Urine tests for kidney disease

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Doctors use different kinds of urine tests to check your kidney health and find other health problems. You will provide a sample of urine in a special cup for a urine test. No special preparation is usually needed.
Medically reviewed by
AKF's Medical Advisory Committee
Last updated
January 31, 2024
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What are urine tests?

Urine tests are when a doctor examines a small amount of your urine (i.e., your pee) to check for signs of kidney disease and other health problems. A urine test is also called urine analysis or urinalysis. 

Why are urine tests used? 

Urine tests help your doctor: 

  • Measure your kidney function 
  • Find out what stage of kidney disease you are in
  • Keep track of health problems that can cause kidney disease, such as diabetes
  • Check for complications (problems) from kidney disease such as anemia and metabolic acidosis 
  • Check for other problems such as a kidney infection or a urinary tract infection (UTI)

When your kidneys are damaged, one of the earliest signs can be protein in your urine. A urine test can find kidney disease early, before the damage to your kidneys is severe. By repeating urine tests as time passes, your doctor can see if the damage to your kidneys is getting worse. 

What are the different types of urine tests?

Doctors use different tests to look for different things:

  • Visual exam: Doctors look at the urine sample to: 
    • See its color — dark yellow or brown urine can be a sign of a problem
    • Check if it is foamy, cloudy or has an unusual smell, which can be signs of a problem
  • Microscopic exam: Doctors look at a small amount of urine under a microscope to check for signs of problems, such as:
    • Bacteria, which may be due to an infection
    • Crystals, which may be signs of kidney stones
    • Red or white blood cells, which may be a sign of an infection or other kidney problems 
  • Dipstick test: Doctors dip a thin plastic strip into your urine, which changes color to show the levels of: 
    • Blood, which can be a sign of problems such as infection
    • Protein, which can be a sign of kidney disease
    • Glucose (sugar), which can be a sign of diabetes in high levels 
    • Acidity (pH), which in abnormal levels can be a sign of problems, such as a UTI 
  • Albumin-to-creatinine ratio (UACR): Your doctor will test your urine to see the amount of albumin (the main protein in your blood) and creatinine (a waste product in your blood that comes from your muscles). Your doctor will compare these results to figure out your UACR. If your UACR is more than 30 mg/g, ask your doctor when you should be tested again. Also ask your doctor if you should have an eGFR test.
  • Microalbumin test: Your doctor may order this test, which detects very small amounts of protein in your urine, if you have a health condition that gives you a higher chance of kidney disease, such as diabetes or high blood pressure.
  • Urine culture: If you have a kidney infection or UTI, a urine culture can show what type of bacteria is present.  
  • 24-hour urine test: You give urine samples in a period of 24 hours, in one1 or more containers. The urine samples must be kept cool, such as in the refrigerator. Doctors check the urine for protein. They may order this test if you have symptoms of glomerulonephritis or nephrotic syndrome. You may have a 24-hour urine test if you have:
  • Nephrin test: The nephrin test, which is a urine (pee) test that may be able to find kidney damage early. There is currently ongoing research on testing nephrin as a future test for detecting kidney damage.  A nephrin test looks for a protein called nephrin in your urine (pee).

What happens during a urine test?

During a urine test, you will urinate (i.e., pee) into a container with a lid that your doctor provides. You may have a urine test at your doctor's office, or your doctor may give you urine sample cups and sterile wipes to collect urine at home. 

To make sure the urine sample is not contaminated, use the clean catch method:

  1. Wash your hands with soap and water.
  2. Clean the area around where your urine comes out using a sterile wipe.
  3. Start to urinate into the toilet.
  4. Stop the urine stream and then urinate into the container.
  5. After you fill the container, finish urinating into the toilet.

Your doctor should follow up with the results of your urine test and discuss them with you. Ask questions if you do not understand what the results of your urine test mean for your kidney disease, or what to do next. 

Do I need to do anything before a urine test?

You can usually eat and drink normally before a urine test. If you are having other tests at the same time, such as blood tests, your doctor will tell you how to prepare.

Let your doctor know about any medicines, vitamins or supplements you take since these can change the results of urine tests.

 

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When your kidneys are damaged, one of the earliest signs can be protein in your urine. A urine test can find kidney disease early, before the damage to your kidneys is severe. By repeating urine tests as time passes, your doctor can see if the damage to your kidneys is getting worse. 

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