If you’re a lupus patient, I’m sure at some point you’ve heard those wonderful words “…now, go pee in this cup.” Unfortunately, holding your morning pee while trying to aim into the miniature size sterile Dixie® cup is the easy part. What is not so easy to understand is the medical jargon that follows when you get the results of your urinalysis. Doctors causally throw out words like ketones and you think, “What, my pee is musical?” Or leukocytes and you go, “Isn’t that some sort of dinosaur fossil? Or creatinine and you ponder, “Are you speaking Latin?” These are just some of the many medical terms that often leave lupus patients scratching their already itchy heads (thanks alopecia) and wondering what on earth is going on? So why don’t we delve a little deeper….into the toilet. Let’s translate what your pee really says about you. Sometimes, doctors don’t have the time to explain the complicated medical jargon – which isn’t very helpful. So how about the CliffsNotes® version? Let’s get down to it, and trust me, urine for a real treat. Sorry I just couldn’t hold that in! Back to top
DEFINITION A urinalysis is the physical, chemical, and microscopic examination of your pee. It involves a slew of different tests to measure various compounds and detect the stuff that pass through the urine. WHY PEE IN A CUP? Urinalyses are done as part of a medical exam to look for signs of disease. If you have signs of kidney disease or nephritis, your doctor will most likely have you perform tests on a regular basis. Sometimes urinalyses are used to detect acute conditions like urinary tract or kidney infections. In a nutshell, your kidneys take out the trash. They filter waste material, fluids and minerals from the blood and pass them through the urine. Everything from how much you exercise – to what you had for dinner…can be found in your pee and ultimately can tell how well your kidneys are working. Back to top
After you have given your sample (btw, I don’t like that it’s called that…it has forever ruined my experience of getting my freebies at the Froyo shop) it is tested ASAP. The health care provider uses a dipstick to test the gravity of your urine (for definition of “gravity” see below) and then often sends it off to the lab. Usually it takes just a few days to get the results. Then comes the fun part, deciphering what those words mean. Back to top
COLOR: How light or dark your urine is can tell you how much water is present in it. Many things can affect the color of your urine. Some things include dehydration, diet, medicine and certain diseases.
ODOR: First off, aren’t you glad it’s not your job to smell someone else’s pee? But, this can play a part in diagnosing certain diseases. Urine should not smell very strong, however, some conditions can cause a change in urine odor. Oh and then there’s the obvious…asparagus pee. Don’t waste a doctor’s call on that one.
GRAVITY: This one measures the amount of “stuff” that is in your urine. It shows how the kidneys balance the amount of water in the urine as well. The higher the gravity is, the more junk that is in your urine. When you are dehydrated, your kidneys make urine with very little water in it, which means it has a high specific gravity. When you drink a lot of water, you have a low specific gravity.
PH: This measures how acidic or alkaline the urine is. A pH of 4 is very acidic, 7 is neutral and 9 is very alkaline. Pee that is very acidic or very alkaline indicates a higher chance of developing kidney stones, and so people with kidney stones especially need to be aware of these numbers and make sure they are eating certain foods to keep their pH balance where their doctor wants it.
PROTEIN: Protein shouldn’t be in your pee. Certain things like, pregnancy, kidney disease, fever, strenuous exercise and other conditions can cause protein to be in your pee. So it’s not that 8oz steak you had for dinner last night, most likely something else is going on.
GLUCOSE: Glucose is sugar that is found in the blood. Usually, there is little to no glucose in the urine. Glucose pops up in the urine when the kidneys are stressed, damaged or diseased or with severe diabetes.
LEUKOCYTES: A fancy name for white blood cells in the urine. This is usually indicative of a urinary tract infection.
KETONES: Ketones are the substances made from your body breaking down fat into energy! Usually your body breaks down carbohydrates in your diet to generate energy, but if your diet doesn’t contain enough carbs, or if your body isn’t metabolizing blood sugar properly (as with diabetes), then ketones are made. When large amounts of ketones are found in the urine, that could mean diabetes, low caloric diet or starvation, or maybe you just had a bad case of stomach flu and tossed your cookies…a lot.
NITRITES: Bacteria that cause a UTI make an enzyme that transforms nitrates to nitrites -crazy, right? Nitrites in the urine mean you definitely have a nice UTI.
RED BLOOD CELLS: Blood in the urine is usually not normal. Inflammation, disease (like kidney stones), or injury to the bladder, ureters, kidneys and urethra can cause blood in the urine.
CREATININE: This is a big one for the lupus nephritis group. Creatinine is made by muscle metabolism, and filtered out of the bloodstream through the kidneys. Creatinine levels will rise in your blood and decrease in your urine if your kidneys are impaired.
OTHER STUFF: Casts, crystals and bacteria…OH MY! Casts are made from different substances (i.e. wax, fat, red and white blood cells) and get flushed out of the kidneys. What type you have determines what type of kidney disease may be at work. Crystals (in large numbers) may mean a kidney stone or problem with your metabolism. Bacteria (as well as yeast or parasites) could mean that you have an infection. Back to top
So, next time you go to pee in a cup, remember this…your pee says A LOT about you. The good news is you can finally understand what it is saying about you and the stuff your doctor is saying. You are now equipped to be part of the conversation. Yay! Now, go flush! Back to top
Author: Kelli Roseta
All images unless otherwise noted are property of and were created by Kaleidoscope Fighting Lupus. To use one of these images, please contact us at firstname.lastname@example.org for written permission; image credit and link-back must be given to Kaleidoscope Fighting Lupus.
All resources provided by us are for informational purposes only and should be used as a guide or for supplemental information, not to replace the advice of a medical professional. The personal views expressed here do not necessarily encompass the views of the organization, but the information has been vetted as a relevant resource. We encourage you to be your strongest advocate and always contact your healthcare practitioner with any specific questions or concerns.