Causes Of White Blood Cells In Urine Test – Urinalysis (UA) is a simple, non-invasive diagnostic tool that examines the visual, chemical and microscopic properties of Urine. It can be used to diagnose and monitor a variety of medical conditions, including kidney disease; urinary tract infections; and systemic diseases, such as diabetes mellitus.
During a urinalysis, a urine sample is collected in a sample cup and analyzed. The first part of the urinalysis involves direct observation to assess the color, clarity, and smell of the urine. Next, the urine is analyzed using a dipstick test, or urine test strip, where chemically treated paper strips are dipped into the urine sample and react with certain substances in the urine, thus changing color. Color changes can be read manually by comparing the colors on the dipstick to the manufacturer’s guide or automatically by specialized laboratory equipment, which provides more accurate test results. The final step of urinalysis is microscopic examination, traditionally performed manually on a sediment from a centrifuged urine sample.
Causes Of White Blood Cells In Urine Test
A urinalysis tests the chemical and microscopic properties of urine. The exact tests included vary depending on the dipstick test, but the most common include urine pH, specific gravity, Blood, protein, glucose, ketones, white Blood Cells (leukocyte esterase), nitrites, bilirubin, and urobilinogen. Microscopic examination can determine the presence of solid elements in the urine, such as red or white blood cells, epithelial cells, urinary casts, microorganisms and crystals.
Blood In Urine (hematuria): Causes, Diagnosis & Treatment
The pH of urine is usually slightly acidic, although it can range from 4.5 to 8.0 depending on the body’s acid-base balance. The formation of kidney stones is highly influenced by urinary pH. Acidic urine favors the crystallization of uric acid or cystine stones, while alkaline urine promotes stones containing calcium and phosphate. Alkaline urine can result from infection with urea-decomposing bacteria – such as Proteus mirabilis, Klebsiella or Pseudomonas – which break down urea molecules into ammonium and carbon dioxide, thereby increasing the pH of the urine to neutral or alkaline values. The urinary pH level is also influenced by dietary factors. A high-protein diet can cause acidic urine, while a vegetarian diet can cause alkaline urine.
Specific gravity measures the kidney’s ability to concentrate or dilute urine by comparing its density to that of distilled water (1,000). Because urine contains multiple solutes, it has a higher specific gravity than water – generally ranging from 1.005 to 1.025. A high specific gravity represents concentrated urine and may indicate dehydration or increased levels of solutes in the urine. Low specific gravity, on the other hand, represents dilute urine and can occur with high fluid intake, diabetes insipidus, or due to kidney disease, when the kidney’s ability to concentrate urine is impaired.
The presence of blood in the urine is known as hematuria. It can be classified as macroscopic hematuria when it is visible to the naked eye or microhematuria when it can only be detected under a microscope. Hematuria can occur due to a variety of causes, including damage to the kidney’s glomerular filtration barrier, which normally prevents the passage of blood into urine; urinary tract injuries, such as urinary tract infections, kidney stones, or tumors; as well as systemic disorders, such as vasculitis, lupus and tuberculosis, among others. In menstruating individuals, blood may occur in the urine due to contamination of the urine sample.
In healthy individuals, urine contains only a small amount of protein because most protein molecules, such as albumin, are too large to pass through the glomerular filtration barrier. When a significant amount of protein appears in the urine, this is known as proteinuria and is usually a sign of glomerular damage. Benign causes of proteinuria include fever, strenuous exercise, dehydration, emotional stress, and acute illness. More serious causes include glomerulonephritis and multiple myeloma.
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Glycosuria, or glucose in the urine, is a common finding in individuals with uncontrolled diabetes mellitus, although it can also occur when glucose levels are normal, such as during pregnancy, in cases of physiological stress, and when taking corticosteroids. There is a group of hypoglycemic medications called sodium-glucose cotransporter-2 (SGLT-2) inhibitors (e.g., canagliflozin, empagliflozin, dapagliflozin) that act on the kidneys to promote the excretion of glucose in the urine, which also leads to glycosuria .
Ketones are metabolic products of fatty acid metabolism. Fat breakdown can occur in states of prolonged hunger, persistent vomiting or diarrhea, chronic alcohol use and with a low-carbohydrate diet (e.g. “keto” or ketogenic diets). Most importantly, ketones can accumulate in the blood of individuals with poorly controlled diabetes mellitus (especially type 1 diabetes mellitus) and cause acidosis. This is known as diabetic ketoacidosis (DKA) and constitutes a potentially fatal emergency. DKA may be suspected when elevated levels of ketones are detected in the blood or urine in individuals with diabetes.
The presence of white blood cells in the urine, or pyuria, is a common sign of a urinary tract infection (UTI). Because white blood cells can only be evaluated by microscopic examination, dipstick tests use leukocyte esterase (i.e., an enzyme within white blood cells) to estimate the concentration of white blood cells in urine. In cases where a UTI is suspected, a urine culture is obtained to confirm the diagnosis and identify the underlying organism. If no bacterial cells are detected, the individual is said to have sterile pyuria – a typical finding in urinary tuberculosis.
Most species of Gram-negative bacteria that colonize the urinary tract produce nitrate reductase, an enzyme that converts dietary nitrates into nitrites. Both urinary nitrites and leukocyte esterase provide a good screening test for urinary tract infections; however, because not all bacteria produce nitrites, a negative nitrite test alone does not rule out a urinary tract infection.
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Bilirubin is a breakdown product of red blood cell metabolism that is not usually found in urine. If bilirubin is found in the urine, liver disease or biliary obstruction (where there is a problem with the drainage of bile into the intestine) may be suspected. On the other hand, there may be small amounts of urobilinogen in the urine of healthy individuals. Urobilinogen is the end product of conjugated bilirubin after it passes through the bile duct and is metabolized by bacteria in the intestine. Some of this urobilinogen is reabsorbed into the portal circulation and eventually filtered by the kidneys. Individuals with increased red blood cell destruction (i.e., hemolytic anemia) or liver disease may have elevated levels of urobilinogen in their urine. Conversely, if the bile duct is obstructed, less bilirubin enters the intestine and, ultimately, less urobilinogen is found in the urine.
Urinalysis is a diagnostic tool that plays an essential role in the health assessment process and is typically done in individuals with urinary symptoms (e.g., painful urination, urinary frequency and urgency, lower abdominal pain), as well as in pregnant individuals to determine the presence of asymptomatic bacteriuria. It also provides doctors with valuable information for monitoring various medical conditions, including diabetes mellitus, liver disease or kidney disease.
Other urine tests that may be done but are not usually part of the urinalysis include screening for recreational drug use (e.g., cannabis, amphetamines, cocaine, opiates, etc.), urine cytology (i.e., urine cell test, used to screen for urological cancers), measurement of electrolyte or hormone levels, as well as a urine pregnancy test.
A urinalysis includes physical examination of the urine, urinalysis, and examination of the urine under a microscope. The urine test can be done to check the pH of the urine and the levels of nitrites, red blood cells, white blood cells, proteins, ketones and glucose, among others. Altered test results can be caused by several conditions that damage the kidneys or urinary tract, including kidney disorders; urinary tract infections; or systemic disorders such as diabetes mellitus.
Urine Microscopy Findings In Ain. (a) Wbcs And Rbcs. (b) Wbc Cast.
Mundt, L. A., Shanahan, K., & Graff, L. (2016). Graff’s book on urinalysis and bodily fluids (3rd ed.). Wolters Kluwer/Lippincott Williams & Wilkins Health.Hematuria refers to the presence of blood in the urine. It is defined by the identification of three or more red blood cells (RBCs) per high power field (HPF) in a urinary sample. Red blood cells in urine can originate from the kidneys or elsewhere in the urinary tract, which is made up of the ureters, bladder, prostate (in individuals assigned male at birth), and urethra.
The term hematuria comes from the Greek words “hema-”, which refers to blood, and “-uria”, which refers to urine. Blood in the urine may be visible to the naked eye (i.e., macroscopic hematuria) or may be detected microscopically (i.e., microscopic hematuria). Asymptomatic or symptomatic hematuria can be associated with many different medical conditions and should be investigated when detected.
Hematuria typically occurs as a result of pathologies in the urogenital system; however, systemic conditions can also present with blood in the urine.
Most commonly, the observation of blood in the urine indicates an infection in the bladder (i.e., cystitis) or kidney (i.e., pyelonephritis). Urinary tract trauma, ranging from kidney stones to accidents such as improper Foley catheter insertion or a fall that injures the kidney, can also cause hematuria. Hematuria is also often associated with nephritic syndrome, which may result from glomerulonephritis, a disease
Causes Of Blood In Urine (hematuria) For Females
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