Complete Urine Examination (CUE) Test in Hyderabad, India
At PACE Hospitals, we offer accurate and reliable Complete Urine Examination (CUE) tests in Hyderabad, Telangana, India through our advanced NABL-accredited diagnostic laboratory. Our experienced medical professionals perform a detailed analysis of urine samples to detect signs of urinary tract infections, kidney disorders, and various metabolic or systemic conditions. With a strong focus on quality, precision, and patient-centered care, we deliver timely results that help guide personalized treatment plans for better health outcomes.
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Urine Test
Urine Test is a broader term that refers to any test performed on a urine sample, and that it includes different types of tests such:
- CUE (Complete Urine Examination) / Urinalysis / Urine Routine Test
- Urine Culture Test
- Urine Pregnancy Test / Urine hCG Level Test
- 24-hour Urine Protein Test / 24-Hour Urinalysis
- Urine Drug Test / Urine Drug Screening
- Microalbumin Test / Urinary Microalbumin
CUE / Complete Urine Examination Test Cost in Hyderabad
Urinalysis / Urine Routine Test Preparation
Proper preparation ensures accurate and reliable results. Follow these guidelines when preparing for a CUE (Complete Urine Examination) / Urinalysis / Urine Routine Test:
✅ General Guidelines:
- Fasting: No special fasting is required unless your doctor has specifically instructed you to do so.
- Hydration: Drink a normal amount of water. Avoid drinking excessive amounts of water right before the test.
- Urination: Avoid urinating for at least 1 to 2 hours before collecting the sample to ensure you have enough urine.
🚫 Things to Avoid:
- Intense Exercise: Refrain from intense physical activity before the test.
- Medications and Supplements: Inform your doctor about all medications and supplements you are currently taking, especially Vitamin C, diuretics, and antibiotics, as these can affect the test results.
- Menstruation (for women): If possible, women should avoid providing a urine sample during their menstrual period to prevent contamination.
🧴 Sample Collection Tips:
- Container: Use the sterile container provided by the laboratory or clinic.
- Midstream Sample: Collect a midstream urine sample. This means letting a small amount of urine flow out first, then collecting the sample in the container.
- Hygiene: Clean the genital area thoroughly before collecting the sample to minimize the risk of contamination.
What is CUE test?
CUE Meaning
A complete urine examination test examines a urine sample for colour and the presence or concentration of specific compounds, providing information in the case of infections, urinary tract diseases, metabolic abnormalities, or cancer. It is termed as CUE or urinalysis.
It is an effective tool for clinical evaluation of individuals with kidney problems. Correct sample collection and analysis within the context of the clinical condition can provide doctors with significant information while also advising the next steps in diagnostic and treatment planning.
Indications of Complete Urine Examination / Urinalysis Test
A urine test may be performed for a variety of reasons. This test is most typically used when doctors suspect an infection and need to check for kidney and metabolic problems. It serves as both a screening and diagnostic test. A complete urine examination is indicated in the following conditions:
- Routine health checkup: As part of a routine health checkup, the individuals undergo a complete urine examination (CUE) test.
- Kidney diseases: This test may be required to identify a condition that has not yet manifested as symptoms. In addition, a general physician may use it to determine the cause of symptoms such as burning micturition, less urine output, and swelling of the body.
- Before the surgery: A urine test is an initial basic test that examines the key characteristics of urine. It is performed when patients are admitted to the hospital or before surgery.
- Diabetes management: People with diabetes need to undergo regular urinalysis to check for glucose and ketones in the urine, which indicates poor management of glycemic levels.
- Urinary tract infections: A complete urine examination is used to diagnose a urinary tract infection (UTIs).
- Abnormal symptoms: A complete urine examination can be required to detect potential causes of symptoms such as lower abdomen pain, blood in the urine, or chronic back pain.
- Hydration assessment: Urinalysis can provide information about hydration levels; concentrated urine indicates dehydration, and excessively diluted may indicate overhydration.
- Systemic health monitoring: The test can detect changes in urine composition, which can help identify systemic illnesses such as liver problems and certain malignancies (cancers).
Benefits of Complete Urine Examination / Urinalysis Test
- Urine testing is a highly sensitive and non-invasive test that can provide helpful information about a variety of conditions. Urine tests are gradually being recognized as a tool for diagnosing several kinds of health issues, including kidney, metabolic, and infectious diseases.
- A urine test is an effective and inexpensive diagnostic and monitoring tool for a variety of medical conditions.
Method of Collecting the Urine Sample
- Before collecting a urine sample, patients need to clean their genital area with water. Otherwise, the urine may get polluted with bacteria, cells, or additional substances.
- To obtain an accurate result and to avoid bacterial contamination, a "clean" midstream urine is taken. People need to collect a sample of midstream urine by stopping the initial flow for a few seconds and then collecting the middle portion of the urine stream in a container.
- Urine needs to be evaluated as soon as possible after collection, since some urine components are unstable. If a urine specimen is cannot be evaluated immediately, it must be preserved at 4–8°C in a refrigerator.
- Long-term storage of urine at room temperature can promote bacterial growth and the breakdown of red and white blood cells.
Complete Urine Examination (CUE) Interpretation
A complete urine examination or urinalysis includes three components or examinations:
- Physical examination
- Chemical examination
- Microscopic examination
Physical examination
Routine urinalysis begins with a physical examination of the urine. The color, odor, or appearance are only clinically relevant in a few cases; however, any abnormal findings need to be noted.
- Colour
- Normal urine colour ranges from straw (pale yellow) to dark amber (dark yellow). Urine having a pale-yellow colour indicates more dilution and low specific gravity. Diabetes mellitus is one example of this condition. Urine in this condition is often pale yellow, but has a high specific gravity due to its high glucose concentration.
- The dark amber (dark yellow) colour indicates concentrated urine with high specific gravity. This type of urine is commonly noticed in the first-morning urine.
- Urine colour is determined after examining a freshly voided urine sample. Failure to note urine sample colour within 30 minutes of collection can lead to false reports due to chemical changes.
- The abnormal colour of urine varies depending on its composition. Pale to colourless urine can indicate excessive fluid intake, diabetes mellitus, diabetes insipidus, alcohol intake, and nervousness. Dark yellow or brown urine indicates concentrated urine, decreased fluid intake, dehydration, fever, or urinary tract infection.
- Transparency
- A freshly voided urine sample is usually clear and transparent. However, due to chemical changes in its normal contents, urine might become turbid over time.
- Urine cloudiness is defined using common terminology, such as clear, hazy, cloudy, very cloudy, and turbid.
- Some common causes of turbid urine after urination include kidney stones, pus cells caused by urinary tract infections, yeast cells, and red blood cells.
- All these findings are confirmed by microscopic urine examination.
- Specific gravity
- Specific gravity is the weight ratio between a particular volume of solution and the same volume of water at a specific temperature, typically 20°C.
- The normal specific gravity of urine is 1.005 to 1.030.
- Low specific gravity of the urine indicates that the urine is diluted.
- High specific gravity of the urine indicates that the urine is concentrated.
- Foam
- Urine samples usually form a small amount of white foam when voided in containers. However, in some abnormal physiological and metabolic conditions, the colour and quantity of foam may change. High bile pigment in urine leads to increased foam production and yellowish discolouration. This could indicate the presence of bilirubin in the urine.
- Yellowish foam in urine is not a reliable indicator of bilirubin levels. Urine should be chemically tested for bilirubin levels.
Chemical examination
Urine chemical analysis is crucial for diagnosing different diseases. Urine normal includes chemical composition. However, in abnormal (pathological) conditions, its composition varies in both type and quantities. Urine chemical changes may indicate disease in its early stage.
- Urine PH
- Urine pH is a crucial source of information that gives information about tubular function. Normally, urine is slightly acidic due to metabolic processes.
- The normal pH of urine is 4.5–7.5
- A urine pH of more than 5.5 in the presence of systemic acidemia (serum pH less than 7.35) indicates renal failure due to an inability to eliminate hydrogen ions. On the other side, the most common cause of alkaline urine is a stale urine sample caused by bacterial development and the breakdown of urea, which releases ammonia.
- Urinary pH determination is useful in diagnosing and treating urinary tract infections and in the forming of crystals or calculi.
- Proteins
- Normal urine proteins consist of albumin, serum globulins, and proteins secreted by the nephron.
- Proteinuria, characterized by excreting more than 150 mg of protein per day (10 to 20 mg per dL), is a sign of kidney disease. Microalbuminuria, defined as excreting 30 to 150 mg of protein per day, is an indication of early kidney damage, especially in diabetic patients.
- Protein in urine may be an early indicator of renal disease before symptoms appear. If a person is at high risk of developing kidney disease, their physician might recommend a urine protein test. Complete urine is screened for protein using a dipstick.
- People are more likely to acquire kidney disease if they have a family history of renal disease, diabetes, hypertension (high blood pressure), and heart disease.
- Glucose
- Glycosuria develops when the filtered load of glucose exceeds the tubular cells' ability to reabsorb it, which usually occurs at a glucose serum concentration of nearly 180 mg/dL.
- Normally, urine contains little or no glucose. If people have too much glucose in their blood, their kidneys will eliminate some of it through their urine. A high amount of urine glucose may indicate that the glucose level in the blood is also high, which could be an indication of diabetes.
- Ketones
- Ketone bodies, also termed ketones, are normal products of fat metabolism. They are usually not seen in blood or urine.
- When ketone bodies form faster than they are consumed, their levels rise in the blood (ketonemia) and eventually in the urine (ketonuria). These conditions are frequently seen in cases of starvation and diabetic ketoacidosis.
- Ketone bodies may also be found in the urine in case of prolonged vomiting, severe diarrhoea, anaesthesia, liver injury, excessive fat intake, and low carbohydrate diets.
- Bilirubin
- Urinary bilirubin and urobilinogen tests are typically performed when there is an abnormal urine color or if a patient has a history of liver illness or hemolysis. The presence of bilirubin and urobilinogen in urine can indicate liver cell damage (hepatocellular disease) or bile flow obstruction (obstructive or post-hepatic jaundice).
- Normal urine does not contain bilirubin.
- Nitrites
- A positive nitrite test indicates significant bacteria in the urine and requires urine culture unless the sample was poorly collected or stored, which could allow bacteria to develop.
- It is generally negative in normal urine, but it is detected as positive in case of urinary infections.
- Leucocytes
- The presence of leukocytes suggests inflammation in the urogenital tract.
- It is normally negative in a urine sample.
Microscopical examination
Microscopic examination of urine is an important part of urinalysis, since it gives extensive information about the urinary system's health. It normally consists of the following elements:
- Cells: This test detects different types of cells in urine, including red blood cells (RBCs), white blood cells (WBCs), and epithelial cells. RBCs may indicate bleeding in the urinary system, whereas WBCs can indicate infection or inflammation.
- Red blood cells: RBCs typically appear in fresh samples as small, pale yellowish discs with darker borders. If the number of red blood cells (RBCs) exceeds the normal range of 5/HPF, it may indicate urinary infections, kidney stones, and glomerular disease.
- White blood cells: Normally, white blood cells are clear, granular, and disc-shaped, and 0-4 WBC/HPF are present. WBCs are sometimes referred to as pus cells due to their high concentration of neutrophils and the presence of bacterial cells with polymorphonuclear cells. Urinary tract infections, renal illness, bladder tumors, and cystitis are all associated with an increase in leukocytes in urine.
- Epithelial cells: Few epithelial cells (0-2 / HPF) are usually observed. The presence of a high number of epithelial cells, particularly in the kidneys, may indicate acute tubular injury and glomerulonephritis.
- Casts: Casts are cylindrical formations made of proteins or cells that, when present in large quantities, indicate renal illness. The presence of bacteria or yeast indicates a urinary tract infection, which can help diagnose underlying infections.
- Crystals: The microscopic analysis looks for crystals produced from compounds in urine that can suggest problems with metabolism or a risk of kidney stones. Crystals of calcium oxalate or uric acid can indicate specific conditions.
Urinalysis Procedure
A complete urine examination (CUE), also known as urinalysis, involves steps that must be taken before, during, and after the test to ensure correct results. Below are the steps:
Before the Urinalysis Test
- Individuals are often advised to clean their genital area using soap, sterile wipes, and water to prevent infections. This is essential for collecting an accurate sample.
- The "clean catch" approach is frequently employed. In this approach, the patient starts urinating in the toilet and then collects urine mid-stream in a sterile container. Only a small amount (15-30 mL) is required for analysis.
During the Urinalysis Test
- The urine sample is initially examined for colour, clarity, and odour. Abnormalities, such as cloudiness or uncommon colour, can suggest underlying health concerns.
- A dipstick test is carried out with a strip that changes colour depending on the presence of several substances such as proteins, glucose, ketones, and nitrites. This helps identify illnesses like diabetes or infections.
- The urine is examined under a microscope to find cells (including red and white blood cells), casts, crystals, and bacteria, which provide further information about possible infections or kidney problems.
After the Urinalysis Test
- Laboratory professionals collect and analyze the results of the visual, chemical, and microscopic examinations. They then provide these findings in the complete urine examination report to the general physician.
- The general physician might suggest additional diagnostic tests or treatments to address any detected illnesses based on the results.
Complete Urine Examination / Urinalysis Normal Values
The chart below summarises the normal values of a complete urine examination and the interpretation for each parameter.
Complete urine examination chart normal:
| Parameter | Normal Values | Interpretation |
|---|---|---|
| Color | Pale yellow to dark amber | Dark yellow or orange may suggest dehydration or liver illness. |
| Transparency | Clear | Cloudy urine can indicate an infection, kidney stones, or other conditions. |
| Specific Gravity | 1.005 - 1.030 | Low readings (<1.005) can suggest overhydration, whereas high readings (>1.030) can indicate dehydration or kidney disease. |
| pH | 4.5- 7.5 | A high pH (>8.0) may indicate a urinary tract infection, whereas a low pH (<4.6) may indicate metabolic issues. |
| Glucose | Negative or trace | The presence of (>0.5 mmol/L) may indicate diabetes or renal glycosuria. |
| Protein | Less than 150 mg/day | Elevated protein levels (>150 mg/day) are signs of renal illness or a urinary tract infection (UTI). |
| Ketones | Negative | Presence indicates diabetic ketoacidosis, fasting, or a low-carbohydrate diet. |
| Bilirubin | Negative | Positive results may suggest liver disease or haemolysis (destruction of RBCs) |
| Nitrite | Negative | Presence indicates bacterial infection, particularly with gram-negative bacteria such as Escherichia coli. |
| Urobilinogen | 0.2 - 1.0 mg/dL | Levels above 1 mg/dL can indicate hemolytic anaemia or liver illness, whereas levels below 0.2 mg/dL may indicate liver malfunction. |
| Leukocyte Esterase | Negative | Positive results indicate the presence of inflammation or infection in the urinary system. |
| Blood | Negative | It can be seen as positive in urinary tract infections (UTIs), kidney stones |
| Red Blood Cells (RBCs) | 0 - 2 cells/HPF | Above 3 cells/HPF may suggest urinary tract problems, such as stones or infections. |
| White Blood Cells (WBCs) | 0 - 5 cells/HPF | More than 5 cells/HPF may indicate an infection or inflammation in the urinary tract. |
| Casts | None or rare | The presence of casts can suggest a variety of renal disorders, with distinct types providing further diagnostic information. |
Complete Urine Examination During Pregnancy
During pregnancy, a complete urine examination (urinalysis) is essential for monitoring both the mother's and the fetus's health. Normal levels for different parameters in a complete urine examination can vary significantly depending on individual circumstances. The following are normal reference ranges for pregnant women:
| Parameter | Normal Range | Significance |
|---|---|---|
| pH | 4.6 - 8.0 | This signifies urine acidity, the usual range changes according to diet. |
| Glucose | Negative or trace (up to 130 mg/dL) | The presence of this condition can indicate gestational diabetes or kidney problems. |
| Specific Gravity | 1.005 - 1.025 | It indicates urine concentration; lower readings can indicate overhydration. |
| Leukocytes (WBC) | 10 - 25 cells/µL | Increased levels indicate infection (e.g., Urinary tract infection). |
| Protein | 7.5 - 20 mg/dL (0.075 - 0.2 g/L) | Mild proteinuria can be normal; greater levels may indicate kidney problems or preeclampsia. |
| Nitrites | Negative | The presence of this indicates a urinary tract infection. |
| Ketones | Negative | Presence could imply starvation, dehydration, or diabetes. |
| Red Blood Cells (RBC) | Occasional to few | The presence of RBC may indicate infection, stones, or damage. |
| Urobilinogen | 0.2 - 1.0 mg/dL | High levels could indicate liver illness, whereas low levels indicate bile duct obstruction. |
| Bilirubin | Negative | Presence can indicate liver failure or haemolysis. |
- During pregnancy, the highest limit of normal urine protein excretion is normally around 260 mg every 24 hours, with albumin levels not greater than 29 mg/24 hours.
- Pregnant women frequently have glucosuria as a result of an elevated renal threshold for glucose.
Factors Affecting Urinalysis
Certain factors can affect the findings of a urine sample analysis. These include the following:
- Heavy exercise: It may affect the urine sample's specific gravity and electrolyte concentration.
- Menstruation: Urine samples can be contaminated with menstrual blood.
- Light and temperature: Bilirubin and urobilinogen can break down after being exposed to light and heat for a considerable period due to their instability under these conditions. Furthermore, room temperature encourages the growth of microorganisms like bacteria.
- Bacterial growth: Contamination of the urine sample with pathogenic microorganisms can result in several incorrect results. They may, for example, cause a false-positive blood reactivity and alter the pH of the specimen to acidic or alkaline conditions.
- Preservatives: Despite their occasional use, they can affect the accuracy of the results. Some preservatives include boric acid, mercury salts, hydrochloric acid and formaldehyde, etc.
- Glucose: If glucose is present in the urine sample, microbes may metabolize it, causing the pH to decrease.
- Foods: The colour, odour, and pH of urine may be changed because of some foods. Examples include red beets, blackberries, rhubarb, and food colouring agents.
Precautions in Urinalysis
Urinalysis is an effective means to identify and monitor illnesses. Precautions to ensure the quality of the urine test include:
- Patients need to stay away from doing excess physical activity before sample collection, as this can cause temporary changes in urine composition, such as proteinuria.
- Women need to avoid collecting urine samples during menstruation or for a few days before and after because menstrual blood can contaminate the sample and affect the results.
- Urine samples are most effective when taken in the morning because they are more concentrated and provide more information about kidney function and any problems.
- To limit the possibility of transferring bacteria from the skin into the urine sample, patients need to thoroughly wash their hands and the genital area with soap and water or antiseptic wipes.
Frequently Asked Questions (FAQs) on Complete Urine Examination
What diseases show up in urine?
Urinalysis is used to diagnose or monitor urinary tract infections (UTIs) such as cystitis, bleeding in the urinary system, and kidney or liver damage. It can also detect diabetes, some blood disorders, and urinary tract stones.
Does fasting affect a complete urine test?
People generally do not need to prepare for a urinalysis. They may eat and drink normally. However, urinalysis is frequently performed with other tests that may necessitate fasting, so people need to check with their physician to confirm their instructions. Certain drugs and supplements can affect urinalysis findings.
What is the difference between complete urine examination and urine culture?
A urine routine or urinalysis is a general test that examines a urine sample for various factors such as colour, clarity, and the presence of glucose or protein. It assists in screening for diseases such as kidney disease, diabetes, and infections. On the other hand, urine culture screens for bacterial or fungal infection by growing microorganisms in a urine sample. This test detects the pathogens causing an infection and determines which drugs are effective against them.
Should I avoid any medications before giving a urine sample?
Before providing a urine sample, some medications should be avoided in order to avoid affecting test results. These include medications such as vitamin C supplements, certain antibiotics, vitamins, sympathomimetic amines, and monoamine oxidase inhibitors. Before stopping any medication, patients need to always get advice from their doctor.
How does alcohol consumption impact urine test results?
Consuming alcohol can change how alcohol and its metabolites are detected in urine tests. Depending on consumption levels and individual characteristics, metabolites such as ethyl glucuronide (EtG) and ethyl sulphate (EtS) can be found in urine for 24 to 80 hours, whereas ethanol itself is detectable for approximately 12 hours. Heavy drinking can increase the amount of alcohol that can be detected in urine.
What is a complete urine examination (urine test)?
A complete urinalysis is performed in a lab. It typically involves three steps: The colour, cloudiness, and concentration of urine are assessed. The chemical composition of urine is determined using a test strip. Urine is examined under a microscope to detect bacteria, cells, and cell components.
What are the different types of urine tests?
Urine tests are essential diagnostic tools that help detect a wide range of health conditions. Here are the main types of urine tests:
- Visual Inspection: Evaluates the urine's color, clarity, and volume.
- Dipstick Test: Uses a chemically treated strip to detect glucose, ketones, protein, blood, and pH.
- Microscopic Examination: Examines urine under a microscope to identify cells, crystals, casts, and bacteria.
- Urine Culture: Detects and grows bacteria to diagnose urinary tract infections (UTIs).
- 24-Hour Urine Collection: Measures substances like protein, creatinine, or hormones over a full day to assess kidney function and metabolic disorders.
These tests are commonly used to diagnose conditions such as urinary tract infections, kidney disease, diabetes, and metabolic abnormalities.
Which urine is good for testing?
To get an accurate result and to avoid bacterial contamination, "clean-catch" midstream urine is utilized. People need to collect a sample of midstream urine by avoiding the flow of urine for a few seconds and then collecting the middle portion of the urine stream in a container.
What is found in abnormal urine?
Infection, illness, medications, or food may all cause an abnormal urine colour. Cloudy or milky urine indicates a urinary tract infection, which may also produce a foul odour. Bacteria, crystals, fat, white or red blood cells, or mucus in the urine can all result in milky urine.
Is mucus in urine normal?
Mucus is a viscous, slippery fluid that coats and moistens specific areas of the body, such as the nose, mouth, throat, and urinary system. A little mucus in the urine is common. Too much mucus may indicate a urinary tract infection (UTI) or another medical issue.
What is a physical test of urine?
The physical examination of urine includes assessing its colour, smell, foam, turbidity, relative specific gravity, and osmolality. For functional assessments, it is important to estimate the volume of urine per defined time.
How long does it take to get urine results from a lab?
Some of the results can be obtained immediately when a healthcare professional performs a 'dip urinalysis test' on the urine sample. Depending on the results and the reason for the sample, it may be sent to a laboratory for additional testing. The results of these tests typically take 2-3 days.
What time is best for collecting urine sample?
Unless specifically ordered by the doctor, collecting an early morning sample is normally advisable as it is more concentrated.
How long can you store a urine sample?
If people are unable to deliver the urine sample to the general physician within an hour, they need to place the container in a tight plastic bag and refrigerate at about 4°C. They need to avoid keeping it for more than 24 hours. If the urine sample is not refrigerated, bacteria in it will grow.
What affects urine analysis test results?
Contrast agents may give false-positive specific gravity findings. Exercise may affect the urine sample's specific gravity and electrolyte concentration. Foods and drugs can affect the colour, odour, and pH of urine.
What cannot be detected in a urine test?
It mostly misses some of the regularly used compounds, such as alcohol, opioids, and synthetic cannabinoids, among other drugs and their metabolites; Physicians must ensure that the laboratory they work with is capable of broadly screening for those often-used substances.
What should I avoid before giving a urine sample?
Avoiding certain practices before providing a urine sample is advised because they may contaminate the specimen or have an impact on test results. During collection, patients need to keep themselves away from possible contaminants and practise good hygiene. Additionally, to avoid bacterial overgrowth, they should not leave the sample at room temperature for a duration of four hours or more.
