Epithelial Cells in Urine: Normal Range, Causes & What it Means

You might be surprised to know that your urine can make significant revelations about your health through some clues. If we talk about the routine urine test, the presence of squamous cells and epithelial cells in urine is a major indicator. Epithelial cells naturally occur in urine in small amounts however excessive count of these cells indicates an underlying cause of health problems such as dehydration, infection, or kidney disease.

Urine tests can help detect certain abnormalities early. Being aware of the normal range of epithelial cells in the urine, associated causes and potential health effects can help medical professionals take effective steps concerning your health, particularly regarding kidney function and urinary health.

This article describes the existence of epithelial cells in urine, the normal range, the possible causes of the increased number of epithelial cells in urine, and what they indicate. Stay tuned to get a clearer picture of Epithelial Cells in Urine: Normal Range, Causes & What it Means, and how you can maintain normal levels.

The body surface is lined by a layer of epithelial cells. These cells are found in the topmost layer of the skin, blood vessels, urinary tract, and internal organs. These are the protective barriers between the internal and external body defending it from inflammation and infections. Epithelial cells are of different types, shapes, and sizes.

Epithelial cells line the body surface and work as a protective barrier. These specialized cells line the surfaces of tissues, body organs, and cavities throughout the body. They create a protective barrier against bladder cells and infection-causing substances, help nutrient absorption, and assist in the body’s secretion and filtration processes. These cells regularly shed and get replaced as part of the natural regeneration cycle of the body. Although a small amount of epithelial cells in urine is considered normal, an increased number may be associated with an underlying health condition.

The main types of epithelial cells are:

• Squamous epithelial cells
• Transitional epithelial cells
• Renal tubular epithelial cells

Normal urine contains a small amount of epithelial cells. The excessive amount of squamous epithelial cells in urine may be due to the contamination of the urine sample. Testing the urine sample for epithelial cells can help diagnose if you have kidney disease, infection, or another health issue.

Elevated levels of epithelial cells in urine may suggest health risks, indicating a variety of urinary tract-related health problems. Such as frequent urination, kidney problems, inflammation, or infections.

Urinary tract infection: Urinary tract infections are a common cause of an increased number of epithelial cells in urine. These infections may aggravate the lining of the urethra and bladder, causing the shedding of epithelial cells due to a yeast infection.

Kidney disease: Medical conditions such as kidney stones, polycystic kidney disease, or glomerulonephritis can elevate renal tubular epithelial cell count in urine due to a kidney disorder.

Inflammation: Inflammation in the urinary tract leads to elevated levels of epithelial cells in urine.

Sample contamination: improper urine sample collection may also increase the number of squamous epithelial cells in urine.

Normal epithelial cells: 1-5 squamous epithelial cells per HPF (high power field). The cell count within this range is considered normal.

Few epithelial cells: Just a few epithelial cells in urine are considered within the normal range and not to be concerned about.

Moderate and many epithelial cells: The presence of moderate or many epithelial cells in urine means an elevated amount indicating a health concern.

A small number of epithelial cells naturally exist in urine however increased count of these cells in urine samples can be an indication of potential health conditions. The amount of epithelial cells in urine is measured through a urine test. The normal range may vary depending on the diagnostic center or laboratory.

Typical normal range: 0-5 epithelial cells per high power field (HPF)

Squamous epithelial cells in urine normal range: 0-5 cells per HPF

Transitional epithelial cells in urine normal range: 0-3 cells per HPF

Renal tubular epithelial cells in urine normal range: 0-2 cells per HPF

Mild contamination or borderline: 6-10 epithelial cells per high power field (HPF)

Abnormal range: More than 10 epithelial cells per high field (HPF). Further evaluation is required.

These cells originate from the urethra or external genitalia. The normal range is 0-5 per HPF. Their presence beyond the normal range indicates sample contamination or improper collection process. 6-15 cells per HPF indicate mild contamination or irritation and more than 15 cells per HPF suggest urinary tract problem infection and kidney disease.

These are found in the urinary bladder, renal pelvis, and ureters as they line the urinary tract and increase due to irritation or infection. The normal range is 0-3 cells per HPF and the presence of cells beyond the normal range suggests urinary tract-related issues.

These cells are found in kidneys and are clinically most significant as their excessive amounts indicate kidney disease or kidney damage. The normal range is 0-2 cells per HPF and more than the normal range indicates kidney disease, infection, or inflammation.

Several risk factors such as bladder infections can be responsible for an increased number of epithelial cells in urine.

Improperly collected urine samples may contain squamous epithelial cells. The urine may get contaminated during the sample collection revealing an increased number of these cells in urine.

Bacterial infections in the urinary bladder or urethra can increase the shedding of epithelial cells. common signs and symptoms associated with a urinary tract infection are a frequent urge to urinate, strong-smelling urine, cloudy urine, and a burning sensation during urine release.

Kidney infections or acute kidney injury, kidney diseases such as nephrotic syndrome can cause high amounts of renal tubular epithelial cells indicating kidney dysfunction.

Bacterial infections, irritants, and interstitial cystitis may cause inflammation in the bladder that leads to increased transitional epithelial cells in urine.

Due to the lack of fluids in the body, your urine becomes more concentrated due to high blood pressure, which leads to an elevated amount of epithelial cells.

The urine test is performed to detect white blood cells in the urine sample which indicate the occurrence of urinary tract infection. Leukocyte esterase is an enzyme produced by white blood cells (neutrophils and its presence in urine samples reveals inflammation and infection. A positive leukocyte esterase test accompanied by pain and burning sensation during urination indicates a possible UTI or a yeast infection and may require further testing to confirm.

RBCs in urine also called hematuria may indicate various health concerns. The normal range is 0-3 red blood cells per HPF and elevated RBC count may indicate urinary tract infections, kidney stones, kidney disease, trauma, blood tests, and glomerulonephritis.

A few leukocytes or white blood cells (WBCs) in urine that are 0-5 leukocytes per HPF are considered normal. An increased number of WBCs in urine indicates infection or inflammation in the urinary tract.

A urine analysis test report or urinalysis offers significant information about your health. Learning the basics of urine test reports can provide you with insights into your health. Typically the report includes information about color, specific gravity, pH, ketones, glucose, protein, nitrites, blood, and blood cells in urine samples. If you find anything less or more than the normal range, you should contact a healthcare professional. Understanding the urinalysis panel can help your healthcare provider detect potential health issues. Your doctor can interpret urine test results better and recommend additional tests to find out the underlying causes and particular health conditions.

Epithelial cells naturally slough off and are regularly replaced. If epithelial cell count is consistently high in urinalysis and accompanied by some other abnormalities, it may suggest various potential health concerns associated with kidneys and urinary tract. The presence of renal epithelial cells in urine samples may indicate potential kidney problems including kidney diseases and damaged renal tubules. In this case, it's crucial to consult a healthcare professional for proper diagnosis and the right treatment. If you have symptoms such as burning, fever, blood in urine, frequent urination, and flank pain you should seek medical attention.

If your urine test results show elevated levels of epithelial cells, your healthcare provider may recommend further tests for accurate diagnosis of the health condition and underlying causes.

Urine culture: A urine culture test is recommended if your doctor is suspicious about bacterial infections. This test diagnoses bacterial infections.

Kidney function tests: Your doctor or health care provider may recommend blood tests to assess kidney function and the possibility of inflammation.

Imaging tests: The healthcare professional may recommend an ultrasound, MRI, or CT scan to get insights into the urinary tract and bladder.

Excess amounts of epithelial cells in a urine sample indicated kidney-related problems and a medical condition like urinary tract infections. You can prevent elevated levels of these cells by maintaining urinary health staying hydrated, practicing good hygiene, and managing chronic conditions.

• Practice proper hygiene, and wash your genitals with mild soaps.
• Drink plenty of water to stay hydrated and flush out harmful toxins and bacteria.
• Eat a healthy diet including whole grains, fruits (cranberries are best to prevent UTI recurrence), and vegetables.
• Avoid processed foods and excessive consumption of caffeine and salt.
• Don’t ignore symptoms of UTIs, early treatment can help you manage better.
• Avoid nephrotoxic substances.

A small count of epithelial cells (0-5 cells per HPF) in a urine sample is normal. Elevated levels of epithelial cells particularly renal tubular cells may signify urinary tract infections, inflammation, or kidney disease. Interpreting epithelial cells alongside other markers is important for comprehending the normal body function, detecting abnormalities, and better diagnostic and therapeutic approaches. Consulting a healthcare provider is essential for accurate diagnosis and effective treatment.