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Urine routine examination (urinalysis)

Urine & Stool · also called Urine R/E, Urine complete examination, UA

What it measures

A three-part screen of urine: physical (colour, clarity, specific gravity), chemical dipstick (pH, protein, glucose, ketones, blood, bilirubin, urobilinogen, nitrite, leukocyte esterase) and microscopy of the sediment.

Specimen and preparation

Specimen: Fresh midstream urine, preferably first morning
Tube: Urine top
Preparation: Clean-catch midstream in a sterile container; examine within 2 hours or refrigerate.

Reference range

Group	Range
Colour / clarity	Pale to dark yellow, clear
Specific gravity	1.005–1.030
pH	4.5–8.0
Protein, glucose, ketones, blood, bilirubin, nitrite, leukocyte esterase	Negative
Pus cells (WBC)	0–5 /HPF
RBC	0–2 /HPF
Casts	Occasional hyaline /LPF
Urobilinogen	0.2–1.0 mg/dL

Reference ranges differ between laboratories, methods and populations. Always use the range printed on your own lab report.

Causes of high values

Pus cells + nitrite: urinary tract infection
Protein and RBC casts: glomerulonephritis
Glucose and ketones: uncontrolled diabetes or DKA
Bilirubin: conjugated hyperbilirubinaemia (hepatitis, biliary obstruction)
Crystals: stone disease

Causes of low values

Low specific gravity: diabetes insipidus, excess fluids, renal concentrating defect

Method

Visual inspection, reagent strip (manual or automated reader), centrifuged sediment microscopy or automated analyser

Good to know

Sperm or Trichomonas in urine of a minor may be a critical finding needing prompt reporting.

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