up, to evaluate certain symptoms, or upon admission to the hospital. It is also a common test if you are pregnant.

About the Test

Purpose of the test

The purpose of a urinalysis test is to check for abnormalities in the appearance or composition of your urine. It is commonly used for screening, diagnosing, and monitoring different health conditions, such as kidney problems, diabetes, or UTIs.

  • Screening tests are used to detect health issues before symptoms appear, allowing for earlier treatment. Because some liver and kidney issues may not initially generate symptoms, a urinalysis test is often used to check the health of these organs. Urinalysis can also screen for underlying health problems during a pregnancy checkup or pre-surgery assessment, looking for unidentified health issues to reduce the risk of future complications.
  • Diagnosis is the process of finding the cause of symptoms. When you begin to experience changes related to urination or other symptoms that can be tied to liver or kidney problems, a doctor may recommend urinalysis to help determine the cause. Urinalysis can help detect UTIs and other conditions that affect the function of the urinary system.
  • Monitoring involves tests that follow the evolution of your condition. Urinalysis tests may be conducted periodically over time to see how well treatment is working or to see if the severity of a condition has changed.

What does the test measure?

A urinalysis involves a series of assessments of a urine sample. It can measure one or more different components depending on the purpose of the test and the health care provider performing it.

A complete urinalysis will typically include a visual (also called physical) examination, a microscopic examination, and a chemical dipstick test, each of which involves different measurements and evaluations.

Visual examination

During the visual examination, a health care provider assesses the appearance of the urine and evaluates the following:

  • Clarity/turbidity: This determines whether the urine is clear or cloudy.
  • Color: This assesses the color of the urine, including whether there are any signs of blood in the urine.
  • Foam content: This checks how foamy the urine is, which can be related to its protein content.
  • Odor: This examination involves checking for any unusual odor from the urine.

Microscopic examination

This examination is done by looking at drops of concentrated urine under a microscope to see if there are physical traces of the following:

  • Bacteria, parasites, or yeast
  • Red or white blood cells
  • Urinary casts, which are small particles shaped like a tube that may contain different types of cells or substances
  • Urinary crystals
  • Sperm

Chemical dipstick test

The dipstick test uses a chemical strip that is submerged in the sample that changes color when exposed to different substances. This test may be used to check various aspects of the urine sample including:

  • Acidity (pH): This is the acid-base or pH level of your urine, which is measured on a scale of 1-14 with 1 being the most acidic and 14 being the most basic.
  • Bilirubin This is a substance produced when the body breaks down red blood cells. It is not normally found in the urine.
  • Concentration/specific gravity: This measures the concentration of particles in your urine and can be related to fluid levels in the body.
  • Glucose This is a type of sugar that is used to provide energy to cells.
  • Enzymes: A dipstick test may check for the presence of an enzyme called leukocyte esterase that is found in white blood cells.
  • Ketones: These develop when the body uses fat instead of glucose for energy production.
  • Nitrites: These are a type of chemical produced when bacteria are present in the urinary system.
  • Protein: These molecules help the body carry out vital functions. Proteins are usually found in the blood and only in small amounts in the urine.
  • Blood cells: Dipstick tests can be used to look for evidence of blood and blood cells in the urine.

When should I get a urinalysis test?

Urinalysis testing is very common. And it’s a good idea to talk to your doctor if you notice changes in your urine’s color, odor, or consistency. Some telling symptoms that trigger health care professionals to suggest a urinalysis include frequent or painful urination, blood in your urine, other urinary difficulties, ongoing abdominal back pain, or if you are pregnant or soon undergoing a surgical procedure. Urinalysis can also be part of a regular medical checkup.

If you have a medical condition such as kidney disease or diabetes, your doctor may advise you to have regular urine tests to monitor your condition and treatment. Or if you are at high risk for these conditions, your doctor might suggest regular testing as a precautionary measure.

A urinalysis can be performed at all ages, including for children who are showing symptoms of a UTI.

Finding a Urinalysis Test

How can I get a urinalysis test?

During an in-office visit, your doctor may order a urinalysis and have you collect the sample in a specialized restroom equipped with cleaning wipes and specimen collection materials. Or, depending on the type of sample required, your health care provider might ask you to collect it at home and bring it into the office.

Certain medical offices and clinics are equipped to perform a complete urinalysis, which includes visual, chemical, and microscopic examinations of the sample. Other providers may collaborate with an external laboratory that specializes in this comprehensive testing.

You can also order a urinalysis online and visit the recommended lab to provide your sample. If you go this route, review your results with a health care professional, who might recommend a follow-up test to confirm results or an office visit to discuss symptoms and next steps.

There are over-the-counter UTI urinalysis kits that work a lot like pregnancy tests. The kits come with a dipstick containing a testing trip that you hold in your urine stream or dip into a urine sample you collect in a cup. The results appear within a couple of minutes. Keep in mind that these tests are designed for if you experience frequent UTIs, and they are not as reliable as a culture performed in a lab.

Can I take the test at home?

You can take an at-home UTI test if you suspect symptoms as a first step before consulting your doctor for a urinalysis culture that is more comprehensive and accurate. Or you can order a urinalysis online and visit the participating lab. Still, follow up with your doctor to discuss results, as a health care provider might recommend a follow-up screening and office visit.

In some cases, a doctor may order at-home urine collection over the course of a full day. For these tests, you will use special containers to obtain your sample and then bring it to a medical office or laboratory for testing.

How much does the test cost?

The cost of urinalysis testing varies depending on a number of considerations, such as where the test is performed, which components of the test are included, and whether you have medical insurance. Although you might be responsible for copays or a deductible, insurance often covers the cost of testing if it is prescribed by your doctor.

If you do not have health insurance or your insurance does not cover the test, it may be helpful to discuss the cost of urinalysis testing with a doctor or hospital administrator.

If you buy a urinalysis online and get tested in the participating lab, the cost can be about $29 for a general urinalysis that tests for proteins and signs of infection. Or it’s $69 for a urinalysis with reflex to a culture that analyzes the physical, chemical, and microscopic quality of your urine sample and includes a culture if necessary.

A protein, 24-hour urine analysis can cost $89 and is a more accurate assessment, usually recommended after a routine urinalysis indicates abnormal protein levels.

At-home urinalysis test strips that are usually used to identify a UTI before you go to the doctor for further screening cost $10 to $25.

Taking a Urinalysis Test

It is necessary to provide a urine sample for a urinalysis. Your doctor will inform you about what kind of sample is required. The two main ways of obtaining a sample are a 24-hour urine collection and a one-time urine collection with the clean-catch method.

  • 24-hour urine collection: This test requires you to collect all of the urine you produce during a 24-hour period.
  • One-time urine collection: Also known as a spot sample, this involves providing just one small sample of urine, often collected with the clean-catch method, which helps to prevent contaminants from entering the urine.

Be sure to carefully follow any instructions from your doctor about the type of sample needed and how to collect it properly because this can impact the accuracy of test results.

Before the test

Usually, you can eat and drink without any restrictions before a urinalysis. However, if the urinalysis is being done along with other tests, you may be required to fast beforehand. Your doctor will advise.

Many drugs, including over-the-counter medications and herbal or dietary supplements, can affect urinalysis results. Inform your doctor about all the medications, vitamins, and supplements you take before the test.

While there are normally few preparations required for a urinalysis test, make sure to follow any specific instructions provided by your doctor.

During the test

A urine sample can be collected at home or at the location of your health care provider depending on the kind of sample needed. Urine specimen containers are usually given to you by the provider.

For a 24-hour urine collection, you will need to obtain all your urine during a specific 24-hour period.

  • On the first day, you will urinate in the toilet when you wake up. Then, for the next 24 hours, you need to collect all your urine into the provided sample container.
  • On the second day, when you wake up in the morning, you urinate into the sample container, which is the last collection during the 24-hour period.
  • During the collection period, you need to keep the sample container in the refrigerator or a cool place.

For a one-time urine sample, you may be asked to collect the sample first thing in the morning when your urine is more concentrated. A clean-catch method may be used to collect urine midstream:

  1. A sterile wipe is used to thoroughly clean the urethral opening.
  2. Urinate into the toilet and then pause the stream after a few seconds.
  3. Place the collection container in the path of your urine stream and begin to urinate into the container.
  4. After filling the collection container with at least a couple of ounces of urine, finish urinating into the toilet bowl.
  5. When finished, screw the lid of the container on tightly and avoid touching the interior of the cup or lid.
  6. If you’re at home, the urine cup should be kept in a plastic bag in the refrigerator until you’re ready to take it to the lab or your provider’s office.

After the test

There are no side effects after a urinalysis test. Once your sample is provided, you can resume normal activities. If you are taking the test because you are experiencing symptoms, continue to report those symptoms to your doctor.

Urinalysis Test Results

Receiving test results

Your doctor may contact you by phone or email to discuss the findings of your test. A copy of the urinalysis lab test result can sometimes be obtained by mail or through an online health platform. Results are usually available within a few business days and sometimes as quickly as 24 hours from the time you provide your urine sample at the lab.

If you use Testing.com, your results will be available on the site in a personal, secured account you can conveniently access. If you buy an at-home urinalysis test kit that is used for identifying a UTI, the dipstick containing the test strip will usually show results within a few minutes.

Interpreting test results

Your test report will list the types of analysis performed on your urine sample. It may include a summary of any specific findings with a written description of results from microscopic and visual examination. The details provided in your test results depend on the type of urinalysis.

For example, a routine urinalysis will share results for gravity, pH, protein, glucose, ketones, occult blood, leukocyte esterase, nitrite, bilirubin, and urobilinogen. A 24-hour protein urinalysis test will indicate more specific levels of protein.

For any measurements taken, the test report may show your levels alongside a reference range. This range reflects the laboratory’s expected values for a healthy person. Reference ranges often vary slightly between different laboratories because they can employ different measurement methods. Because these ranges may differ by the laboratory, read your test report carefully and discuss it with your doctor.

Urinalysis tests are interpreted based on the results of the different components of the test and other factors, including your symptoms and overall health. Your doctor will look for any abnormalities in the test. The significance of an irregularity in the urine’s physical, chemical, or microscopic characteristics might vary depending on your health history and current situation.

Many different health conditions can cause abnormal results on a urinalysis test. Examples of conditions that may lead to abnormal results include:

  • UTIs
  • Kidney stones
  • Diabetes
  • Trauma to the kidneys
  • Liver diseases
  • Some types of cancer

Certain medications, vitamins, and supplements can cause irregularities in urinalysis results. Some foods can also cause changes to the color and odor of urine that may lead to an irregularity during urinalysis. Other circumstances that can impact test results include:

  • Stress
  • Exercise
  • Fever
  • Aspirin therapy
  • Foods like beets
  • Prescription medications
  • Improper urine collection
  • Failing to collect all urine within a 24-hour sample period
  • Failing to clean the urethral opening before obtaining a one-time sample

It is important to talk with your health care provider to understand the details of your urinalysis test and what the results mean for your health. Keep in mind, an abnormal urinalysis screening does not indicate the underlying cause, so your doctor might need to collect additional information with other testing to confirm or rule out a diagnosis.

Keep the lines of communication open with your health care provider. Regardless of your results, here are some questions to ask:

  • Were any parts of my urinalysis test abnormal?
  • Do the test results help address why I might be having symptoms?
  • Are any follow-up tests needed in this situation?
  • Do you recommend any treatments or lifestyle changes based on these results?
  • Should I have a urinalysis test again in the future?

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