Urinalysis with reflex to Culture

This test is commonly ordered if an individual is experiencing symptoms that may indicate a UTI (urinary tract infection). These may include: frequent urination, lower back pain, cloudy or strong smelling urine, pain or burning sensation when urinating.

Components of this test include:

Visual Test -A visual test, also known as macroscopic test, that will observe the quantity, clarity, color and cloudiness. Your normal urine must be clear and not cloudy. Abnormal results can suggest many conditions. A cloudy urine can indicate infection while a dark urine color indicates dehydration. If your urine is tea colored, it could be due to liver disease. An orange urine can indicate a breakdown of colors while blood in urine can be due to a UTI or stones.

Chemical Test - A chemical test can analyze many components of your urine such as:

• Specific gravity: calculates the concentration of urine to assess if your kidneys are concentrating your urine the right way. It also considers the concentration of every chemical particle that is found in your urine. So, the gravity of the urine would then be compared to that of the water. Normal levels fall between 1.000 and 1.030. If you drink too much before the test, normal gravity levels will be around 1.000. if you avoid fluids before the test, normal results would be 1.030.
• Acidity: detects the urine pH levels to analyze the acidity or alkalinity. Extreme levels (upper high or lower low) of acidity are normally indicative of higher risks for kidney stones.
• Protein: tests for the levels of proteins in the urine, mainly albumin levels, also known as proteinuria. Normal urine samples contain low levels of urine proteins while persistent high levels can indicate kidney disease.
• Glucose levels: this test checks the sugar levels in the urine, also known as glycosuria. Our body needs and uses sugar as a source of energy by converting carbohydrates into glucose. When your body has elevated levels of glucose, this normally means that you have a malfunction in your system (like diabetes). If left untreated, this could progress into a serious condition (kidney failure or nerve damage).
• Ketones: this test measures the levels of ketones that are the products of fat breakdown, also known as ketonuria. When glucose is deficient, your body will utilize other sources of energy. High levels of ketones can indicate ketoacidosis, which is a complication of diabetes. Assessing your ketone levels can help prevent a medical emergency from happening.
• Hemoglobin: detects the presence of blood in the urine that was the result of broken red blood cells that have not been reabsorbed by the kidneys. Hemoglobin in the urine will render it dark in color. Healthy individuals do not have hemoglobin in their urine.
• Leukocyte esterase: examines the presence of white blood cells in urine. Leukocyte esterase is a kind of enzyme that is formed by leukocytes. A positive result indicates the presence of an infection.
• Nitrite: detects the presence of nitrites in the urine that can suggest the presence of bacteria. When bacteria are present in the urinary tract, nitrates that are normally found in the urine, will transform into nitrites. A positive nitrite test will have to be investigated further in the lab to detect the specific kind of bacteria and its susceptibility to the different treatments.
• Bilirubin: detects the levels of bilirubin that can suggest liver, gallbladder disease or the breakdown of red blood cells. Bilirubin is a yellow pigment, found in the bile and is the result of the breakdown of red blood cells.
• Urobilirubin: this test can suggest the presence of a possible liver disease. Urobilirubin is the result of the reduction of bilirubin. Healthy individuals have a little amount of Urobilirubin in their urine. Positive results can indicate liver conditions like hepatitis, cirrhosis, liver damage, or hemolytic anemia. They can also be the result of taking certain medications like etodolac.

A sensitivity test may be performed based on the results of the culture portion of this test. 

Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Feb 12, 2022