White Blood Cells in Urine: All You Need To Know About Urinalysis

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White blood cells are specialized blood cells with the primary role of an immune response. White blood cells respond to infection and illness, mounting an immune response to counteract invading bacteria or viruses. Occasionally, a doctor will order a urinalysis to test for the presence of blood cells (including white blood cells) in a urine sample.

Urinalysis is more commonly known as a urine test. Urinalysis is, essentially, the chemical analysis of your urine. The results of a urinalysis can reveal or diagnose a number of serious health problems, including (but not limited to) infection, diabetes, and kidney disease.

Although physicians and lab technicians examine many aspects of a urine sample, screening for the presence of blood (either red or white blood cells) in urine is very common. Even urine that appears normal to the naked eye can prove otherwise when examined under a microscope, or when subjected to various testing procedures.

Evidence of leukocytes (white blood cells) in urine are often related to infection or other immune response, while other types of blood in urine (red blood cells) may be related to other causes.

What Causes White Blood Cells In Urine?

Although there are many potential causes of white blood cells in urine, infection and immune response are the most common cause. White blood cells are tasked with immune response: in the case of an infection or illness, more white blood cells are produced, are consequently shed in urine.

The most common test for the presence of white blood cells in urine is known as a leukocyte esterase urine test. Abnormal results most commonly point to a urinary tract infection, more commonly known as a UTI.

Urinary Tract And Bladder Infections Are Common Causes

Urinary tract and bladder infections are common and are typically easily treated with medication.

However, like any other infection, urinary tract and bladder infections can be serious and have long-term health effects if they are not diagnosed and treated promptly and appropriately. Although rare, kidney damage and sepsis may occur if the condition goes untreated.

Causes of urinary tract infections include (but are not limited to) a bacterial infection (commonly, E. Coli), infections of the urethra (urethritis), and infections of the bladder (cystitis).

Infections of the urethra may arise due to bacterial spread from the anus to the vagina or a sexually transmitted infection (STI). Chlamydia, herpes, gonorrhea, and mycoplasma are all sexually transmitted infections that may cause infections of the urethra and urinary tract.
Infections of the bladder may arise due to bacteria spread during sexual intercourse, or bacteria spread from the anus to the vagina, or another source entirely.

Symptoms of urinary tract infection include pain, burning, or irritation upon urination, the persistent urge to urinate even in the absence of urine outflow, frequent urination, cloudy urine, pink or red urine, pelvic pain, and strong smelling urine.

Kidney Infections Are A More Serious Cause

White Blood Cells in Urine

While rarer than urinary tract infections, kidney infections can also present with white blood cells in urine. Oftentimes, kidney infections begin as urinary tract infections that then progress to the kidneys.

However, in rare cases, bacteria in the bloodstream may make its way to the kidneys, causing a kidney infection. Individuals with weakened immune systems or those who have recently undergone urinary catheterization are more likely to have kidney infections.

Kidney infections require prompt diagnosis and medical care, as an untreated kidney infection can lead to irreversible organ damage and/or sepsis.

Symptoms of a kidney infection include fever, chills, back pain, frequent urination or the urge to urinate frequently, nausea, vomiting, blood or pus in urine, strong smelling urine, cloudy urine, and burning, pain, or irritation upon urinating.

What If There Are White Blood Cells In Urine With No Infection?

While the infection is the most common cause of white blood cells in urine, there are other potential causes, including (but not limited to) kidney stones, cancer, sickle cell anemia, lupus, diabetes, cystitis, and certain medications.

Kidney stones can raise white blood cells in the urinary system

Urinary tract infections and kidney infections aside, kidney stones may increase white blood cell presence in the urinary system, with those cells then shed in urine. Kidney stones are hard mineral deposits made from salt and other minerals that form inside the kidneys. Kidney stones are typically very painful and are typically treated with medical supervision, medication, and hydration during the time it takes to “pass” a kidney stone in the urine.

Symptoms of kidney stones include severe pain in the back and sides (near the ribs), pain that comes and goes in waves, nausea, and vomiting, cloudy or strong-smelling urine, frequent urination, painful urination, the persistent urge to urinate even with low or absent urine, and fever and/or chills.

While there are many causes and contributing factors for kidney stones, the most common causes are lifestyle related.

These causes include (but are not limited to) obesity, poor hydration, and poor diet. Other causes include family history and digestive diseases. Calcium stones and uric acid stones are common types of kidney stones and may be caused by insufficient water consumption and dietary factors.

White Blood Cells In Urine Cancer Connection

High white blood cells count is used as a diagnostic biomarker for cancer. However, it’s important to note that other causes of white blood cells in urine (such as urinary tract infections, bladder infections, and kidney infections) are far more common than cancer.

A urinalysis is typically not used to diagnose cancer. However, high white blood cell count in a urine sample may indicate the presence of cancers of the prostate, kidneys, or bladder.

Diseases Like Sickle Cell Anemia, Lupus, And Diabetes Can Also Be A Cause

Occasionally, diseases like sickle cell anemia, lupus, and diabetes will present with high numbers of white blood cells in urine due to the heightened immune response associated with these conditions. However, it’s rare that leukocytes in urine serve as the first indicator or symptom of these conditions.

Make Sure That Your Medications Are Not The Cause

Occasionally, medications will cause an abnormal number of white blood cells in a urine sample. Be sure to tell your physician if you have begun taking any new medications (including over the counter medications) or dietary supplements, as these may impact lab results.

Blood-thinning medications, pain medications, antibiotics, and certain types of anti-inflammatory drugs may be associated with the presence of white blood cells in a urine sample.

The Differences Between Red And White Blood Cells In Urine

Red and white blood cells have different tasks within the body, but both are important in the context of total health, and both are regularly tested in urinalysis. Abnormal amounts of either serve as an indicator of disease or infection.

The Presence Of Red Blood Cells Is Called Hematuria

The presence of an abnormal number of red blood cells in a urine sample is known as hematuria. Hematuria often presents with abnormally colored urine, such as urine that is pink, red, cloudy, or tea-colored. However, the presence of red blood cells in a urine sample does not always mean that the sample will look different to the naked eye. Occasionally, the irregularity of the sample is only apparent under a microscope.

The Underlying Causes Of Red And White Blood Cells In Urine Are Often The Same

Just as there are many potential causes of white blood cells in a urine sample, the presence of red blood cells in a sample is also associated with a number of diseases, infections, and conditions.

An abnormal number of red blood cells in a urine sample may be attributed to a urinary tract infection, kidney infection, bladder infection, kidney stones, kidney disease, sickle cell anemia, an enlarged prostate, medications, a sports injury, and- in rare cases- certain forms of cancer.

How to treat high white blood cells in urine

The presence of white blood cells in a urine sample almost always points to an underlying infection.

While these infections are often associated with the urinary tract, infections of the kidney or bladder, or infections of an entirely different source are also possible. Kidney stones, sickle cell anemia, lupus, and diabetes may also be at fault. There is no singular treatment for the presence of white blood cells in urine, given a large number of potential causes.

There is no single treatment for blood in urine

The treatment for white blood cells in urine is not so much to treat the presence of the cells but to treat the underlying cause of their presence. In the case of urinary tract infections, for example, the course of treatment focuses on controlling and eliminating the infection causing the heightened immune response and subsequently high number of white blood cells present in urine output.

Consult with your doctor to find the underlying cause

Given the relatively large number of potential causes for white blood cells in a urine sample, your doctor will work to identify the underlying cause in order to determine the best course of treatment.

Treatment for urinary tract infections may be as simple as antibiotic medication and pain medication, while treatment for kidney stones typically involves pain medication, hydration therapy, and medical supervision while a kidney stone passes.

Just as there is no singular cause for white blood cells, there is no singular treatment. Your physician will work to identify the cause of your specific condition and the treatment appropriate for you.

What Do White blood cells in urine mean for otherwise healthy men?

Occasionally, a high number of white blood cells in a urine sample serves as a sign of an enlarged or inflamed prostate in otherwise healthy men. An enlarged prostate is incredibly common in aging men, with about 50% of men over age 50 living with the condition. An inflamed prostate- also known as prostatitis– is also very common, and is the most common urinary tract problem for men younger than age 50.

An enlarged prostate typically presents with increased urination, a slow, low, or unsteady urine stream, frequent nighttime urination, the urgent need to urinate, and incontinence.

An inflamed prostate may be asymptomatic, or may present with pain in the pelvis, penis, or urethra during urination or ejaculation, pain in the pelvis, lower panic, penis, scrotum, groin, or central lower abdomen, frequent urination, the urgent need to urinate, and a slow, weak, or interrupted urine stream.

White Blood Cells In Urine Is Not Always An Indicator Of A Serious Health Condition

While the presence of white blood cells in a urine sample occasionally serve as an indicator of a serious or life-threatening disease or conditions, white blood cells in a urine sample are not always associated with a serious health condition or life-threatening disease.

In most cases, the presence of white blood cells in a urine sample is associated with an infection of the urinary tract, kidneys, or bladder. These types of infections are usually treated easily with antibiotics and pain medications. However, it’s important that the underlying cause is promptly identified in order to determine the best course of treatment.

White Blood Cells In Urine: Where To Go From Here

There are many potential causes associated with the presence of white blood cells in urine. Luckily, in most cases, the presence of white blood cells serves as an indicator of urinary tract infections, kidney infections, and bladder infections, most of which are easily treated with medication.

However, there are instances in which the presence of white blood cells in a sample serves as an indicator for a more serious disease or condition that requires more intensive short or long-term management, such as diabetes, lupus, sickle cell anemia, or cancer.

In men, white blood cells in a sample may indicate an enlarged or inflamed prostate. If the results of your urinalysis show a high number of white blood cells, work with your physician to determine the additional tests necessary to diagnose the underlying cause of your abnormal lab value. The cause of the abnormal value will ultimately determine the treatment best for your individual condition.

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