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Epithelial Cells

Urine Analysis Biomarker

Sample Needed

Collection Type: Blood, Urine

Body System

Related System: Urine Analysis

Overview

Epithelial cells in a urine test are cells that line the urinary tract (squamous cells from the distal urethra/vagina, transitional cells from the bladder/ureters/renal pelvis, and renal tubular epithelial cells from the kidney tubules). The urine sediment examination measures the number and type of these cells to help distinguish contamination from true urinary tract pathology. Increased squamous cells commonly indicate sample contamination; increased transitional cells suggest bladder/upper tract irritation or instrumentation; any renal tubular epithelial cells point toward tubular injury (e.g., acute tubular necrosis, toxic or ischemic injury). Test is indicated for symptoms such as dysuria, frequency, hematuria, flank pain, fever, or abnormal urine dipstick results. Females and samples collected without a clean-catch technique tend to have higher squamous cell counts; catheterized patients often show more transitional cells; age and pregnancy may also affect results.

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Test Preparation

Overnight fasting (8-12 hrs) is required
Do not eat or drink anything except water before the test
Do not stop taking your thyroid medications on the day of the test unless otherwise advised by the doctor
The urine sample must preferably be the first morning midstream urine (part of urine that comes after the first and before the last stream)
Collect the urine sample in a sealed and sterile screw-capped container provided by our sample collection professional
Ensure that the urethral area (from where the urine is passed) is clean & container doesn't come in contact with your skin
Women are advised not to give the sample during the menstrual period unless prescribed
You should submit all the required samples for this package at once during the scheduled sample collection

Why Do I Need This Test

Profile: Urine analysis (urinalysis) with microscopic urine sediment.
Symptoms: dysuria, urinary frequency/urgency, hematuria, flank pain, fever, cloudy or foul urine.
Diagnoses/monitoring: urinary tract infection, contamination assessment, tubular kidney injury, urinary tract stones, urothelial malignancy.
Reasons for abnormal levels: contamination, infection/inflammation, catheterization/instrumentation, stones, renal tubular damage, malignancy.
Biological meaning: elevated squamous cells → likely contamination; elevated transitional cells → bladder/ureter/urethral pathology or instrumentation; renal tubular cells → kidney tubular injury.
Behaviors/lifestyle: poor perineal hygiene, sexual activity, recent instrumentation or catheter use can raise counts.
Family history: recurrent kidney disease, hereditary renal disorders or urinary tract cancers may increase need for testing.

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Understanding Test Results

0-5 cells/HPF normal (few squamous cells expected in clean-catch specimens).
6-10 cells/HPF mild increase; may reflect contamination, minor inflammation or early/low-grade infection; repeat clean-catch and correlate with symptoms and dipstick/culture.
11-20 cells/HPF moderate increase; more likely true urinary tract inflammation or infection (UTI), recent instrumentation, or bladder irritation; consider urine culture and imaging if indicated.
>20 cells/HPF marked increase; suggests significant infection, pronounced inflammation, stones, catheter-associated changes, or possible urothelial pathology; further evaluation (culture, imaging, cystoscopy if transitional/atypical cells) is warranted.
Presence of renal tubular epithelial cells (even few) abnormal and concerning for renal tubular injury (acute tubular necrosis, toxic or ischemic injury); prompt correlation with serum creatinine, urine sediment (casts) and clinical context is required.
Clusters of atypical/abnormal epithelial cells raise concern for urothelial carcinoma and need urgent urologic evaluation.
Always interpret counts alongside urine culture, dipstick, patient symptoms, collection method, and clinical history.

Normal Range

0-5 cells/HPF

FAQs

Q: What happens if epithelial cells are high?

A: High epithelial cells in a urine test usually indicate contamination from the skin/genital tract but can also signal urinary tract infection, inflammation, kidney disease, stones, or recent catheterization. Clinically this may accompany dysuria, frequency, or cloudy urine; persistent elevation warrants a repeat clean-catch sample, urine culture, and possibly imaging or referral to rule out infection or renal pathology.

Q: What are the epithelial cells?

A: Epithelial cells form the sheets lining body surfaces, cavities and organs. They provide protective barriers, control absorption and secretion, enable sensation and selectively transport substances. Epithelia rest on a basement membrane, are usually avascular, regenerate rapidly, and join tightly to one another. Types include squamous, cuboidal and columnar, arranged as simple, stratified or pseudostratified layers, often forming glands or ciliated surfaces.

Q: What does it mean to have epithelial cells in urine?

A: Epithelial cells in urine are cells shed from the urinary tract lining. Small numbers are common and often reflect contamination from the urethra or genital area. Higher counts can indicate infection, inflammation, urinary tract disease, or stones; renal tubular epithelial cells specifically suggest kidney tubular injury. Clinicians may repeat a clean-catch sample or order urine culture, imaging, or blood tests to clarify.

Q: Are 8/10 epithelial cells in urine normal?

A: 8–10 epithelial cells per high-power field is mildly above the typical “few” expected and often reflects contamination from skin or genital shedding. By itself it’s not diagnostic of urinary tract or kidney disease, but if you have symptoms or other abnormal urine results (blood, many white cells, casts), further testing is advised. Repeat a clean‑catch midstream sample and consult your clinician.

Q: How do you reduce epithelial cells in urine?

A: To reduce epithelial cells in urine: provide a proper clean‑catch midstream specimen with thorough perineal cleansing and a sterile container to avoid skin or vaginal contamination. Treat any urinary or vaginal infections, remove/change indwelling catheters if present, and repeat testing after therapy. Adequate hydration and correct sample handling/storage also help. Consult your clinician for persistent abnormalities.

Q: What causes epithelial cells?

A: Epithelial cells in a urine sample usually arise from normal shedding of lining cells or contamination from the skin, urethra, or vagina. Increased numbers can indicate urinary tract infection, inflammation, catheterization, kidney or bladder disease (stones, obstruction) or, less commonly, malignancy. Sexual activity and poor collection technique also raise counts. Clinical correlation and repeat testing help determine significance.