Urinalysis with Reflex to Microscopic

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The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.

Amorphous Sediment



Bacteria are living things that have only one cell. Most bacteria won't hurt you - less than 1 percent of the different types make people sick. Many are helpful. Some bacteria help to digest food, destroy disease-causing cells, and give the body needed vitamins. But infectious bacteria can make you ill. They reproduce quickly in your body. Many give off chemicals called toxins, which can damage tissue and make you sick. Examples of bacteria that cause infections include Streptococcus, Staphylococcus, and E. coli.


Bilirubin is a yellowish pigment found in bile, a fluid made by the liver. A small amount of older red blood cells are replaced by new blood cells every day. Bilirubin is left after these older blood cells are removed. The liver helps break down bilirubin so that it can be removed from the body in the stool.

Calcium Oxalate Crystals

Calcium oxalate is a chemical compound that forms envelope-shaped crystals. A major constituent of human kidney stones.


Urinary casts are cylindrical structures produced by the kidney and present in the urine in certain disease states. They form in the distal convoluted tubule and collecting ducts of nephrons, then dislodge and pass into the urine, where they can be detected by microscopy.



Abnormal crystals may appear in urine as a result of pathology or due to normal catabolism


A blood glucose test measures the amount of a sugar called glucose in a sample of your blood. Glucose is a major source of energy for most cells of the body, including those in the brain. The hormones insulin and glucagon help control blood glucose levels.

Granular Cast

The second-most common type of cast, granular casts can result either from the breakdown of cellular casts or the inclusion of aggregates of plasma proteins (e.g., albumin) or immunoglobulin light chains. Depending on the size of inclusions, they can be classified as fine or coarse, though the distinction has no diagnostic significance. Their appearance is generally more cigar-shaped and of a higher refractive index than hyaline casts. While most often indicative of chronic renal disease, these casts, as with hyaline casts, can also be seen for a short time following strenuous exercise

Hyaline Cast

Urinary casts are tiny tube-shaped particles. Urinary casts may be made up of white blood cells, red blood cells, kidney cells, or substances such as protein or fat. The most common type of cast, hyaline casts are solidified Tamm-Horsfall mucoprotein secreted from the tubular epithelial cells of individual nephrons. Low urine flow, concentrated urine, or an acidic environment can contribute to the formation of hyaline casts, and, as such, they may be seen in normal individuals in dehydration or vigorous exercise. Hyaline casts are cylindrical and clear, with a low refractive index,


Ketones are substances produced in the liver when fat cells break down in the blood. A serum ketone test is a measurement of how many ketones are in the blood.

Leukocyte Esterase

Leukocyte esterase is a urine test to look for white blood cells and other signs associated with infection.


Occult Blood

The test looks for hidden (occult) blood in a specimen sample. It can find blood even if you cannot see it yourself.


Level of acid


Body fluids contain many different proteins that serve diverse functions such as transport of nutrients, removal of toxins, control of metabolic processes, and defense against invaders. Protein electrophoresis is a method for separating these proteins based on their size and electrical charge. When body fluids are separated by electrophoresis, they form a characteristic pattern of bands of different widths and intensities, reflecting the mixture of proteins present. This pattern is divided into five fractions, called albumin, alpha 1, alpha 2, beta, and gamma. In some cases, the beta fraction is further divided into beta 1 and beta 2. Albumin, which is produced in the liver, accounts for about 60% of the protein in the blood. "Globulins" is a collective term used to refer to proteins other than albumin. With the exception of the immunoglobulins and some complement proteins, most of the globulins are also produced in the liver. Immunofixation electrophoresis (IFE) is a method used to identify abnormal bands seen on serum, urine, or CSF protein electrophoresis, as to which type of antibody (immunoglobulin) is present.


RBCs contain hemoglobin, which carries oxygen. How much oxygen your body tissues get depends on how many RBCs you have and how well they work.

Reducing Substances

Renal Epithelial Cells

Specific Gravity

Squamous Epithelial Cells

Transitional Epithelial

Triple Phosphate Crystals

Struvite stones (triple phosphate/magnesium ammonium phosphate) - about 10–15% of urinary calculi are composed of struvite (ammonium magnesium phosphate, NH4MgPO4·6H2O).[44] Struvite stones (also known as "infection stones", urease or triple-phosphate stones), form most often in the presence of infection by urea-splitting bacteria

Uric Acid Crystals

Abnormal crystals may appear in urine as a result of pathology or due to normal catabolism


WBCs help fight infections. They are also called leukocytes. There are five major types of white blood cells: basophils, eosinophils, lymphocytes (T cells and B cells), monocytes and neutrophils


Candida is the scientific name for yeast. It is a fungus that lives almost everywhere, including in your body. Usually, your immune system keeps yeast under control. If you are sick or taking antibiotics, it can multiply and cause an infection.
*Important Information on Lab Test Processing Times: Ulta Lab Tests is committed to informing you about the processing times for your lab tests processed through Quest Diagnostics. Please note that the estimated processing time for each test, indicated in business days, is based on data from the past 30 days across the 13 Quest Diagnostics laboratories for each test. These estimates are intended to serve as a guide and are not guarantees. Factors such as laboratory workload, weather conditions, holidays, and the need for additional testing or maintenance can influence actual processing times. We aim to offer estimates to help you plan accordingly. Please understand that these times may vary, and processing times are not guaranteed. Thank you for choosing Ulta Lab Tests for your laboratory needs.

The Urinalysis with Reflex to Microscopic test contains 1 test with 27 biomarkers.

Brief Description: A Urinalysis with Reflex to Microscopic is a diagnostic test that evaluates the physical, chemical, and microscopic properties of urine. It is one of the most commonly ordered laboratory tests and provides valuable information about kidney function, hydration status, and the presence of various substances or abnormalities in the urinary system.

IMPORTANT - This REFLEX TEST WILL result in an additional charges if reflex tesing is run.

Collection Method: Urine Collection

Specimen Type: Urine

Test Preparation: No preparation required

When and Why a Urinalysis with Reflex to Microscopic Test May Be Ordered:

A healthcare provider may order a Urinalysis with Reflex to Microscopic for several reasons:

  1. Routine Health Checkup: As part of a routine checkup, a urinalysis may be ordered to assess overall kidney function and identify any potential underlying health issues.

  2. Monitoring Chronic Conditions: For patients with chronic conditions such as diabetes, kidney disease, or hypertension, regular urinalysis helps monitor kidney function and detect complications.

  3. Urinary Tract Infections (UTIs): A urinalysis can help diagnose UTIs by identifying the presence of bacteria, white blood cells, and other indicators of infection.

  4. Kidney Stones: Urinalysis may aid in identifying crystals or substances that could indicate the presence of kidney stones.

  5. Unexplained Symptoms: If a patient presents with unexplained symptoms like frequent urination, pain during urination, or changes in urine color, a urinalysis may provide clues to the underlying cause.

What a Urinalysis with Reflex to Microscopic Test Checks For:

A Urinalysis with Reflex to Microscopic evaluates multiple aspects of urine, including:

  1. Physical Properties: Color, appearance, and specific gravity of urine, which can indicate hydration status and possible kidney function.

  2. Chemical Composition: Detection of glucose, protein, ketones, bilirubin, urobilinogen, and other substances that can indicate metabolic or kidney disorders.

  3. Microscopic Examination: Identification of red blood cells, white blood cells, epithelial cells, crystals, and bacteria, which can suggest infections, inflammation, or other conditions.

Other Lab Tests That May Be Ordered Alongside a Urinalysis with Reflex to Microscopic Test:

When a Urinalysis with Reflex to Microscopic test is ordered, it's often part of a broader evaluation of kidney function and urinary tract health. Here are some tests commonly ordered alongside it:

  1. Complete Blood Count (CBC):

    • Purpose: To evaluate overall blood health, including red and white blood cells, and platelets.
    • Why Is It Ordered: To check for signs of infection or anemia, which can be associated with urinary tract disorders or kidney disease.
  2. Kidney Function Test:

    • Purpose: To evaluate kidney function.
    • Why Is It Ordered: To assess how well the kidneys are filtering waste and to detect any signs of kidney disease.
  3. Electrolyte Panel:

    • Purpose: To measure key electrolytes in the blood.
    • Why Is It Ordered: To assess electrolyte balance, which can be affected by kidney function and urinary tract disorders.
  4. Liver Function Test:

    • Purpose: To assess liver health.
    • Why Is It Ordered: To evaluate liver function, as liver diseases can sometimes influence kidney function and vice versa.
  5. Urine Culture:

    • Purpose: To identify any bacteria present in the urine.
    • Why Is It Ordered: If the urinalysis indicates a possible infection (e.g., presence of leukocytes or nitrites), a urine culture can confirm the infection and help in selecting appropriate antibiotics.
  6. Blood Glucose and Hemoglobin A1c (HbA1c):

    • Purpose: To measure blood sugar control over time.
    • Why Is It Ordered: To assess for diabetes, as diabetes can affect kidney function and is a common cause of urinary tract issues.
  7. 24-Hour Urine Collection for Protein:

    • Purpose: To measure the amount of protein excreted in urine over a 24-hour period.
    • Why Is It Ordered: To assess for proteinuria, which can be a sign of kidney damage.

These tests, when ordered alongside a Urinalysis with Reflex to Microscopic test, provide a comprehensive assessment of kidney and urinary tract health. They are crucial for diagnosing and managing conditions affecting these systems, assessing the impact of systemic diseases like diabetes on the kidneys, and guiding appropriate treatment strategies. The specific combination of tests will depend on the individual’s symptoms, medical history, and preliminary test results.

Conditions or Diseases That Would Require a Urinalysis with Reflex to Microscopic Test:

 Urinalysis with Reflex to Microscopic may be ordered for various conditions or diseases, including:

  1. Kidney Disorders: To assess kidney function and detect conditions like kidney stones, infections, or kidney damage.

  2. Urinary Tract Infections (UTIs): To diagnose and monitor the treatment of UTIs.

  3. Diabetes: To monitor blood glucose control and detect possible kidney damage related to diabetes.

How Health Care Providers Use the Results of a Urinalysis with Reflex to Microscopic Test:

Healthcare providers use the results of a Urinalysis with Reflex to Microscopic to:

  1. Diagnose Conditions: The test aids in the diagnosis of kidney diseases, UTIs, and other urinary tract abnormalities.

  2. Monitor Treatment: For patients with known conditions, urinalysis helps monitor treatment effectiveness and disease progression.

  3. Identify Asymptomatic Issues: It may detect underlying health issues before the appearance of symptoms, enabling early intervention.

  4. Screening: For routine health checkups, a urinalysis may be part of the screening process to assess kidney and metabolic health.

In summary, a Urinalysis with Reflex to Microscopic is a valuable tool for evaluating kidney function and detecting various urinary tract abnormalities, helping healthcare providers make informed diagnoses and develop appropriate treatment plans.

Most Common Questions About the Urinalysis with Reflex to Microscopic test:

Understanding the Urinalysis with Reflex to Microscopic Test

What does the Urinalysis with Reflex to Microscopic test measure?

The Urinalysis with Reflex to Microscopic test is a common diagnostic test that measures various components of the urine, including its appearance, concentration, and content of chemicals and microscopic elements like cells, crystals, and organisms. If abnormalities are detected, the sample is automatically sent for a microscopic examination for further analysis.

Why might a doctor recommend a Urinalysis with Reflex to Microscopic test?

A doctor might recommend this test if a patient presents with symptoms like abdominal pain, back pain, painful urination, or frequent urination, which might indicate conditions such as a urinary tract infection, kidney disease, or diabetes. It's also commonly used as part of a routine health examination.

Interpreting Urinalysis with Reflex to Microscopic Test Results

What do abnormal results in the Urinalysis with Reflex to Microscopic test indicate?

Abnormal results can indicate a variety of conditions depending on the specific finding. For instance, high levels of protein could suggest kidney disease, the presence of glucose may indicate diabetes, and the presence of red or white blood cells might suggest an infection, inflammation, or kidney disease.

What do normal results in the Urinalysis with Reflex to Microscopic test mean?

Normal results indicate that no abnormal substances were detected in the urine and that the physical characteristics of the urine appear typical.

Urinalysis with Reflex to Microscopic Test and Specific Health Conditions

How is the Urinalysis with Reflex to Microscopic test used in diagnosing urinary tract infections (UTIs)?

This test is commonly used to diagnose UTIs. If the initial chemical analysis detects nitrites (a byproduct of bacteria) or leukocyte esterase (an enzyme present in certain white blood cells), it suggests a UTI. The reflex to microscopic examination would then look for bacteria and white blood cells in the urine.

Can the Urinalysis with Reflex to Microscopic test be used to monitor kidney disease?

Yes, the test can help monitor kidney disease. Protein or blood in the urine can indicate kidney disease, and the microscopic examination can identify casts (tube-shaped proteins) and abnormal cells that can give further information about the type and severity of kidney damage.

Urinalysis with Reflex to Microscopic Test in Treatment Considerations

How does a Urinalysis with Reflex to Microscopic test result guide treatment decisions?

Test results can guide treatment decisions by identifying the underlying cause of symptoms. For example, if the test detects a urinary tract infection, antibiotics will be prescribed. If the test indicates kidney disease, further investigation and potentially different treatment strategies would be required.

How can the Urinalysis with Reflex to Microscopic test evaluate the effectiveness of treatments for conditions like UTIs or kidney disease?

By comparing the results before and after treatment, healthcare providers can assess the effectiveness of treatment. For example, if a UTI is being treated, bacteria and white blood cells should decrease or disappear in subsequent tests.

Urinalysis with Reflex to Microscopic Test and Other Diagnostic Tools

How does the Urinalysis with Reflex to Microscopic test complement other diagnostic tools in diagnosing and managing urinary or kidney disorders?

The test can confirm or rule out conditions suggested by symptoms, physical examination, or other tests. For example, if a patient has high blood pressure and swelling, a urinalysis can help confirm if kidney disease is the underlying cause. It also complements imaging tests by providing information at a cellular level that imaging can't provide.

How does the Urinalysis with Reflex to Microscopic test fit into the broader context of diagnosing diabetes?

The presence of glucose in the urine, detected by the urinalysis, can be an indicator of diabetes. However, a formal diagnosis of diabetes requires further tests, such as fasting blood glucose test, oral glucose tolerance test, or HbA1c test.

Patient Considerations for the Urinalysis with Reflex to Microscopic Test

How might medications or supplements affect the Urinalysis with Reflex to Microscopic test results?

Certain medications or supplements can affect test results. For example, vitamin C can interfere with the detection of glucose or blood in the urine, and some medications can change the color of the urine.

What lifestyle factors can affect the Urinalysis with Reflex to Microscopic test results?

Dehydration can concentrate the urine and potentially increase the detection of some substances. Also, consuming certain foods like beets or blackberries can change the color of the urine, which might be mistaken for blood.

Can the Urinalysis with Reflex to Microscopic test be used to monitor health during pregnancy?

Yes, it is routinely used during prenatal visits to detect urinary tract infections, which are more common during pregnancy, and to monitor for preeclampsia, a condition characterized by high blood pressure and protein in the urine.

Understanding the Advancements and Limitations of the Urinalysis with Reflex to Microscopic Test

How have advancements in laboratory technology improved the accuracy of the Urinalysis with Reflex to Microscopic test?

Modern automated analyzers have improved the speed and accuracy of the chemical part of the urinalysis, and digital microscopy has improved the accuracy and consistency of the microscopic examination.

Can the Urinalysis with Reflex to Microscopic test help predict the risk of certain conditions?

While the test is primarily used for diagnosis rather than prediction, persistent abnormalities like protein in the urine can indicate a higher risk of kidney disease. It can also detect asymptomatic urinary tract infections, which if left untreated, can lead to kidney infections.

How can the Urinalysis with Reflex to Microscopic test results guide preventive care?

Early detection of abnormalities in a urinalysis can prompt further investigation and early intervention, potentially preventing the progression of conditions like kidney disease or urinary tract infections.

Can the Urinalysis with Reflex to Microscopic test guide personalized treatment plans?

Yes, by identifying the cause of symptoms, such as differentiating between types of urinary tract infections, treatment can be tailored to the specific cause. Also, in kidney disease, the type of casts or cells present can guide personalized treatment.

Are there populations that may benefit from more frequent Urinalysis with Reflex to Microscopic testing?

People with conditions like diabetes, hypertension, or known kidney disease, which put them at a higher risk for kidney damage, might benefit from more frequent testing. Pregnant women are also routinely tested at prenatal visits.

Can the Urinalysis with Reflex to Microscopic test results guide lifestyle modifications?

If the test results indicate a condition like diabetes or kidney disease, it could lead to recommendations for lifestyle changes like dietary modifications or increased physical activity.

Can the Urinalysis with Reflex to Microscopic test be used to assess the need for intervention in specific populations?

Yes, populations at higher risk of kidney disease, such as those with diabetes or hypertension, can benefit from this test as it can identify early signs of kidney damage, guiding the need for interventions.

Can the Urinalysis with Reflex to Microscopic test be used to assess the effectiveness of different treatment plans?

Yes, for conditions like urinary tract infections or kidney disease, changes in the urine can reflect the effectiveness of treatment.

How does the Urinalysis with Reflex to Microscopic test results impact follow-up testing decisions?

If abnormalities are found, additional testing may be needed to further investigate. For example, if protein is found in the urine, more specific tests for kidney function might be ordered.

Can the Urinalysis with Reflex to Microscopic test be used to monitor health during medication use?

Yes, some medications can affect kidney function, and this test can help monitor for any adverse effects. Additionally, if medication is being used to treat a urinary or kidney disorder, the test can monitor the effectiveness of the treatment.

Are there specific populations that may benefit from more frequent Urinalysis with Reflex to Microscopic testing?

Individuals with chronic conditions that affect the urinary system, such as diabetes and high blood pressure, may require more frequent testing. Likewise, individuals on certain medications that can affect the kidneys may also require regular monitoring.

Can the Urinalysis with Reflex to Microscopic test be used to screen for asymptomatic disease in healthy populations?

Yes, the urinalysis is often used as part of a routine health checkup to screen for asymptomatic diseases, such as diabetes or kidney disease.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

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