Abnormal Urinalysis Results: What They Mean for Your Health

Q: Abnormal Urinalysis Results: What They Mean for Your Health

Hello： In cases of urethritis, the urine report should show a white blood cell count exceeding 5/HPF. <br>The presence of urine ketones (1+) and urine bilirubin (1+) is not indicative of urethritis. <br>Vaginal inflammation can certainly affect the test results. <br>Additionally,

Urinalysis items in a health examination?

Hello, I underwent a health check in September, and the report indicated positive results for urine bilirubin (1+), urine ketones (1+), and urine leukocyte esterase (1+), as well as elevated epithelial cells (6-10).
On the day of the health check, I had to fast from 11 PM the previous night until around 3 PM on the day of the check due to morning commitments, and I also drank less water than usual.
Could this have affected the test results? Additionally, I previously visited a gynecologist for vaginal inflammation; could this condition also impact the results? Furthermore, I usually urinate more frequently than others, but I do not experience any discomfort while urinating.
I would like to ask the doctor what the abnormal findings in the health check might indicate and whether I need to follow up with a specific specialty.

Mandy, 20~29 year old female. Ask Date: 2020/09/14

Dr. Wu Zongying reply Family Medicine

Hello: In cases of urethritis, the urine report should show a white blood cell count exceeding 5/HPF.
The presence of urine ketones (1+) and urine bilirubin (1+) is not indicative of urethritis.
Vaginal inflammation can certainly affect the test results.
Additionally, frequent urination does not necessarily indicate urethritis, as increased fluid intake from water, tea, or coffee can also lead to frequent urination.
Since you mentioned that you do not experience discomfort while urinating, I recommend checking the white blood cell count (WBC count) in your urine report.
If it falls within the normal range, there is no need for concern; you may first seek treatment for your vaginal inflammation at a gynecology clinic.
It is advisable to drink plenty of water and avoid holding in urine.
Wishing you good health.

Reply Date: 2020/09/14

More Info

Understanding abnormal urinalysis results is crucial for assessing your overall health and identifying potential underlying conditions. Based on your recent health check-up results, several abnormalities were noted: positive urine bilirubin (1+), positive urine ketones (1+), positive urine leukocyte esterase (1+), and an elevated number of epithelial cells (6-10). Let's break down what these findings could indicate and how they might relate to your health.

1. Urine Bilirubin (1+): The presence of bilirubin in urine can indicate liver dysfunction or bile duct obstruction. Bilirubin is a byproduct of the breakdown of red blood cells, and its presence in urine typically suggests that the liver is not processing it effectively, possibly due to liver disease or hemolysis. It's essential to consider other liver function tests to get a clearer picture of your liver health.

2. Urine Ketones (1+): Ketones in urine can occur when the body is using fat for energy instead of glucose, which can happen in conditions like diabetes, prolonged fasting, or a low-carbohydrate diet. Since you mentioned fasting before the test, this could explain the presence of ketones. However, if you have not been on a strict diet and do not have diabetes, further evaluation may be warranted to rule out any metabolic issues.

3. Urine Leukocyte Esterase (1+): This finding suggests the presence of white blood cells in your urine, which can indicate a urinary tract infection (UTI) or inflammation. Given your history of vaginal inflammation, it is possible that this could have influenced the results. Infections or inflammation in the genital area can sometimes lead to the presence of leukocytes in urine.

4. Epithelial Cells (6-10): An elevated number of epithelial cells in urine can indicate contamination of the urine sample, which is common if the sample is not collected properly. It can also suggest inflammation or irritation in the urinary tract. If the sample was collected mid-stream, this could help reduce contamination.

Regarding your fasting state and reduced fluid intake prior to the test, both can affect urine concentration and the presence of certain substances. Dehydration can lead to more concentrated urine, which might amplify the presence of ketones and bilirubin.
Given your symptoms of frequent urination without discomfort, it is advisable to follow up with a healthcare provider. They may recommend further tests, such as a urine culture, blood tests to assess liver function, or imaging studies if necessary. If there is a suspicion of a UTI or other infection, appropriate treatment can be initiated.

In summary, while some of your results may be influenced by your fasting state and hydration levels, the presence of bilirubin, ketones, and leukocyte esterase warrants further investigation. It is essential to consult with a healthcare professional, possibly a urologist or a primary care physician, to interpret these results in the context of your overall health and any symptoms you may be experiencing. Regular monitoring and follow-up can help ensure that any potential issues are addressed promptly.

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