Interpreting a Urinalysis

Table from UTD

Urinary patterns associated with different kidney diseases

Urinary pattern	Kidney disease suggested by pattern
Hematuria with dysmorphic red blood cells, red blood cell casts, varying degrees of albuminuria	Proliferative glomerulonephritis (eg, IgA nephropathy, ANCA-associated vasculitis, lupus nephritis)
Heavy albuminuria with minimal or absent hematuria	Nonproliferative glomerulopathy (eg, diabetes, amyloidosis, membranous nephropathy, focal segmental glomerulosclerosis, minimal change)
Multiple granular and epithelial cell casts with free epithelial cells	Acute tubular necrosis in a patient with underlying acute kidney injury
Isolated pyuria	Infection (bacterial, mycobacterial) or tubulointerstitial disease
Normal urinalysis with few cells, no casts, and no or minimal proteinuria	In presence of acute kidney injury: prerenal disease, urinary tract obstruction, hypercalcemia, acute phosphate nephropathy, myeloma cast nephropathy
	In presence of chronic kidney disease: ischemic nephropathy, hypertensive nephrosclerosis, urinary tract obstruction, hepatorenal disease, cardiorenal disease

IgA: immunoglobulin A; ANCA: antineutrophil cytoplasmic antibody.