Epithelial Cells in Urine

the-test-1006795_1920Epithelial cells can be found in urine during urinalysis which represents a diagnostic procedure which uses urine as a sample material to examine the ingredients from numerous views. Examination of urine consists of the color and clarity of the fluid, the smell, acidity and the density of the urine. The density of urine is being used as an indicator of the substance concentration. It makes the urine thicker and usually darker. There is also microscopic exam included or, at least, urine test strips which have all the things included but is not that precise. Under a microscope, we can see all the cells and structures which include red and white blood cells, some other particles and epithelial cells. They belong to urinary tract lining walls, including kidney.

Epithelial Cells in Urine

Particles like epithelial cells inside urine can be normal findings depending on the number range. It occurs as a natural event when the sloughing process happens where the urinary tract renews the lining. It changes from time to time, resulting in a small quantity of these cells appearing in the urine. They get excreted with the rest of the metabolites and it is nothing pathological and it’s being considered normal. They can be also found in older women presenting parabasal squamous epithelial cells which can be present after low estrogen level effects. Transitional cells can be found in elderly, where in other findings can indicate the transitional cell cancer of the renal pelvis.

Abnormal Reasons Of Epithelial Cells In Urine

Even though the epithelial cells in urine are nothing to worry about, when it appears outside the boundaries, it can be a sign of a disease. Here are some of the possibilities.


This is the most common reason for abnormal range or epithelial cells in urine. Contamination happens when your genitals are not clean, so when you’re giving the urine sample, you can get the other substances inside. The cell particles may be from elsewhere and it can contaminate the sample. It is important to wipe genitals before giving the sample and to use clean, sterile cups which will prevent any wrong results. It is important to use the midstream for the sample and do not touch the inside of the cup when handling with a sample.

Signs Of An Infection

If you have increased a number of epithelial cells in urine, it can be due to an infection. The most common bacteria causing urinary tract infection is Escherichia Coli which causes irritation and inflammation of the bladder and the rest of the urinary tract, resulting in mucus sloughing. It is mostly due to bacteria entrance from the outside, especially in women. It can go from urethra to the bladder and up all the way to the kidneys.

Nephrotic Syndrome

Nephrotic syndrome is a syndrome indicating an event inside the kidneys. It causes the changes in the urine findings such as cell findings like epithelial cells inside the urine, increased concentration of proteins and density. Since there is a damage, the excretion process will have flaws where the bigger substances will come through the membranes appearing in the urine. This can be expressed as proteinuria and lipiduria. It needs medical attention and it’s considered as a severe condition with urgent treatment.

Other Findings

When doing urinalysis or doing urine test strips which you dip into the urine, you can get all sorts of findings. They can include:

  • White And Red Blood Cells. They are normal to be found, but also in certain range. It is normal that there is about 1-5 erythrocytes per view space under a microscope and 4-10 leukocytes. Higher than that can be micro or microhaematuria and infection with increased white blood cells.
  • Bacteria. They can be found in urinary tract infections, where the E. Coli is the most common one.
  • Crystals. They are not normal to be found in the urine, and they indicate a high concentration of calcium or other substances in urine.
  • Glucose. It is usually negative in the urine samples.
  • Creatinine. This is the metabolism product which gets excreted through kidneys. It is widely being used as kidney function indicator. When the creatinine levels are high, it is a sign of a kidney damage, where the membranes do not keep the necessary products, and the bigger substances get excreted.
  • Casts. They represent the urinary tract tubules drain which forms from the protein or other structures inside the blood. They can be cholesterol crystals or casts with leukocytes or erythrocytes. They are often present in kidney disease, diabetes, some inflammation inside the renal tubules, and can be present in diseases linked with high cholesterol levels. It is an event which can happen after exercising where the proteins from the muscles are being disassembled.

The Normal Range Of Epithelial Cells In Urine

If the reason for a high level of epithelial cells is not contamination or bad instructions while taking a urine sample, it can be a sign of a kidney damage or other disease. It is important to know the normal range in order to differentiate the normal from the pathological sign. It ranges from a few cells to a moderate level or many. There are also measurements which are presented in numbers or concentration which is normal to be less than 15-20 per high power field (HPF).


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