Category: General
Urinalysis Explained: What Your Urine Says About Your Health
Your urine is a direct reflection of your kidney function, metabolism, and potential infections. A simple urine test can provide early warning signs of diabetes, kidney damage, or a urinary tract infection. By taking urine tests seriously, you can detect health problems sooner and take more targeted action.
You urinate several times a day without giving it a second thought. Yet your urine reveals a lot about your health. A urinalysis can show whether you’re drinking enough, how well your kidneys are functioning, and whether you have an infection. A urinalysis can also detect signs of high blood sugar or a liver problem.
Most people are familiar with blood tests. A urine test is often only done once symptoms have already appeared. That’s a shame, because a urine test is simple, painless, and you can easily do it at home.
What does healthy urine look like?
Your body produces about 1 to 2 liters of urine per day. The exact amount depends on what you drink, eat, and sweat. Healthy urine is clear and light yellow to amber in color. That yellow color comes from urochrome, a breakdown product of hemoglobin. The more you drink, the lighter your urine becomes.
Fresh urine has a mild, not strong, odor. Most people urinate 4 to 8 times a day. If you urinate much more frequently, it could be due to drinking a lot of fluids, but it could also be caused by a bladder infection, high blood sugar, or pregnancy.
Abnormal color, odor, or clarity
If you notice anything different from usual, there’s usually a harmless explanation. Sometimes, however, it’s a reason to have your urine tested. Below is a list of the most common abnormalities.
| What You See or Smell | Often harmless | Have it checked if |
|---|---|---|
| Dark yellow to orange | Not drinking enough, vitamin B2, certain medications | It persists even after drinking more |
| Dark brown or tea-colored | Severe dehydration, rhubarb, or beans | Do you also have yellow eyes or light-colored stools? |
| Pink or red | Beets, menstruation, strenuous exercise | There is no clear explanation |
| Cloudy | Phosphate crystals after a high-protein meal | You also have pain when urinating or a fever |
| Foamy | A strong stream or cleaning agent in the toilet bowl | The foam often reappears and doesn't go away |
| Sweet or fruity | Fasting or a Low-Carb Diet | You’re also very thirsty and urinate frequently |
| Strong or fishy | Not drinking enough, urine that’s been sitting for a while | Do you also experience a burning sensation when you urinate or have to go often? |
What values does a urine test measure?
During a urine test, a test strip with colored panels is first dipped into your urine. Each panel reacts to a different substance. Afterward, the lab may also examine your urine under a microscope. The table shows the most important values.
| Value | What it measures | What an Abnormal Result Might Mean |
|---|---|---|
| Specific gravity | How concentrated your urine is (normally about 1.005 to 1.030) | High: not drinking enough. Low: drinking too much or kidneys that aren’t concentrating urine as well |
| pH | How acidic your urine is (normally about 4.5 to 8) | Low: increased risk of uric acid crystals. High: sometimes an infection |
| Protein | Whether Your Kidneys Are Leaking Protein | Kidney damage, high blood pressure, or diabetes. Temporary changes may also occur after a fever or strenuous exercise. |
| Glucose | Sugar in Your Urine | High blood sugar, such as in diabetes |
| Ketones | Metabolites from fat burning | Fasting or a keto diet. A warning sign for type 1 diabetes |
| Leukocytes | White blood cells | Usually an inflammation or infection of the urinary tract |
| Nitrite | A substance produced by certain bacteria | A bacterial urinary tract infection |
| Red cells | Red blood cells or hemoglobin | Infection, kidney stones, physical exertion, or menstruation. Sometimes a kidney or bladder problem |
| Bilirubin | Breakdown product of red blood cells | A problem with the liver or bile ducts |
| Urobilinogen | Bilirubin breakdown product | Levels that are too high or absent may indicate problems with the liver, bile ducts, or rapid breakdown of red blood cells |
Protein in Your Urine
Healthy kidneys retain protein. If you do find protein in your urine, it could be an early sign of kidney damage. Protein levels can also be temporarily elevated after a fever, strenuous exercise, or standing for long periods. If the levels remain elevated, further testing is needed. To detect early kidney damage more accurately, you look at the albumin-to-creatinine ratio. You can read about how that works in our blog post on the ACR urine test.
Glucose and Ketones
Normally, your kidneys reabsorb all the sugar from your urine. Only when your blood sugar rises above the so-called renal threshold—around 10 mmol/L—does glucose leak into your urine. If glucose is found in your urine, have your blood sugar level checked as well. A single instance of a small amount of glucose does not necessarily mean you have diabetes.
Ketones are produced when your body burns fat instead of sugar. This is normal during fasting or when following a keto diet. In people with type 1 diabetes, ketones combined with high blood sugar can indicate ketoacidosis. This is dangerous and requires immediate medical attention.
White Blood Cells and Nitrite
White blood cells in your urine usually indicate an inflammation of the urinary tract. If you see them along with nitrite, a bacterial infection is likely. A negative nitrite test does not rule out an infection, because not all bacteria produce nitrite. Your urine must also have been in your bladder for a few hours. If there is any doubt, a urine culture is often performed. You can read more about normal ranges in the section on normal leukocyte levels in urine. If you have leukocytes but no symptoms, read the section on leukocytes in urine without pain.
Blood in Your Urine
Red blood cells in your urine are called hematuria. Sometimes you can see them with the naked eye, and sometimes only under a microscope. It’s often caused by an infection, kidney stones, strenuous exercise, or menstruation. Sometimes, however, it can be a sign of a kidney, bladder, or prostate problem. That’s why you should always have blood in your urine checked by a doctor if there’s no obvious cause.
Under the microscope, the lab also examines the shape of the red blood cells. If many cells are misshapen (dysmorphic), the blood likely originates from the kidney itself. If they are normally shaped, the cause is more likely to be in the bladder or urinary tract.
Bilirubin and urobilinogen
Bilirubin shouldn’t be present in your urine. If it is, your urine often takes on a dark, tea-like color. Along with yellow eyes and pale stools, this indicates a liver or gallbladder problem. Small amounts of urobilinogen are normal. An abnormal level helps a doctor further investigate liver and gallbladder problems.
Urine sediment: What does the lab see under the microscope?
During a sediment analysis, your urine is centrifuged. Cells and other particles then settle to the bottom. The lab examines this sediment under a microscope.
- Cells, such as red and white blood cells and epithelial cells from the bladder or urethra.
- Crystals, such as uric acid or calcium oxalate. These aren’t always a problem, but they can indicate a higher risk of kidney stones. You can read more about uric acid in the section on what to do if your uric acid levels are high.
- Cylinders: small, tube-shaped deposits from the renal tubules. Hyaline cylinders are often harmless. Cylinders containing red or white blood cells indicate inflammation in the kidney.
- Bacteria and yeasts, such as Candida, in the case of an infection.
When should you get a urine test?
A urine test is recommended if you have symptoms such as pain or a burning sensation when urinating, frequent urination, pain in your lower abdomen or flank, or a fever with no apparent cause. It’s also recommended if there is blood in your urine or if your urine is consistently cloudy, dark, or has a strong odor.
Even if you have no symptoms, a urine test can still be useful as a preventive measure. For example, if you have diabetes or high blood pressure, if kidney disease runs in your family, or if you frequently get urinary tract infections. A urine test is a good complement to a blood test. In your blood, for example, you check creatinine levels to assess your kidney function. Read more about creatinine levels.
How a home urine test works
At Bloedwaardentest, you can order a urine analysis and sediment test without a referral from your primary care physician. You can take the test at home.
- Order the test. The test kit will be mailed to your home.
- Collect your first morning urine. It’s the most concentrated. First, urinate a little into the toilet, and then collect the middle stream. This way, fewer bacteria from your urethra will end up in the sample.
- Use the vacuum system to draw urine into the tube and seal it tightly.
- Send the tube the same day so that bacteria cannot multiply and your test results remain reliable.
- The lab analyzes your urine, and you’ll receive your results afterward.
Conclusion: What Does Your Urine Reveal About Your Health?
Your urine reveals a lot about your fluid balance, your kidneys, your metabolism, and possible infections. Protein can indicate early-stage kidney damage, glucose can indicate high blood sugar, and leukocytes with nitrite can indicate an infection. The sooner you detect something like this, the more you can do about it.
Want to know what your urine says? With the urine status and sediment test, you can easily check it at home, without a referral.
Frequently Asked Questions About Urinalysis
Can I take a urine test without seeing my doctor?
Yes. You can order the urine analysis and sediment test without a referral and collect the urine sample at home.
Which urine sample should I use for a urine test?
It’s best to use your first morning urine and collect the middle stream. That urine is the most concentrated and contains the fewest bacteria from your urethra.
Does a urine test replace a blood test?
No. A urine test and a blood test complement each other. For example, the best way to measure your kidney function is by checking the creatinine in your blood along with the protein in your urine.
Medical disclaimer: This information is general in nature and is not intended to replace personal medical advice, diagnosis, or treatment. If you have any symptoms, receive an abnormal test result, or have any concerns, please contact your primary care physician or treating physician.
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