Epithelial cells line various surfaces of the body, including the skin, blood vessels, organs, and urinary tract. A high or raised amount of epithelial cells in a person’s urine may be a sign of an underlying condition.
Healthy urine contains a small number of epithelial cells. Testing for epithelial cells can help determine if a person has an infection, kidney disease, or other medical condition.
This article explores how and why urine is tested for epithelial cells. It also discusses what the results mean and what conditions cause an increase in epithelial cells.
Epithelial cells are cells on the surfaces of the body that act as a protective barrier. They stop viruses getting inside the body.
Epithelial cells cover a person’s skin, but they also occur along the surfaces of the digestive tract, the internal organs, and blood vessels.
It is natural for some of these cells to occur in urine. However, too many epithelial cells in the urine usually indicate an underlying health condition.
There are three main types of epithelial cells:
- Renal tubular: Also known as renal cells, an increase in renal tubular cells in the urine may indicate a kidney disorder.
- Squamous: These are large epithelial cells that come from the vagina and urethra. They are the type most often found in a woman’s urine.
- Transitional: These occur in men between the urethra and renal pelvis. They tend to be found in older men and are also called bladder cells.
The test for epithelial cells in urine is part of a urinalysis — a test that measures the levels of different substances in urine.
A doctor may order this test if a person comes to them with symptoms of a urinary infection or kidney disorder, such as:
- frequent urination
- pain when urinating
- pain in lower tummy
- back pain
A doctor may also order urinalysis if a visual or chemical urine test showed that there might be a raised number of epithelial cells in a person’s urine.
Before the test, a doctor will give a person a container to collect their urine in and explain how to take the sample.
Most people will use what is called the “clean catch method.” A person is given a sterile pad and container to take to the bathroom.
The person uses the pad to clean their genitals before urinating in a sterilized container. They allow a small amount of urine to flow and then collect the sample midstream. It is crucial that they do not touch the inside of the specimen cup with their genitals or hands.
The urine sample is then sent to a lab where it will be analyzed for different substances.
There are three possible results of a test for epithelial cells in urine. These are:
- few
- moderate
- many
If a person’s test result is “few,” this means their results are normal. Having a result of “moderate” or “many” may indicate a medical condition.
Unless the person has other symptoms that point to a clear cause, the doctor will likely recommend further tests before making a diagnosis.
The next section of this article explores some medical conditions associated with high levels of epithelial cells in the urine.
An increased amount of epithelial cells in the urine may indicate one of the following conditions:
Urinary tract infection
There are three types of urinary tract infection (UTI). They each affect a different part of the urinary tract:
- Cystitis: This is a UTI that affects the bladder.
- Urethritis: This is a UTI that affects the urethra.
- Kidney infection: This is a UTI that affects the kidneys.
Symptoms of a UTI include:
- frequent or urgent need to urinate
- pain or burning sensation when urinating
- cloudy or smelly urine
- blood in urine
- pain in lower abdomen
- feeling tired or unwell
Doctors typically prescribe antibiotics or antiviral medication to treat UTIs.
Yeast infection
Yeast is a natural fungus. Every woman has a small amount of yeast in her vagina.
Changing hormone levels or taking antibiotics may change the balance of bacteria in the vagina. As a result, yeast may grow more than usual and lead to a yeast infection.
Symptoms of a yeast infection include:
- itching or soreness in the vagina
- pain or burning when urinating or having sex
- thick or clumpy white discharge
Treatments for yeast infections include antifungal tablets, cream, or a suppository.
Kidney disease
Kidney disease is a long-term condition where the kidneys do not work as well as they should.
The risk of kidney disease increases with age. Other risk factors include:
- kidney stones
- a weak immune system
- diabetes
- high blood pressure
- a family history of kidney disease
- an enlarged prostate
There is no cure for kidney disease, but the following treatments may help a person manage their symptoms:
- following a healthful diet
- exercising regularly
- drinking less alcohol
- quitting smoking
- taking medication to control blood pressure and cholesterol
- undergoing kidney dialysis
- having a kidney transplant
Liver disease
There are some different types of liver disease. These include:
- alcohol-related liver disease
- non-alcoholic fatty liver disease
- hepatitis
- hemochromatosis
- primary biliary cirrhosis
Symptoms of liver disease include:
Treatment for liver disease depends on the cause. If the disease is caused by excess alcohol consumption, a doctor will help a person seek support to stop drinking.
Bladder cancer
Bladder cancer occurs when abnormal tissue grows in the bladder lining. It is the
Bladder cancer may cause an increased amount of epithelial cells in urine. However, it is important to remember that this alone does not indicate cancer.
Symptoms of bladder cancer include:
- streaks of blood in the urine that may turn the urine brown
- frequent urges to urinate
- sudden urges to urinate
- burning sensation when urinating
- pelvic pain
- bone pain
- unexpected weight loss
- swelling in the legs
There are many surgical and non-surgical treatments available for bladder cancer. A team of healthcare workers will help an individual with bladder cancer determine the best treatment plan for them.
A person is at increased risk of having a raised number of epithelial cells in their urine if they have:
- kidney stones
- diabetes
- high blood pressure
- a family history of kidney disease
- an enlarged prostate
- frequent UTIs
- a compromised immune system
Pregnant women are also at increased risk of having a raised number of epithelial cells in their urine.
High levels of epithelial cells in urine are also typical for people who are:
- African
- Hispanic
- Asian
- Native American
Treatment for high levels of epithelial cells in the urine will depend on the underlying cause.
The most common cause is a UTI, and treatment typically includes antibiotics or antiviral medication.
Kidney disease has a range of different treatments, depending on the cause. Some lifestyle changes may also be advised, including losing weight, exercising regularly, and eating a healthful diet.
Hydration is vital to prevent the conditions that cause high levels of epithelial cells. It is a good idea to drink several glasses of water a day.
Some people believe cranberry juice promotes kidney health and many people drink it as a home remedy for UTIs. A 2013 study concluded there was a lack of evidence that cranberry juice was effective for treating UTIs.
A raised amount of epithelial cells in the urine are often the sign of a minor infection, such as a UTI or yeast infection.
Anyone with bothersome urinary symptoms should see a doctor for urinalysis and a proper diagnosis.
The sooner the underlying condition is diagnosed, the sooner treatment can begin to alleviate symptoms.