Understanding Epithelial Cells in Urine: Tests, Ranges, and Causes

What are Epithelial Cells?

Epithelial cells are specialised cells that form the protective lining of the body’s surfaces, cavities, and organs. They cover both external and internal areas, including the skin, blood vessels, and the urinary tract. The primary function of epithelial cells is to act as a barrier, protecting tissues from harmful substances, pathogens, and physical damage. They also assist in absorption, secretion, and filtration processes within the body.

In the urinary system, epithelial cells line the kidneys, bladder, ureters, and urethra. It is normal for a small number of these cells to shed into the urine as part of the body’s natural cell turnover. However, when elevated levels of epithelial cells in urine are detected, it may indicate an underlying issue such as a urinary tract infection (UTI), kidney disorder, or contamination during sample collection.

Monitoring epithelial cells in urine helps healthcare providers assess urinary health and detect potential infections or other medical concerns early.

Types of Epithelial Cells

There are three main types of epithelial cells in urine:

• Squamous epithelial cells: These are the largest and most common type of epithelial cells in urine. They are flat and thin, originating from the lower urinary tract, such as the urethra and bladder.
• Transitional epithelial cells: Also known as urothelial cells, these cells line the bladder, ureters, and part of the kidneys. They are smaller than squamous cells and appear round or polygonal.
• Renal tubular epithelial cells: These cells come from the kidney tubules and are the smallest of the three types. Their presence in urine may indicate kidney damage or disease.

Causes of Elevated Epithelial Cells in Urine

An increased number of epithelial cells in urine can result from various factors, including:

• Urinary tract infections (UTIs): UTIs can cause inflammation and shedding of epithelial cells from the bladder or urethra.
• Kidney diseases: Conditions such as glomerulonephritis or acute tubular necrosis can lead to the presence of renal tubular epithelial cells in urine.
• Contamination during sample collection: Improper collection techniques, especially in women, can lead to the presence of squamous epithelial cells from the genital area.
• Certain medications: Some drugs, such as chemotherapy agents, may cause increased shedding of epithelial cells.

What are Epithelial Cells in Urine Test?

The epithelial cells in urine test, also known as a urine microscopy or urinalysis, is a diagnostic tool that examines the urine sample under a microscope to identify and count the number and type of epithelial cells present. This test can help healthcare providers determine if there is an underlying condition affecting the urinary tract or kidneys.

What is it Used For?

The epithelial cells in urine test is used to:

• Detect urinary tract infections (UTIs) and signs of inflammation
• Assess kidney health and identify possible renal tubular damage
• Identify contamination in urine samples, which may affect test accuracy
• Monitor ongoing diseases that impact the urinary tract or kidneys
• Support the diagnosis of bladder or kidney cancers in rare cases

This test helps healthcare providers understand the condition of the urinary system and detect potential problems early. Understanding the epithelial cells in urine normal range can help prevent infections or kidney disorders.

Why Do I Need Epithelial Cells in the Urine Test?

Your doctor may order an epithelial cells in urine test if you experience symptoms such as:

• Painful urination or blood in urine
• Frequent urination or urgency
• Flank or abdominal pain
• Signs of kidney dysfunction or infection
• Unexplained abnormalities in routine urine tests

Interpreting Your Test Results

The epithelial cells' normal range in urine is typically reported as "few" or "rare". The table below shows the normal ranges and possible significance of elevated levels for each type of epithelial cell:

While the exact numeric range of epithelial cells in urine normal range can vary by laboratory, 0-5 cells per high power field (hpf) is generally considered within the epithelial cells normal range.

When Should You Be Concerned?

You should consult your healthcare provider if your epithelial cells in urine test shows:

• Your urine test consistently shows high levels of renal tubular or transitional epithelial cells
• You have symptoms of infection or kidney problems (e.g., fever, flank pain, persistent dysuria)
• There are abnormalities in the shape or nuclei of epithelial cells (may suggest malignancy)
• Results are accompanied by other abnormal urine findings, such as elevated white blood cells or protein

What Happens During an Epithelial Cells in Urine Test?

During an epithelial cells in urine test, you will be asked to provide a urine sample, typically using the midstream clean-catch method to minimise the risk of contamination. Once the sample is collected, it is examined under a microscope to count and identify the types of epithelial cells present. This helps determine whether the cell levels are within the normal range or suggest signs of infection, kidney issues, or other urinary tract problems. Based on the test results and your symptoms, your doctor may recommend further tests, such as a urine culture or imaging studies, for a more accurate diagnosis.

What are the Risk Factors for Increased Epithelial Cells?

Several factors can increase your risk of having elevated epithelial cells in urine:

• Being female (due to shorter urethra and proximity to the vagina)
• Pregnancy
• Menopause (due to hormonal changes affecting the urinary tract)
• Poor hygiene practices
• Holding urine for extended periods
• Certain medications that irritate the bladder
• Chronic conditions like diabetes or autoimmune disorders

Treatment Options For Epithelial Cells in Urine

The treatment options for epithelial cells in urine vary depending on the underlying cause.

1. Urinary tract infection (UTI): UTIs are typically treated with antibiotics.
2. Kidney disease: Treatment options for kidney disease include diet changes, medications and dialysis.
3. Kidney damage: The treatment for kidney damage will depend on the underlying cause. 
4. Cancer of the urinary tract: Treatment options may include surgery, radiation therapy and chemotherapy.

How to Maintain a Healthy Urinary System?

To keep your urinary system healthy and reduce the risk of issues that may lead to increased epithelial cells, follow these tips:

• Maintain proper hydration by drinking adequate water daily
• Practice good hygiene, especially after using the restroom
• Urinate regularly and avoid holding it for too long
• Wipe from front to back after bowel movements (for women)
• Wear breathable cotton underwear
• Avoid using harsh soaps or douches in the genital area
• Manage chronic conditions like diabetes as per your doctor's advice

Conclusion

While it's normal to have a small number of epithelial cells in your urine, elevated levels can indicate underlying health issues that require attention. If you have concerns about your epithelial cells in urine results or are experiencing symptoms, don't hesitate to consult with your healthcare provider.

At Metropolis Healthcare, we understand the importance of accurate and reliable diagnostic testing. Our team of skilled technicians and state-of-the-art laboratories ensure that your urine test results are precise and timely. With our convenient at-home sample collection services and user-friendly online report access, prioritising your health has never been easier.

FAQs

What is a normal epithelial cell range in urine?

The epithelial cells normal range in urine is typically low, with 0-5 cells per high power field (hpf) generally considered normal. However, the exact range may vary slightly depending on the laboratory.

What if epithelial cells are high in urine?

If your urine test shows consistently high levels of epithelial cells, particularly renal tubular or transitional cells, it may indicate an underlying issue such as a urinary tract infection, kidney damage, or inflammation. Consult with your healthcare provider for further evaluation and appropriate treatment.

How serious are 10-12 epithelial cells in urine?

The severity of 10-12 epithelial cells in urine depends on the type of cells present and other accompanying findings. While squamous epithelial cells at this level may simply indicate sample contamination, elevated renal tubular or transitional cells may signify a more serious issue like kidney disease or a UTI. Your doctor will consider your symptoms and overall health to determine the significance of the result.

Which disease is caused by epithelial cells?

Epithelial cells themselves do not cause disease, but their increased presence in urine can be a sign of various conditions affecting the urinary tract or kidneys, such as infections, inflammation, or certain cancers. Proper diagnosis and treatment by a healthcare professional are essential for managing any underlying issues.