Urinalysis, Microscopic
A microscope-level look at urine sediment that flags infection, blood, and kidney trouble routine dipsticks miss.
Consider this test if:
- Burning, urgency, frequency, or other symptoms of a urinary tract infection
- Visible or dipstick-detected blood in the urine
- A history of kidney stones or flank pain you want characterized
- Following up an abnormal dipstick for protein, blood, or leukocytes
- Monitoring kidney health when diabetes, hypertension, or kidney disease runs in the family
- HSA/FSA eligible
- Results delivered to your dashboard · Reviewed by a real clinician
- Drawn at a CLIA/CAP-accredited lab near you ·
Pre-test considerations
No fasting required. A clean-catch midstream sample is best to avoid contamination from skin cells and bacteria. Heavy exercise shortly before collection can transiently raise red blood cells, and collecting during menstruation can introduce blood into the sample. Submit the sample promptly, since cells and casts degrade over time.
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What this test is for
Microscopic urinalysis examines the cells and formed elements that settle out of a urine sample under the microscope, including white and red blood cells, epithelial cells, bacteria, yeast, crystals, and casts. White blood cells and bacteria point toward urinary tract infection; red blood cells flag bleeding anywhere from the kidneys to the bladder; casts and renal epithelial cells suggest the problem is in the kidney itself rather than lower down. Crystals such as calcium oxalate, uric acid, and triple phosphate connect to kidney stones and can hint at the stone type. It is the detailed follow-through to a dipstick: when a chemical screen shows blood, protein, or leukocytes, the microscopic exam shows what is actually there. Findings are read against symptoms and other tests, since crystals and a few cells can appear in healthy urine too.
Biomarkers tested
Includes 15 biomarkers
- Specimen
- Urine sediment
- Method
- Light microscopy
- Measures
- Presence / threshold
This test counts bacteria per high power field in urine sediment examined under a microscope, a direct look for organisms that shouldn't be living in your urinary tract. Elevated counts point to a urinary tract infection, especially alongside white blood cells, and often explain burning with urination, urgency, frequency, pelvic pain, or cloudy, foul-smelling urine. It's a quick way to confirm or rule out infection when symptoms flare, or to check that a prior UTI has actually cleared.
- Specimen
- Urine sediment
- Method
- Light microscopy
- Measures
- Count per area
This marker counts calcium oxalate crystals seen directly under the microscope in a spun sample of your urine, the same crystal type that forms most kidney stones. Finding them is common and often harmless, but frequent or heavy amounts point to concentrated urine, low fluid intake, or a diet high in oxalate (spinach, nuts, chocolate, tea), and correlate with stone risk over time. It's a useful check if you've had a kidney stone before, get recurrent flank pain or blood in your urine, or want to confirm that hydration and dietary changes are actually reducing your crystal load.
- Specimen
- Urine sediment
- Method
- Light microscopy
- Measures
- Count per area
- Specimen
- Urine sediment
- Method
- Light microscopy
- Measures
- Count per area
This test looks under the microscope at urine sediment to count crystals per high power field, the mineral and salt deposits that form when urine holds more of a substance than it can keep dissolved. Certain crystal types point to specific problems: calcium oxalate and uric acid crystals often accompany kidney stone formation, while others can flag dehydration, diet extremes, or liver and metabolic conditions. It's a useful add-on if you've had flank pain, blood in your urine, or a history of kidney stones, and useful for tracking whether hydration or dietary changes are actually reducing stone-forming risk.
- Specimen
- Urine sediment
- Method
- Light microscopy
- Measures
- Count per area
Granular casts are cylindrical clumps of degenerated cellular material that form in the kidney's tubules and wash out into urine, visible under the microscope during a urine sediment exam. A few granular casts can turn up after hard exercise or dehydration, but larger numbers point to tubular cell injury and often show up in acute kidney injury, dehydration, or chronic kidney disease. This test is useful for investigating unexplained changes in urine output, swelling, rising creatinine, or fatigue, and for tracking kidney recovery after an insult like illness, medication exposure, or a low-flow event.
- Specimen
- Urine sediment
- Method
- Light microscopy
- Measures
- Count per area
Hyaline casts are protein molds that form in the kidney's tubules and wash into urine, and technicians count them under the microscope during a urine sediment exam. A few are normal, especially after exercise, dehydration, or a fever, so an isolated finding usually needs no action. A high number, particularly alongside protein in urine, reduced output, or symptoms like swelling and fatigue, points toward more concentrated urine or early kidney stress worth tracking with follow-up testing.
- Specimen
- Urine sediment
- Method
- Light microscopy
- Measures
- Count per area
This test counts red blood cells per high-power field in urine sediment examined directly under the microscope, catching hematuria that dipstick testing can miss or falsely flag. Elevated counts point toward kidney or urinary tract sources of bleeding: infection, kidney stones, inflammation in the filtering units of the kidney, or irritation anywhere along the bladder and urinary tract. It's useful both as a routine check on kidney and urinary health and for investigating visible blood in urine, unexplained flank pain, or burning with urination.
- Specimen
- Urine sediment
- Method
- Light microscopy
- Measures
- Count per area
Renal epithelial cells line the kidney's tubules, and finding them shed into urine sediment means those tubules are shedding their lining faster than normal. A microscopist counts them per high power field, and elevated numbers point to acute tubular injury, infection, or toxin exposure (from medications, contrast dye, or heavy metals) rather than a bladder or urethral source of blood or protein. This test is most useful when you already have signs of kidney irritation, such as unexplained protein or blood in urine, and need to pinpoint whether the tubules themselves are under stress.
- Specimen
- Urine sediment
- Method
- Light microscopy
- Measures
- Count per area
This counts squamous epithelial cells shed into urine sediment and viewed under the microscope, cells that line the urethra, vagina, and outer skin rather than the kidney or bladder itself. A high count usually signals that the sample picked up cells from external contamination during collection rather than pointing to disease, which matters for interpreting everything else in the urinalysis correctly. Labs use this count to judge whether a sample is clean enough to trust, so a raised result on a symptom workup (burning, urgency, cloudy urine) often just means a repeat, better collected sample is needed before drawing conclusions about infection or kidney issues.
- Specimen
- Urine sediment
- Method
- Light microscopy
- Measures
- Count per area
Transitional cells line the bladder, ureters, and upper urethra, forming a flexible barrier that stretches as your bladder fills and shields deeper tissue from urine's caustic contents. Finding more than a few under the microscope points to irritation from a urinary tract infection, catheter use, or kidney stones, and persistently elevated or atypical counts warrant a closer look at the bladder lining. This one usually comes up when someone is investigating urinary symptoms like burning, urgency, or blood in the urine rather than as a routine baseline check.
- Specimen
- Urine sediment
- Method
- Light microscopy
- Measures
- Count per area
This measures triple phosphate (struvite) crystals seen under the microscope when a urine sample is examined for sediment. These crystals form in alkaline urine and often point to a urease-producing bacterial infection (commonly Proteus), so finding them alongside symptoms like cloudy urine, urinary urgency, flank pain, or recurrent UTIs helps confirm infection and flags a risk factor for struvite kidney stones. For most people this is a follow-up test rather than a routine baseline, ordered when a urinalysis raises questions about infection or stone risk.
- Specimen
- Urine sediment
- Method
- Light microscopy
- Measures
- Count per area
This test looks for urate crystals in urine sediment under the microscope, a marker of how concentrated your urine is and how acidic your pH runs. Crystals show up when urine is too acidic or too concentrated for uric acid to stay dissolved, conditions that also favor kidney stone formation. If you've had a uric acid kidney stone, gout flares, or unexplained flank pain, this finding connects the dots and often prompts a look at hydration, diet, and urine pH management.
- Specimen
- Urine sediment
- Method
- Light microscopy
- Measures
- Count per area
This test counts white blood cells sitting in your urine sediment under the microscope, cell by cell, per high power field. Neutrophils flood into urine when they're fighting a bladder or kidney infection, so elevated counts point to a urinary tract infection, and can also flag inflammation from kidney stones, an enlarged prostate, or, less commonly, interstitial cystitis. It's the natural next step if you're dealing with burning, urgency, cloudy urine, pelvic or flank pain, or a positive leukocyte esterase on a dipstick, and it's how you confirm an infection is actually clearing after treatment.
- Specimen
- Urine sediment
- Method
- Light microscopy
- Measures
- Count per area
This test counts yeast cells per high power field in urine sediment examined under the microscope, usually as part of a urinalysis. Yeast in urine most often signals a fungal infection (commonly Candida), and shows up more frequently in people with diabetes, recent antibiotic use, or a weakened immune response. Paired with symptoms like burning with urination, urgency, or vaginal or genital irritation, it helps distinguish a yeast infection from a bacterial UTI so treatment actually matches the cause.
- Specimen
- Urine sediment
- Method
- Light microscopy
- Measures
- Count per area
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Frequently asked questions
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Is this eligible for HSA/FSA?
Yes. This test is HSA/FSA eligible, and you can pay with your HSA/FSA card at checkout.
When will I get my results?
Your results post to your dashboard once your lab completes them, then a clinician reviews them and your full analysis and personalized action plan (with clear next steps) follow. Turnaround varies by test: specialty assays and at-home kits take longer, and each test shows its expected turnaround before you buy.
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