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Experience:  17 years of RN experience. Most of my experience has been Director of Nursing.
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Urinary Tract Infection

Resolved Question:

I went to a new doctor a couple weeks ago she ordered some routine blood + urinalysis test then scheduled a physical exam two months from now, I got the lab work done and the lab sent me the results I noticed some of the results are out of range with the urinalysis they are listed below.

Protein: 10-20 mg/dl
RBC: 20 HPF
WBC: 19 HPF
WBC CLUMPS: MANY
BACTERIA, URINE: MODERATE
SQUAMOUS EPITH: 4 HPF

are these results something to be concerned about, the doctor never contacted me regarding the results, I'm suspecting it might be a UTI even though I have no symptoms, does this problem need to be treated now or can it wait another month, what concerns me most is the protein in the urine 10-20 mg/dl I'm worried that it's the begining stages of kidney disease my GFR is 79 ml/min/1.73m2 which is considered to be a mild decrease in the kidney function,can you let me know if this sounds abnormal for a 27 year old.

Thanks in Advance


Thanks in advance for your help
Submitted: 8 years ago.
Category: Health
Expert:  Pam replied 8 years ago.
Hello and Welcome to Just Answer:

I have the explanations and values of a normal urinalysis.

Color. Many factors affect urine color, including fluid balance, diet, medications, and disease. The intensity of the color generally indicates the concentration of the urine; pale or colorless urine indicates that it is dilute, and deep yellow urine indicates that it is concentrated. Vitamin B supplements can turn urine bright yellow. Reddish brown urine may be caused by certain medications; by blackberries, beets, or rhubarb in the diet; or by the presence of blood in the urine.

Clarity. Urine is normally clear. This test determines the cloudiness of urine, also called opacity or turbidity. Bacteria, blood, sperm, crystals, or mucus can make urine appear cloudy.
Odor. Urine usually does not smell very strong, but has a slightly "nutty" (aromatic) odor. Some diseases can cause a change in the normal odor of urine. For example, an infection with E. coli bacteria can cause a foul odor, while diabetes or starvation can cause a sweet, fruity odor.

Specific gravity. This measures the amount of substances dissolved in the urine. It also indicates how well the kidneys are able to adjust the amount of water in urine. The higher the specific gravity, the more solid material is dissolved in the urine. When you drink a lot of liquid, your kidneys should produce greater-than-normal amounts of dilute urine (low specific gravity). When you drink very little liquid, your kidneys should make only small amounts of concentrated urine (high specific gravity).

pH. The pH is a measure of how acidic or alkaline (basic) the urine is. A urine pH of 4 is strongly acidic, 7 is neutral (neither acidic nor alkaline), and 9 is strongly alkaline. Sometimes the pH of urine may be adjusted by certain types of treatment. For example, efforts may be made to keep urine either acidic or alkaline to prevent formation of certain types of kidney stones.

Protein. Protein is normally not detected in the urine. Sometimes a small amount of protein is released into the urine when a person stands up (this condition is called postural proteinuria). Fever, strenuous exercise, normal pregnancy, and some diseases, especially kidney disease, may also cause protein in the urine.

Glucose. Glucose is the type of sugar usually found in blood. Normally there is very little or no glucose in urine. However, when the blood sugar level is very high, as in uncontrolled diabetes, it spills over into the urine. Glucose can also be present in urine when the kidneys are damaged or diseased.

Nitrites. Bacteria that cause a urinary tract infection (UTI) produce an enzyme that converts urinary nitrates to nitrites. The presence of nitrites in urine indicates a UTI.

Leukocyte esterase (WBC esterase). Leukocyte esterase detects leukocytes (white blood cells [WBCs]) in the urine. The presence of WBCs in the urine may indicate a urinary tract infection.

Ketones. When fat is broken down for energy, the body produces by-products called ketones (or ketone bodies) and releases them into the urine. Large amounts of ketones in the urine may signal a dangerous condition known as diabetic ketoacidosis. A diet low in sugars and starches (carbohydrates), starvation, or prolonged vomiting may also cause ketones in the urine.

Microscopic analysis. In this test, urine is spun in a centrifuge so the solid materials (sediment) settle out. The sediment is spread on a slide and examined under a microscope. Types of materials that may be found include:

Red or white blood cells. Normally blood cells are not found in urine. Inflammation, disease, or injury to the kidneys, ureters, bladder, or urethra can cause blood in urine. Strenuous exercise (such as running a marathon) can also cause blood in urine. White blood cells are often a sign of infection, cancer, or kidney disease.

Casts. Some types of kidney disease can cause plugs of material (called casts) to form in tiny tubes in the kidneys. The casts can then get flushed out into the urine. Casts can be made of different types of material, such as red or white blood cells, waxy or fatty substances, or protein. The type of cast can provide clues about the type of kidney disease that may be present.

Crystals. Healthy people often have only a few crystals in their urine. However, a large number of crystals, or the presence of certain types of crystals, may indicate kidney stones or a problem with how the body is using food (metabolism).

Bacteria, yeast cells, or parasites. Normally there are no bacteria, yeast cells, or parasites in urine. Their presence can indicate an infection.

http://www.webmd.com/hw/lab_tests/hw6580.asp

Give me a few minutes and I will give you the normal ranges. Having protein in your urine could be from infection such as a bladder infection, which looks like you have. My opinion would be to call the doctor and make sure he has looked at this report.

Thank you,
Pam Russell RN
Pam, Nurse (RN)
Category: Health
Satisfied Customers: 313
Experience: 17 years of RN experience. Most of my experience has been Director of Nursing.
Pam and 5 other Health Specialists are ready to help you
Expert:  Pam replied 8 years ago.
Here is the normal ranges for you.

Urinalysis

Specific gravity     1.002-1.030

pH                   5-7

Protein              negative-trace

Glucose              negative

Ketone              negative

Bilirubin           negative

Blood               negative

Nitrite             negative

Leukocyte           negative          

Urobilinogen       0.2-1.0 Ehr U/dL


Micro

RBCs      0-2/HPF

WBCs      0-2/HPF

RBC casts 0/HPF


If you have anymore questions please let me know.

Thank you,
Pam Russell RN

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