Urinalysis – Understanding Your Urine Test Results

Section Editor: Christopher McCudden Ph.D., DABCC, FADLM, FCACB
November 12, 2026

A urinalysis is one of the most common laboratory tests in medicine, and it checks a small urine sample for signs of infection, kidney disease, and diabetes. Your report may call it a urinalysis or a UA, and some reports say urine test, urine dip, or routine and microscopic urinalysis instead.

This article explains what a urinalysis measures and how to read the words and numbers on a urinalysis report. It also describes what each item on the report usually means and the common, harmless reasons a urine test may come back slightly abnormal.

The reference range that applies to your result is the one printed on your laboratory report, not the typical ranges shown here. Reference ranges vary between laboratories based on the equipment used, the population tested, and individual factors such as age, sex, and pregnancy status. Always compare your result to the reference range printed on your own report, and discuss any abnormal (or unexpectedly normal) result with your doctor.

Why is a urinalysis ordered?

A urinalysis is ordered because urine carries information about the kidneys, the bladder, and the rest of the body. Your kidneys filter your blood and send waste into the urine, so many changes in the blood also show up in a urine test. Common reasons for a urinalysis include:

A routine check-up, a visit before surgery, or a regular check during pregnancy.
Symptoms of a urinary tract infection, such as burning or needing to urinate more often than usual.
Checking for kidney disease or diabetes, or following either condition over time.

A urinalysis is three tests in one.

A urinalysis is really three separate tests done on the same urine sample. Each one answers a different question, and most urinalysis reports list the results in the same three groups.

How the urine looks. A laboratory technologist records the urine’s color and clarity, sometimes called the physical or macroscopic examination.
The dipstick. A plastic strip with small chemical pads is dipped into the urine, and each pad changes color when a particular substance is present. A machine usually reads the colors, and this part is sometimes called the chemical examination.
The microscope. The urine is spun to collect any cells and particles, which are then counted under a microscope or by an automated analyzer. This part is called the microscopic examination or urine sediment.

Many laboratories only perform the microscope part when the dipstick shows something unusual, which is why some urinalysis reports have no microscope results at all.

How is a urinalysis performed?

A urinalysis needs only a small cup of urine, but the way the sample is collected matters a great deal. Contamination is the most common reason for a confusing urinalysis result. Germs and cells from the skin or genital area can enter the cup and look like a urinary tract problem.

Most urinalysis samples are collected as a clean catch or midstream sample. You clean the area around the opening of the urethra, start to urinate into the toilet, and then collect the middle part of the stream in the cup. Some tests ask for the first urine of the morning because it is more concentrated and easier to read. The urine should reach the laboratory quickly or be refrigerated, because cells break down and germs multiply if a sample sits at room temperature.

How to read a urinalysis report

A urinalysis report uses only a few kinds of results, and knowing them makes the rest of the report much easier to follow.

Negative. The substance was not detected, and for almost every dipstick item, this is the normal result.
Trace. A very small amount was detected, close to the lowest level the dipstick can measure, and a trace result is often not significant on its own.
1+, 2+, 3+ (or small, moderate, large). These grades show increasing amounts on the dipstick, and they are estimates rather than exact measurements.
Positive. A few items, such as nitrite, are reported only as positive or negative.
/hpf and /lpf. Microscope results are counts per high-power field (hpf) or per low-power field (lpf), where a field is the circle of urine seen through the microscope at one time. A result such as “RBC 0-2/hpf” means that zero to two red blood cells were seen in each field.

Results outside the laboratory’s range may be marked with an H for high, an L for low, or an A for abnormal.

What do the results on a urinalysis mean?

Each item on a urinalysis report describes one feature of the urine, and the short descriptions below follow the order most reports use. Three of the most commonly flagged findings have their own articles, which are linked below.

How the urine looks

Color. Normal urine ranges from pale yellow to dark amber, depending mostly on how much you have been drinking. Foods, medicines, and blood can also change the color.
Clarity. Normal urine is clear, and cloudy urine can come from cells, bacteria, or mucus. Harmless crystals that form as the urine cools are also a common cause.

Dipstick results

Specific gravity. This shows how concentrated the urine is, with a typical range of about 1.005 to 1.030. A high number usually means you were low on fluids, while a low number usually means you had been drinking a lot.
pH. This shows how acidic the urine is, with a typical range of about 4.5 to 8, and diet has a large effect on it.
Protein. Normal urine has little or no protein, so a negative or trace result is usual. Our article on protein and albumin in the urine explains higher results.
Glucose. Glucose (sugar) normally stays in the blood and spills into the urine when blood sugar is high, as in diabetes. Some diabetes medicines also cause glucose in the urine on purpose.
Ketones. Ketones are made when the body burns fat for energy, for example after fasting, vomiting, or a very low-carbohydrate diet. A high level can also be a sign of uncontrolled diabetes.
Blood. The square on the dipstick for blood changes color when it detects hemoglobin, the protein in red blood cells, or myoglobin, a similar protein in muscle. Our article on blood in the urine explains a positive result.
Bilirubin and urobilinogen. These substances come from the normal breakdown of old red blood cells. Bilirubin is normally negative, and when positive, can point to a liver or bile duct problem, while a small amount of urobilinogen is normal.
Leukocyte esterase. This is a chemical released by white blood cells, and a positive result suggests white blood cells in the urine, often from infection or inflammation.
Nitrite. Some bacteria turn a normal substance in urine into nitrite, so a positive result suggests bacteria, but a negative result does not rule out infection. Both tests are explained in our article on signs of infection on a urinalysis.

Microscope results

Red blood cells (RBC). A few red blood cells are normal, typically 0 to 2 per hpf, and higher counts are called microscopic hematuria.
White blood cells (WBC). A few white blood cells are normal, typically 0 to 5 per hpf, and higher counts suggest infection or inflammation.
Squamous epithelial cells. These are flat squamous cells from the skin around the urethra. Many of them usually means the sample picked up cells from outside the urinary tract.
Bacteria. Bacteria in the urine can come from an infection or from contamination during collection. The microscope cannot tell the two apart, so a urine culture is used when infection is suspected.
Mucus. Mucus threads are common in normal urine and are not a sign of disease.
Casts. Casts are tiny tube-shaped plugs formed inside the kidney, and a few hyaline casts are normal, especially after exercise. Casts containing red or white blood cells point to a problem inside the kidney itself.
Crystals. Most crystals form as urine cools in the cup and are harmless, although a few rare types are linked to kidney stones or other conditions.

Common reasons for a slightly abnormal urinalysis

A urinalysis result just outside the normal range is common, and often it does not mean disease. Everyday things that can change a urinalysis result include:

Exercise. Hard exercise can briefly add protein, blood, and hyaline casts to the urine.
Not drinking enough. Concentrated urine makes trace dipstick results more likely.
Menstruation. Menstrual blood can enter the sample and cause a positive blood result.
A contaminated sample. Skin cells and bacteria from outside the urinary tract can cause a positive leukocyte esterase, white blood cell, or bacteria result.
Fever or a recent illness. These can briefly cause protein in the urine that disappears once you recover.
Some foods, vitamins, and medicines. These can change urine color or affect individual dipstick results.

What other tests are ordered with a urinalysis?

A urinalysis is often ordered with other tests that help explain an abnormal urine result.

Urine culture. A urine culture grows any bacteria in the urine to confirm an infection and identify the organism.
Urine albumin-to-creatinine ratio (ACR). This urine test measures small amounts of albumin that a dipstick can miss.
Kidney function blood tests. Creatinine and eGFR show how well the kidneys are filtering, as explained in our article on kidney function tests.
Blood glucose tests. Fasting glucose and other blood sugar tests are used when glucose appears in the urine.

What happens after a urinalysis?

What happens after a urinalysis depends on which results were abnormal and whether you have symptoms. A normal urinalysis usually needs no follow-up, and a single mildly abnormal result is often repeated on a fresh, carefully collected sample. A urine culture may be added if infection is suspected. Persistent protein, blood, or casts may lead to kidney blood tests, a urine ACR, or a referral to a kidney or bladder doctor.

Questions to ask your doctor

Which results on my urinalysis were flagged as abnormal, and what do they mean for me?
Do any of these urine test results need to be repeated on a fresh sample?
Could the way my sample was collected have affected any of the results?
Did my report include a microscopic examination, and if not, should one be done?
Could exercise, my period, or a recent illness explain these results?
Do I need a urine culture to check for an infection?
Should my kidney function be checked with blood tests or a urine ACR?
Do these results change how my diabetes or blood pressure is being managed?
When should I have another urinalysis, and what would you expect it to show?
Which symptoms should prompt me to contact you before my next appointment?