What are Epithelial cells in urine and its normal range?

Epithelial cells are the type of cells that form a protective layer for your body against infections from the outside world. These cells are of utmost importance when it comes to infection and inflammation. Their presence in the urine sample after a certain range is indicative of various adverse health conditions.
In this article, let us study the epithelial cells, their types, the normal range of epithelial cells in the urine sample, risk factors that can increase the level of epithelial cells in the urine sample, and the ways by which the levels of epithelial cells in urine sample can be evaluated.

Epithelial Cells in Urine

The surface of your body is lined with a layer of cells known as epithelial cells. These cells are present in the top most layer of skin, urinary tract, blood vessels, and organs. These cells act as a protective barrier between the outside and the inside of your body, thereby protecting it from the infection of viruses. Epithelial cells are of three different types that differ in their shape, size, and appearance. The types of epithelial cells are:

Squamous Epithelial Cells

• These are the largest epithelial cells present in the human body.
• Squamous cells are mostly found in the vagina and the urethra region.
• These epithelial cells are commonly found in female urine.

Renal Tubular Epithelial Cells

• Renal Tubular cells are the most important epithelial cells found in the human body.
• These are commonly known as renal cells
• An increased number of renal cells in the urine sample indicate a kidney disorder.

Transitional Epithelial Cells

• These types of cells commonly occur in elderly people.
• Transitional cells are also known as bladder cells.
• They are present in the region between the male urethra and the renal pelvis.

Normal Range of Epithelial Cells in Urine

A small number of epithelial cells may be routinely present in your urine. However, an increased number of epithelial cells in your urine sample are an indication of kidney disease, infection, or any other medical condition. The number of epithelial cells in your urine sample is measured through a urine test. The normal range of epithelial cells remains constant in people of all gender and ages. The optimum range of epithelial cells in urine is less than 15 - 20 squamous epithelial cells / HPF ( high power field). Epithelial cells more than the optimum range indicate a health disorder. 

Interpreting the Results of Epithelial Cells in Urine

The presence of some squamous cells in your urine sample is normal. However, if the count of epithelial cells increases above the normal value, it may be an indication of some disease. Common health conditions indicated by an increase in the number of epithelial cells are:

• Liver disease
• Kidney disease
• Urinary tract infection (UTI) includes infection in the urinary bladder (cystitis), urethra (urethritis), or the kidney.
• Glomerulonephritis or nephrotic syndrome
• Kidney stones or renal calculi
• Kidney damage caused due to the use of nonsteroidal anti-inflammatory drugs
• Certain kinds of cancer

The presence of renal tubular epithelial cells of more than 15 in your urine sample is an indication of improper functioning of your kidney. The epithelial cells in your urine sample are also an indication of contamination.

Sometimes, the results of the epithelial cells in the urine sample are indicated in the form of an approximate amount, like “few”, “moderate” or “many” in your urine test reports. Few epithelial cells in the urine sample indicate a normal range of epithelial cells in your urine sample. “Moderate” or “many” epithelial cells in your urine test report indicate an excess of epithelial cells in your urine sample.

Risk factors that can cause an increase in the count of epithelial cells

The count of epithelial cells in a urine sample may increase due to some risk factors as well. The major risk factors that cause an increase in the number of epithelial cells include:

• Weak immune system
• Liver disease
• High blood pressure
• Diabetes
• A family history of kidney disease
• Enlarged prostate gland
• Pregnancy 
• Ethnicity (Asian, African, American Indian, Hispanic)

When are tests for epithelial cells in urine done?

The epithelial cells in urine tests are done for various reasons. Sometimes it is also done when there are no symptoms related to an increase in epithelial cell count. The major reasons why you might get an epithelial cell in urine test done are:

• Regular checkup
• Abnormality in the appearance of your urine sample
• Abnormality in the chemical parameters of your urine test.
• If you experience symptoms like painful urination, frequent urination, back pain, or abdominal pain.

Treating the increased count of epithelial cell in urine

The abnormal levels of epithelial cells in urine can only be treated by treating the underlying cause that is responsible for the increase in the number of epithelial cells. Various ways by which the common underlying health conditions can be treated are:

• Bacterial infections in the urinary tract are treated through antibiotics.
• Viral infections in the urinary tract are treated through antiviral medicines.
• For treating kidney diseases, you need to initially manage the related diseases like blood sugar, blood pressure, and blood cholesterol levels.
• Blood pressure is regulated through medicines so that kidney function is not affected.
• Diabetes is controlled through insulin injections.
• Cholesterol levels are kept in check through a healthy diet that includes food like vegetables, fresh fruit, and grains.
• Salt intake is restricted
• You are advised to drink plenty of water that speeds up healing and recovery.
• Include an optimum duration of physical activity in your daily regime.
• Maintain optimum weight.
• Limit the consumption of alcohol and quit smoking completely.

Takeaway 

The presence of an increased number of epithelial cells in your urine sample is an indication of an underlying medical health disorder. Now, that you know the normal range of epithelial cells in the urine sample and the group of people that are more prone to getting an infection or inflammation, make sure that you manage the levels of epithelial cells in the urine sample accordingly.

Frequently Asked Questions (FAQs)

1. What indicates epithelial cells in urine?

   You might be recommended to get an epithelial cell in urine test done by a doctor as either a part of your regular checkup or if your chemical and visual urine tests indicate some abnormality. You might also have to get a test done if you experience one or more of the following symptoms:

   • Abdominal pain
   • Frequent urination
   • Back pain
   • Painful urination

2. Why do epithelial cells increase in urine? 

   The number of epithelial cells may increase in urine as an indication of an underlying adverse health condition. The major reasons that can cause the epithelial cells to increase in number in urine samples include:

   • Liver or kidney disease
   • Urinary tract infection (UTI) 
   • Infection in the urinary bladder (cystitis)
   • Infection in the urethra (urethritis)
   • Kidney infection
   • Kidney stones or renal calculi
   • Glomerulonephritis or nephrotic syndrome
   • Renal cancer
   • Inflammation 
   • Kidney damage caused due to the use of nonsteroidal anti-inflammatory drugs

3. How to prevent an increase in epithelial cells in urine?

   The best way by which you can prevent urinary tract infection or inflammation that ultimately reduces the count of epithelial cells in urine is to stay hydrated at all times. Drink plenty of water during the day which will help prevent infection and will also reduce the toxins in your body. Consuming cranberry in the form of fruit or juice can also help in lowering the risk of infection or inflammation in your urinary tract. Other ways by which you can reduce the count of epithelial cells in your urine sample include:

   • Limit the intake of salt
   • Control diabetes
   • Avoid high cholesterol food
   • Increase physical activity
   • Avoid consumption of alcohol
   • Quit smoking
   • Maintain proper weight
   • Have a healthy diet

4. How can I get a test for epithelial cells in urine done?

   You can get the epithelial cell count done in your regular urine test at Redcliffe labs. You can easily get a test booked from the comfort of your home by booking the test through the official website of Redcliffe or by calling our centre. Your sample will be collected from your home by our expert Phlebotomist and the reports will also be electronically sent on Whatsapp. Therefore, there is no need for you to visit our centre at any stage of the test.

5. How is the urine sample for epithelial cell count collected?

   The epithelial cell count is done on a urine sample that can be collected at any time of the day. In order to collect the sample for the test, you need to follow the following steps:

   • Wash your hands and clean your genitals with a cleansing pad.
   • Start urinating as usual.
   • Place the sample container below the stream of urine and collect the required sample.
   • Return the container to the Phlebotomist for the test.