Epithelial Cells in Urine: Normal Range, Causes, Test Results

Epithelial Cells in Urine: Normal Range, Causes, Test Results Epithelial Cells in Urine: Normal Range, Causes, Test Results

Several things can be found in the urine, such as bacteria, red blood cells, white blood cells, and pus. Another common finding includes epithelial cells in urine. A raised amount of epithelial cells in your urine may indicate an illness, such as an infection or other serious conditions like kidney or liver problems. 

But what exactly are epithelial cells? How concerned should one be if a doctor finds epithelial cells present in urine? The following blog discusses the meaning, causes, tests, and treatment of epithelial cells. Furthermore, it also discusses epithelial cells in urine in the normal range. Continue reading to find out!

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What are Epithelial Cells?

Epithelial cells are the cells on the body's surface, such as the skin, urinary tract, blood vessels, and organs. They act as a protective barrier, stopping viruses from entering the body. Besides the protective function, epithelial cells perform other functions as well, such as:

  1. Helps with sensory detection of taste, smell or sight as they transfer signals through the sensory nerve endings
  2. Secretes hormones, enzymes, hormones, and fluids
  3. Absorbs certain substances, such as nutrients from the food
  4. Epithelial cells in the kidney excrete waste, and epithelial cells in the sweat glands excrete sweat
  5. Filters blood, dirt, and particles
  6. Allows selective diffusion of materials to pass through
It is normal to have a few epithelial cells eliminated in the urine due to the normal shedding of cells along the urinary tract. However, many epithelial cells in urine may indicate an underlying health condition.

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Types of Epithelial Cells in Urine

Epithelial cells can be of different shapes, sizes, and appearances. However, depending on the origin, three types of epithelial cells are present in the urine. These types include:

  1. Renal tubular epithelial cells: Also called renal cells, these are the most important epithelial cells. An increase in these cells in the urine may indicate a kidney disorder. 
  2. Squamous epithelial cells: They are the largest epithelial cells in the human body and are found in the vagina and urethra. These types of cells are commonly found in female urine.
  3. Transitional epithelial cells: Also called bladder cells, they are present between the male urethra and the renal pelvis. These types of cells are commonly present in older men.

Symptoms of Elevated Epithelial Cells in Urine

Your body undergoes normal wear and tear. As a result, cells die and are removed from the body through various excretory methods, such as urine. Therefore, the presence of epithelial cells in urine in the normal range is possible. However, elevated levels are a cause of concern.

Elevated epithelial cells in urine may cause symptoms such as:

  1. Pain or burning sensation while urination or sex
  2. Frequent need to urinate
  3. Blood in urine
  4. Thick white discharge
  5. Cloudy or smelly urine
  6. Pain in the lower abdomen
  7. Back pain
  8. Soreness or itching in the vagina
  9. Feeling tired or unwell

Causes of Epithelial Cells in Urine

Epithelial cells in urine are usually not a cause of concern. However, if the amount of these cells in the urine exceeds the normal range, it may indicate an infection or a serious condition. Epithelial cells can be present in the urine due to several reasons, such as:

  1. Specimen Contamination: Contamination while specimen collection is the most common cause of too many epithelial cells in the urine, especially in women.
    Contamination can occur due to using an unsterile collection cup or unclean genitals. To avoid specimen contamination, clean the genital area with a wet wipe. Urinate into the toilet to remove urethral bacteria before urinating into the collection cup. Submit the specimen immediately. 
  2. Urinary Tract Infections (UTIs): The presence of epithelial cells in urine is mostly due to urinary tract infections. In such cases, microorganisms are also present. In some cases of UTIs, the urine will also have mucus strings.
    If a UTI is diagnosed, your doctor may also evaluate the number of leukocytes (white blood cells) in urine.  
  3. Kidney problems: The presence of several tubular or columnar-shaped epithelial cells in urine may be due to a kidney problem. If most of these cells are columnar, it may indicate a severe kidney injury with a risk of decreased functioning.
    Other changes that may point towards kidney damage include creatinine and urea in the urine. 
  4. Menopause: Women in the post-menopausal phase with low estrogen levels may also have many epithelial cells in the urine. However, this does not mean they are necessarily at a higher risk for disease.
    Women who suspect menopause should get their hormone levels checked. 
  5. Physical trauma or irritation: Activities like catheterisation, vigorous sex, or injury to the urinary tract can lead to physical trauma or irritation. This results in the increased shedding of squamous epithelial cells. 
  6. Bladder or urethral diseases: Certain diseases like bladder cancer, urethral cancer, and urethritis can cause increased shedding of epithelial cells into the urine.

Risk Factors for Increased Epithelial Cells in Urine

Having more than normal epithelial cells in urine is not a good sign. Some people are at a higher risk of having epithelial cells in their urine than others.

While epithelial cells in urine can be caused due to several diseases, certain factors can increase the risk for elevated levels of these cells. You should talk to your healthcare provider if you have a higher risk of increased epithelial cells.

The risk factors of increased epithelial cells in urine include:

  1. Kidney stones: Kidney damage or failure is a common complication of kidney stones. Kidney damage can cause an increase in the epithelial cells in urine. 
  2. Weak immune system: A weak immune system can cause an infection to reach a more advanced stage. As a result, the symptoms of a UTI may appear, which causes an increase in the epithelial cells in urine.
  3. Liver disease: People with autoimmune liver disease are prone to recurrent urinary tract infections, increasing the epithelial cells in the urine range. 
  4. Diabetes: High blood glucose levels can increase the risk of developing UTIs since the body cannot fight the germs. 
  5. High blood pressure: High blood pressure for prolonged periods can stop the kidneys from working correctly. As a result, kidney damage may cause epithelial cells in urine to increase. 
  6. Family history of chronic kidney disease: People with a family history of chronic kidney disease are more prone to developing this condition. Chronic kidney disease is a common cause of higher than-normal epithelial cells in urine. 
  7. Enlarged prostate: An enlarged prostate can place pressure and compress the urethra. It can cause urinary tract infections due to incomplete bladder emptying. 
  8. Pregnancy: A higher count of epithelial cells in urine during pregnancy is normal since the woman’s body undergoes many changes. Furthermore, UTIs are common during pregnancy, which may result in elevated epithelial cells. 
  9. Ethnicity: The presence of epithelial cells in urine is typical for people who are African, Asian, American Indian, and Hispanic.

Testing for Epithelial Cells in Urine

Your doctor will order a urinalysis to measure the number of epithelial cells in urine. You may need this test if you experience symptoms such as pain when urinating, frequent urination, pain in the lower abdomen, and back pain.

You may also need the test if a visual or chemical urine test shows an elevated level of epithelial cells. The test is performed through the following steps:

  1. The doctor or nurse will give you a sterile pad and container for urine collection and explain how to take the sample. 
  2. You must use the pad to clean your genitals before urinating in the container. 
  3. Let a small amount of urine flow before collecting the sample midstream. 
  4. Do not touch the inside of the sterilised container with your hands or genitals. 
  5. The urine specimen is sent to a lab and analysed for different substances. 

Understanding the Urine Test Results

It is essential to know the epithelial cells in urine range to understand what is considered normal and excessive. A small number of epithelial cells are normally present in your urine. The count of epithelial cells present in urine is measured through a urine test. 

Normal epithelial cells in urine remain constant for people of all age groups and gender. The optimum level of epithelial cells in a urine sample is about 15 to 20 squamous epithelial cells per HPF (high power field). 

The results of the urinalysis may show a few, moderate, or many epithelial cells in urine. But what do epithelial cells in urine mean? If your test result is few, there are normal epithelial cells in the urine.

However, a result of moderate or more may indicate a medical condition, such as a yeast or urinary tract infection, liver or kidney disease, or certain kinds of cancer.

Prevention of Elevated Epithelial Cells in Urine

Urinary tract infections and kidney diseases are two of the most common causes of elevated epithelial cells in urine. However, there are specific ways in which you can prevent these conditions, such as:

  1. Staying hydrated: Drink several glasses of water daily to prevent diseases that cause high levels of epithelial cells in urine. 
  2. Cranberry: They include a chemical that guards against bacteria attaching to the uterus lining. Drinking cranberry juice or eating cranberries helps promote kidney health and lower the risk of developing UTIs. However, the efficacy of cranberries is still debatable. 
  3. Urinate as soon as you feel the urge: Holding urine for longer periods increases the risk of infection. Therefore, you should immediately urinate when you feel the urge. 
  4. Urinate after sexual intercourse: Both men and women must urinate after sex. It flushes out any bacteria that was introduced into the urethra. 
  5. Wipe carefully: You must wipe from front to back after urination or a bowel movement, as it prevents the spread of bacteria to your urethra. 
  6. Do not use products in the genital area: Products like deodorant sprays or douches for the genital area can increase irritation and infection risk. 
  7. Wear loose-fitting clothes: Breathable clothes allow the area around the urethra to stay dry, limiting bacterial growth. 

Lifestyle Changes to Manage Abnormal Epithelial Cells in Urine

The doctor may advise some lifestyle changes to help manage the abnormal levels of epithelial cells in urine. Some of these changes include:

  1. Reduce the intake of foods high in cholesterol
  2. Cut back on salt
  3. Limit alcohol
  4. Quit smoking
  5. Engage in physical activity
  6. Lose weight
  7. Drink more water
  8. Eat a heart-healthy diet

Treatment for Epithelial Cells in Urine

While elevated epithelial cells present in the urine may indicate serious conditions, it is possible to reduce the number of these cells through different treatments.

Wondering how to reduce epithelial cells in urine? The treatment approach depends on the cause of high levels of epithelial cells. The following are the treatment methods for various underlying causes of epithelial cells in urine:

  1. Urinary Tract Infections: Bacterial UTIs can be treated with antibiotics, such as Amoxicillin, Nitrofurantoin, etc. Fungal UTIs can be treated with antifungal. Viral UTIs can be treated with antivirals. 
  2. Yeast infections: You can treat a yeast infection by taking antifungal medications, available as creams, ointments, and tablets, for three to seven days. 
  3. Kidney disease: To treat kidney diseases, it is important to manage related diseases like blood pressure, blood sugar, and blood cholesterol levels.
    The doctor will prescribe blood pressure medicine to manage blood pressure and slow the progression of the disease. Blood sugar is controlled through insulin injections. Cholesterol levels can be kept in check through a healthy diet, including fruits, vegetables, and grains. 
  4. Liver disease: The treatment for liver disease depends on its type. Certain liver problems can be treated with lifestyle modifications like avoiding alcohol, increasing fibre intake, and limiting fat and calories.
    Some other liver diseases may be treated with medications for viral infections. A liver transplant is usually the best treatment option when the liver problem progresses to liver failure. 
  5. Bladder and urethral cancer: Surgery, radiation therapy, and chemotherapy are the most commonly used methods for treating bladder and urethral cancers.

When to Consult a Doctor?

Urinalysis is a simple and easy test that can provide vast information about your health. At-home urine tests are quick to perform. The test can help catch an infection early and save time and money.

If the results of a urine test indicate more than normal epithelial cells in the urine, you should talk to a doctor about what this means for your health. You should also consult a healthcare professional if you experience the following symptoms:

  1. Fever
  2. Frequent, painful urination
  3. Pain in the lower abdomen
  4. Back pain
  5. Blood in the urine

Takeaway

Epithelial cells on the skin, urinary tract, and blood vessels are protective barriers preventing viruses from entering the body. Normally, epithelial cells in urine range from 15-20 squamous epithelial cells per HPF. However, exceeding this normal range may indicate a serious condition, such as UTIs or kidney disease. Urinalysis is the test doctors use to measure the levels of various substances in your urine. 

If you are experiencing symptoms of epithelial cells in urine or have other concerns about your health, it is essential to consult your healthcare professional. They can tell if you have an underlying condition that needs treatment by conducting further testing. The medical professionals at HexaHealth will help you with free consultations regarding your concerns. Moreover, we will connect you with the best doctors if further treatment is required. Contact a HexaHealth expert TODAY!

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Frequently Asked Questions

What are epithelial cells in urine?

Epithelial cells are found on the skin, blood vessels, urinary tract, and organs. These cells stop viruses from entering the body. Few epithelial cells in urine are normal due to the normal shedding of cells along the urinary tract. However, many cells in the urine can be a cause for concern.

What is the normal range of epithelial cells in urine?

The normal range of epithelial cells in urine is 15 to 20 squamous epithelial cells per high power field (HPF). Anything between this range is considered normal and results from the normal shedding of epithelial cells. Having moderate or several cells may indicate conditions such as urinary tract infections and kidney disease.

What are the different types of epithelial cells found in urine?

Epithelial cells can differ based on size, structure, and origin. Based on the origin, three types of epithelial cells are present in urine. Three types of epithelial cells in urine include:

  1. Transitional: Present between the male urethra and the renal pelvis.
  2. Renal tubular: The most important epithelial cells, an increase of which may indicate a kidney disorder.
  3. Squamous: Found in the vagina and urethra.

What causes an increase in epithelial cells in urine?

Several factors can increase the count of epithelial cells in urine. The most important cause is specimen contamination due to using an unsterilised collection cup and unclean genitals. Medical conditions that may cause an increase in these cells include:

  1. Urinary tract infections (UTIs)
  2. Kidney diseases
  3. Menopause
  4. Physical trauma or irritation
  5. Bladder or urethral diseases

What are the symptoms of high epithelial cells in urine?

Higher than normal epithelial cells in urine can be due to an underlying disease. Symptoms that may indicate high levels of epithelial cells include:

  1. Pain in the lower abdomen
  2. Back pain
  3. Pain or burning while urination or having sex
  4. A frequent urge to urinate
  5. Soreness or itching in the vagina
  6. Blood in urine
  7. Thick white discharge
  8. Cloudy or smelly urine
  9. Feeling tired or unwell

How is the test for epithelial cells in urine done?

The doctor recommends a urinalysis to check epithelial cells in the urine. You will be given a specimen container and sterile pad during this test. The pad is used to clean the genitals before urinating into the container.

You must allow a small amount of urine to flow and collect the midstream sample. You will typically need to collect 15-30 millilitres of urine. Once you have collected the sample, secure the container lid and submit it immediately.

How can you prepare for the test for epithelial cells in urine?

You do not need any special preparations for the test for epithelial cells in urine. Your doctor will let you know if any special instructions need to be followed.

Generally, it is important to clean your genital area before providing the urine sample, as it can help prevent specimen contamination. If you are using an at-home test to collect a sample, the sample should be handed to the clinic within one hour of collection.

What are the possible treatments for high epithelial cells in urine?

The treatment for high epithelial cells in urine depends on its underlying cause. One common cause of epithelial cells in urine is UTIs, which can be treated with antibiotics or antivirals.

Kidney disease has several different treatment approaches, depending on its cause. The doctor will prescribe blood pressure medications to manage blood pressure, insulin injections to control blood sugar, and a healthy diet to keep cholesterol levels in check.

Certain lifestyle changes like regular exercise, losing weight, drinking more water, limiting alcohol, etc., are also effective.

How long does it take to recover from high epithelial cells in urine?

The treatment for high epithelial cells in urine involves treating their underlying cause. Therefore, the time taken to recover from high epithelial cells depends on the time taken to recover from these underlying causes.

Are there any complications associated with high epithelial cells in urine?

Epithelial cells in urine in the normal range do not cause any complications. However, high epithelial cells may indicate serious complications, such as urinary tract infections, kidney problems, certain types of cancer, or other serious conditions.

Can high epithelial cells in urine be prevented?

Since high epithelial cells in urine are caused by conditions such as UTIs and kidney diseases, it can be prevented by preventing these conditions. Some measures to prevent UTIs and kidney problems include:

  1. Drinking several glasses of water every day.
  2. Eating cranberries or drinking cranberry juice promotes kidney health and lowers the risk of infections.

Is high epithelial cells in urine a sign of a serious condition?

Yes, high epithelial cells in urine indicate a serious condition. Anything above the normal epithelial cells in the urine range may be due to conditions such as urinary tract infections, kidney diseases, bladder or urethral cancer, etc. The doctor may order further testing to identify the cause of the underlying condition.

Can stress affect epithelial cells in urine?

There is no evidence that stress relates to epithelial cells in urine. Therefore, it is still being determined whether stress alters the characteristics of epithelial cells in your urine.

Can medications affect epithelial cells in urine test results?

Medications treat the underlying causes of epithelial cells in urine. However, they do not affect the cells in urine test results. Factors affecting urine test results include specimen contamination, UTIs, kidney problems, bladder and urethral diseases, physical trauma or irritation, and menopause.

Can a urinary tract infection cause high epithelial cells in urine?

Yes, a urinary tract infection can cause high epithelial cells in urine. UTI is one of the most common causes of epithelial cells in urine.

Can dehydration affect epithelial cells in urine?

Dehydration is not directly related to epithelial cells. However, prolonged dehydration can cause urinary tract infections, kidney stones, and other kidney problems that may increase the count of epithelial cells in urine. Therefore, dehydration can affect epithelial cells in your urine.

Can pregnancy affect epithelial cells in urine test results?

Urinary tract infections are common during pregnancy. UTIs cause epithelial cells to increase in the urine. Therefore, pregnant women are at an increased risk of having elevated epithelial cells in their urine.

What other tests may be recommended if epithelial cells in urine are high?

Urinalysis is the test to determine the levels of epithelial cells in urine. It includes tests for certain chemicals and examination under a microscope to find specific types of cells.

If the test results show high epithelial levels, the doctor may recommend tests to diagnose or rule out urinary tract infections, kidney or liver diseases, and certain types of cancer.

Can a change in diet help reduce high epithelial cells in urine?

A change in diet can help reduce high epithelial cells in urine. High epithelial cells in urine can be caused by kidney problems, which are caused due to several factors, such as blood pressure, blood sugar, and cholesterol.

Replacing cholesterol-rich foods with a heart-healthy diet, including fruits, vegetables, and whole grains, can manage cholesterol levels and kidney problems. Therefore, diet modification is a healthy lifestyle change that affects epithelial cells in urine.

How frequently should a test for epithelial cells in urine be done?

Test for epithelial cells in urine should be a part of your routine health checkup, i.e., once every three years if you are under 50. Besides normal routine tests, you will need to get epithelial cells tested if you experience symptoms such as abdominal pain, back pain, frequent urge to urinate, and pain when urinating.

What may happen if epithelial cells in urine are not treated in time?

Too many epithelial cells in your urine may indicate serious conditions like urinary tract infections or kidney diseases. If left untreated, the underlying condition that caused epithelial cells in urine may worsen.

If you experience bothersome urinary symptoms, consult a doctor for a proper diagnosis. The sooner your doctor diagnoses the underlying condition, the sooner treatment can reduce symptoms. 

What is epithelial cells in urine?

Epithelial cells line the surfaces of organs and tissues, including the urinary tract. When these cells are shed into the urine, they can be detected through urinalysis. The presence and quantity of epithelial cells in urine can provide information about the health of the urinary tract.
Updated on : Tuesday, 05 September 2023

References

All the articles on HexaHealth are supported by verified medically-recognized sources such as; peer-reviewed academic research papers, research institutions, and medical journals. Our medical reviewers also check references of the articles to prioritize accuracy and relevance. Refer to our detailed editorial policy for more information.

  1. Epithelium
  2. Why Are There Epithelial Cells in My Urine?
  3. Epithelial cells in urine: What does it mean?

Reviewer

Dr. Aman Priya Khanna

MBBS, DNB General Surgery, Fellowship in Minimal Access Surgery, FIAGES
12 years experience

Author

Sangeeta Sharma

BSc. Biochemistry I MSc. Biochemistry (Oxford College Bangalore)
6 years experience

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