Educational Disclaimer: This tool is for educational purposes only and is not intended to replace clinical judgment. Always interpret urinalysis results in the context of the patient's clinical status, serum studies, and imaging findings. Use appropriate clinical references and consult with specialists when necessary.
Urinalysis Interpretation Tool
Interactive clinical decision support for urinalysis interpretation
Color
✓ Normal Value
Pale to dark yellow
⚠ Abnormal Findings
Red (hematuria), Brown (hemoglobinuria), Clear (dilute), Dark/cola (myoglobinuria)
📋 Clinical Relevance
Indicates hydration status, presence of blood, hemoglobin, or myoglobin
🚩 Red Flags
Red/brown color → possible glomerulonephritis, trauma, or rhabdomyolysis
Clarity
✓ Normal Value
Clear
⚠ Abnormal Findings
Cloudy, turbid, or hazy
📋 Clinical Relevance
Cloudiness suggests WBCs, bacteria, crystals, or protein precipitation
🚩 Red Flags
Cloudy UA → possible infection, pyuria, or crystalluria
Specific Gravity (SG)
✓ Normal Value
1.005-1.030
⚠ Abnormal Findings
<1.005 (dilute), >1.030 (concentrated)
📋 Clinical Relevance
Reflects kidney's ability to concentrate urine; affected by hydration and solute load
🚩 Red Flags
Fixed SG (~1.010) → possible renal dysfunction
pH
✓ Normal Value
4.5-8.0
⚠ Abnormal Findings
<4.5 (acidic), >8.0 (alkaline)
📋 Clinical Relevance
Alkaline urine favors crystal formation; acidic urine may indicate metabolic acidosis
🚩 Red Flags
Persistently alkaline + positive nitrites → possible UTI with urease-producing organisms
Protein
✓ Normal Value
Negative or trace (<150 mg/day)
⚠ Abnormal Findings
1+ (30 mg/dL), 2+ (100 mg/dL), 3+ (300 mg/dL), 4+ (>1000 mg/dL)
📋 Clinical Relevance
Indicates glomerular or tubular proteinuria; >3.5 g/day suggests nephrotic syndrome
🚩 Red Flags
Heavy proteinuria (3-4+) → glomerulonephritis, nephrotic syndrome, or severe CKD
Glucose
✓ Normal Value
Negative
⚠ Abnormal Findings
Positive (1+ to 4+)
📋 Clinical Relevance
Glucose appears when serum glucose >180 mg/dL (exceeds renal threshold)
🚩 Red Flags
Glucosuria + hyperglycemia → diabetes mellitus or SGLT2 inhibitor use
Ketones
✓ Normal Value
Negative
⚠ Abnormal Findings
Trace, small, moderate, large
📋 Clinical Relevance
Indicates ketosis from fasting, diabetes, or starvation
🚩 Red Flags
Ketonuria + hyperglycemia → diabetic ketoacidosis (DKA)
Blood (Dipstick)
✓ Normal Value
Negative
⚠ Abnormal Findings
Trace, small, moderate, large
📋 Clinical Relevance
Detects RBCs, hemoglobin, or myoglobin; positive without RBCs suggests hemoglobinuria
🚩 Red Flags
Positive blood + RBC casts → glomerulonephritis; positive without RBCs → hemolysis or rhabdomyolysis
Nitrites
✓ Normal Value
Negative
⚠ Abnormal Findings
Positive
📋 Clinical Relevance
Indicates gram-negative bacteria (E. coli, Klebsiella); specific for UTI
🚩 Red Flags
Positive nitrites + LE + symptoms → UTI; start antibiotics
Leukocyte Esterase (LE)
✓ Normal Value
Negative
⚠ Abnormal Findings
Trace, small, moderate, large
📋 Clinical Relevance
Indicates WBCs; sensitive for pyuria and UTI
🚩 Red Flags
Positive LE + nitrites → UTI; positive LE alone → possible sterile pyuria
WBCs (Microscopy)
✓ Normal Value
0-5/hpf
⚠ Abnormal Findings
>5/hpf
📋 Clinical Relevance
Pyuria suggests infection, inflammation, or contamination
🚩 Red Flags
WBC casts → pyelonephritis; WBCs without bacteria → viral infection or interstitial nephritis
RBCs (Microscopy)
✓ Normal Value
0-3/hpf
⚠ Abnormal Findings
>3/hpf
📋 Clinical Relevance
Hematuria indicates bleeding from GU tract or glomerulus
🚩 Red Flags
RBC casts → glomerulonephritis; dysmorphic RBCs → glomerular bleeding
Casts
✓ Normal Value
0-2 hyaline/lpf
⚠ Abnormal Findings
RBC, WBC, granular, waxy, fatty casts
📋 Clinical Relevance
RBC casts = glomerulonephritis; WBC casts = pyelonephritis; granular = acute tubular necrosis
🚩 Red Flags
RBC casts → GN (IgA, ANCA, post-streptococcal); WBC casts → pyelonephritis
Crystals
✓ Normal Value
Absent or rare
⚠ Abnormal Findings
Uric acid, oxalate, cystine, phosphate crystals
📋 Clinical Relevance
Crystal type indicates metabolic disorder or stone risk
🚩 Red Flags
Cystine crystals → cystinosis; uric acid crystals → gout or tumor lysis; oxalate → hyperoxaluria
Bacteria
✓ Normal Value
Absent or rare
⚠ Abnormal Findings
Present (rods or cocci)
📋 Clinical Relevance
Indicates UTI if >10^5 CFU/mL; may be contamination if <10^4
🚩 Red Flags
Bacteria + nitrites + LE → UTI; bacteria alone → possible contamination
Epithelial Cells
✓ Normal Value
0-5/lpf
⚠ Abnormal Findings
>5/lpf
📋 Clinical Relevance
Squamous cells = contamination; transitional/renal tubular cells = possible renal pathology
🚩 Red Flags
Many renal tubular cells → acute tubular necrosis or toxic injury
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