Urine Full Report (UFR) / Urinalysis Explained

Why Might My Doctor Request a UFR?

A urine test may be requested for many reasons.

For example, your doctor may use it when:

• you have burning or pain when passing urine;
• you need to pass urine frequently;
• a urinary infection is suspected;
• there is visible or suspected blood in the urine;
• a kidney or urinary-tract problem is being investigated;
• diabetes or another medical condition is being assessed;
• you are having a general medical assessment.

Sometimes a UFR is performed even when you do not have urinary symptoms.

The reason for the test affects how the results are interpreted.

How Do I Give a Urine Sample?

You will usually be asked to pass urine into a clean specimen container.

For some tests, you may be asked to provide a clean-catch midstream urine sample.

This generally means allowing the first small amount of urine to pass into the toilet and then collecting urine into the container without touching the inside of the container.

The exact collection method can vary depending on why the test is being done.

Follow the instructions given by your doctor, nurse or laboratory.

Correct collection is important because contamination can affect some urine-test results.

Do I Need to Fast for a UFR?

Usually, you do not need to fast simply for a routine UFR or urinalysis.

However, you may be having other blood or urine tests at the same time that have different preparation requirements.

Follow the instructions given for your particular tests.

What Does a UFR Check?

A urine report can contain several types of information.

Depending on the laboratory, these may include:

Physical appearance

For example:

• colour;
• whether the urine is clear or cloudy.

Chemical testing

This may include:

• protein;
• glucose;
• ketones;
• blood;
• pH;
• specific gravity;
• nitrite;
• leukocyte esterase.

Microscopic examination

The laboratory may also look for:

• red blood cells;
• white blood cells or pus cells;
• epithelial cells;
• bacteria;
• crystals;
• casts.

Not every laboratory report uses exactly the same format or reports every item in the same way.

Do Not Read One Result in Isolation

A UFR contains several findings that need to be considered together.

For example:

• white blood cells alone do not automatically prove a urinary infection;
• blood in urine can have several possible causes;
• protein in urine does not automatically mean kidney failure;
• crystals do not automatically mean that you have a kidney stone.

Your symptoms and other investigations may change the meaning of the result.

What Do Colour and Appearance Mean?

Normal urine can vary from very pale yellow to darker yellow depending partly on how concentrated it is.

A report may also describe urine as:

• clear;
• slightly cloudy;
• cloudy.

Cloudiness does not identify one particular disease.

Cells, crystals, mucus, contamination and infection are among the different things that can affect the appearance of urine.

Similarly, an unusual urine colour can have several possible explanations, including foods, medicines, hydration and medical conditions.

The rest of the report and your symptoms are therefore more useful than colour alone.

What Is Urine Specific Gravity?

Specific gravity gives an indication of how concentrated or dilute the urine sample is.

A higher value generally means the urine is more concentrated.

A lower value generally means it is more dilute.

The result can be affected by factors such as how much fluid you have been drinking.

A single specific-gravity result should therefore not be used by itself to decide whether your kidneys are functioning normally.

What Does Urine pH Mean?

Urine pH describes how acidic or alkaline the urine is.

Urine pH can vary for several reasons, including diet, medicines and some medical conditions.

The pH result is usually interpreted together with the rest of the urine report rather than by itself.

An abnormal-looking pH number alone does not diagnose a urinary infection or kidney disease.

What Does Glucose in Urine Mean?

Glucose is the main sugar used by your body for energy.

Normally, urine contains little or no glucose that is detected by routine testing.

Glucose may appear in urine when the blood glucose level is high enough for glucose to pass into the urine.

However, urine glucose does not replace blood glucose testing for diagnosing or monitoring diabetes.

Some medicines and some less common kidney-related conditions can also affect urine glucose.

If glucose is found in your urine, your doctor may consider your blood glucose and other information before deciding what it means.

What Do Ketones in Urine Mean?

Ketones are produced when the body uses more fat for energy instead of glucose.

Ketones may appear in urine in several situations.

These can include:

• fasting or not eating enough;
• prolonged vomiting;
• some low-carbohydrate diets;
• diabetes, particularly when insulin is insufficient.

A small ketone result does not have the same meaning in every person.

However, high ketones can be important in a person with diabetes, particularly if blood glucose is high or the person is unwell.

What Is Leukocyte Esterase?

Some urine reports include leukocyte esterase.

This is a chemical test that can suggest that white blood cells are present in the urine.

A positive result may support the possibility of urinary inflammation or infection.

However, it should be interpreted together with the other urine findings and your symptoms.

It does not diagnose a UTI by itself.

What Does Nitrite in Urine Mean?

Some bacteria that cause urinary infections can produce nitrite in urine.

Therefore, a positive nitrite result can support the possibility of a bacterial urinary infection.

However, not every urinary infection produces a positive nitrite result.

This means:

The result should be interpreted together with symptoms and other urine findings.

What Does Bacteria in Urine Mean?

Bacteria seen or detected in a urine sample can occur with a urinary infection.

But bacteria can also appear if the sample becomes contaminated during collection.

This is why the collection method matters.

The presence of bacteria on a UFR does not always mean that antibiotics are needed.

If a urinary infection needs to be confirmed or the exact bacteria need to be identified, your doctor may request a urine culture.

Is a UFR the Same as a Urine Culture?

No.

A UFR or urinalysis examines different features of the urine and can provide clues suggesting infection.

A urine culture is used to look for and identify bacteria that may be causing a urinary infection.

Depending on the situation, your doctor may request:

• only a UFR;
• only a urine culture;
• or both.

A UFR showing white blood cells or bacteria does not replace a urine culture when a culture is clinically needed.

What Do Epithelial Cells Mean?

Epithelial cells are cells that come from surfaces lining parts of the urinary and genital systems.

A small number may be seen in a urine sample.

Larger numbers can sometimes occur because the urine sample has been contaminated during collection.

The meaning depends partly on the type and number of cells reported.

For a patient reading a routine UFR, the important point is:

What Do Crystals in Urine Mean?

Crystals can sometimes be seen when substances dissolved in urine form small solid particles.

Some crystals can occur in people without kidney stones or other serious disease.

Their presence can be influenced by factors such as:

• urine concentration;
• urine pH;
• substances present in the urine.

Certain crystal patterns can be useful to doctors when investigating urinary stones or other conditions.

However:

What Are Urinary Casts?

Some UFR reports may mention casts.

Casts are tiny structures that can form inside the small tubes of the kidneys and then pass into the urine.

Different types of casts can have different meanings.

Some may occur without serious kidney disease, while certain types can be associated with kidney problems.

A report mentioning casts therefore needs to be interpreted according to:

• the type of cast;
• the amount;
• other urine findings;
• your kidney blood tests;
• your clinical situation.

Do not try to diagnose a kidney disease from the word “casts” alone.

Why Are the “Normal Values” Different Between Laboratories?

Urine reports are not completely identical between laboratories.

Different laboratories may:

• use slightly different methods;
• report results in different units;
• use words such as negative, trace, few or many;
• provide different reference ranges.

For this reason, use the reference information printed on your own laboratory report.

Do not compare a result with a random range found online and assume that your laboratory uses exactly the same method.

Does an Abnormal UFR Mean I Have a Disease?

Not necessarily.

A UFR provides clues.

Some findings may be temporary, affected by sample collection or related to a condition that needs further assessment.

Doctors interpret the report by considering:

• why the test was requested;
• your symptoms;
• whether the sample may have been contaminated;
• which findings are abnormal;
• how the findings fit together;
• whether other tests are needed.

This is why one highlighted or abnormal value should not be interpreted on its own.

When Should I Speak to a Doctor?

Arrange medical review if your urine report is abnormal and you have been advised to discuss the result, particularly if abnormalities such as blood, protein or signs suggesting infection continue to be present.

Seek prompt medical advice if you have symptoms such as:

• visible blood in your urine;
• burning or significant pain when passing urine;
• fever with urinary symptoms;
• pain in your side or back with urinary symptoms;
• repeated vomiting;
• difficulty passing urine;
• markedly reduced urine output.

The urgency depends on your symptoms and overall condition, not simply on whether a UFR value is marked abnormal.

Remember

Your symptoms and the rest of the report matter.

Related kidney and urine health topics

Key Points

• UFR means Urine Full Report.
• Urinalysis is another commonly used name for urine testing.
• A UFR can examine the appearance, chemical contents and microscopic findings in urine.
• Protein, glucose, ketones, blood, WBC, nitrite and bacteria are among the common findings.
• WBC or pus cells can occur with urinary infection but do not prove a UTI by themselves.
• Positive nitrite can support the possibility of bacterial UTI, but negative nitrite does not completely rule it out.
• Blood or RBC in urine can have several possible causes.
• Routine urine protein testing is different from an ACR test.
• Crystals do not automatically mean kidney stones.
• Bacteria in a sample can sometimes result from contamination.
• A urine culture is different from a UFR.
• Results should be interpreted together with symptoms and other medical information.