Urine Test

Urine Routine & Microscopy (R/M)

Name: Urine Routine Test (R/M): Normal Range & Protein
Creator: Suman Konda
Published: 2026-07-05

A urine routine test checks your urine for signs of infection, kidney disease, diabetes and other conditions. Here's what every value on your report means.

Written and clinically reviewed by Suman Konda, PharmD, Clinical Pharmacist · Based on peer-reviewed sources · Editorial policy · Not medical advice

Last reviewed and updated: 01 August 2026 · How we check our content

What is a Urine Routine test?

A Urine Routine and Microscopy (R/M) test examines your urine in two ways: a dipstick chemical analysis (checking for protein, sugar, blood, pH etc.) and a microscopic examination of the urine sediment (looking at cells, casts and crystals). It is one of the cheapest and most informative tests available, often ordered as a first check for kidney disease, urinary tract infections (UTIs) and diabetes.

Urine Routine Normal Values Chart

Parameter	Normal Value	Notes
Colour	Pale yellow to amber	Clear, not cloudy
Appearance	Clear	Cloudy may indicate infection
pH	4.5 – 8.0	Usually 6.0 (slightly acidic)
Specific Gravity	1.005 – 1.030	Measures urine concentration
Protein	Nil / Negative	<150 mg/day is normal
Glucose (Sugar)	Nil / Negative	Should not be present
Ketones	Negative	Absent in healthy urine
Blood / RBC	Negative / 0–2 per HPF	HPF = high power field
Pus Cells (WBC)	0 – 5 per HPF	>5 suggests UTI or inflammation
Epithelial Cells	Few / Occasional	Many may indicate contamination
Casts	Absent / Rare hyaline	Other casts need investigation
Crystals	None or rare	Depends on type
Bacteria	Nil / Negative	Any bacteria may signal UTI

What does PROTEIN in urine mean?

ABNORMAL Protein present (Proteinuria)

Protein in urine (proteinuria) is an important warning sign of kidney disease. The kidneys normally filter protein back into the blood. When they're damaged, protein leaks into urine. Causes include diabetic nephropathy, hypertensive kidney disease, glomerulonephritis and pre-eclampsia in pregnancy. A single positive result after heavy exercise or fever may be temporary: a repeat test confirms it. Persistent proteinuria needs further investigation with a urine protein-creatinine ratio and kidney function tests.

What the Protein Dipstick Cannot Tell You

The protein pad on a urine strip is a screening tool, and it is worth knowing what that means in practice: it is designed to be quick and cheap, not to be the final word, and it can be normal in someone who has kidney disease.

Two limitations explain most of the confusion. The strip reacts mainly to albumin at fairly high concentrations, so the small amounts that mark early kidney damage often do not register at all. And it measures concentration rather than quantity, so the same amount of protein looks worse in concentrated morning urine and can disappear in dilute urine after you have drunk a lot of water.

The accuracy has been measured. In a meta-analysis of dipstick testing for proteinuria in pregnancy, a reading of 1+ had a pooled sensitivity of 0.68 and specificity of 0.85 — meaning roughly a third of women who genuinely had significant protein were missed by the strip. The authors concluded the dipstick performed poorly at ruling the problem out.²

The test that answers the questionAn albumin-to-creatinine ratio, done on a single urine sample, measures albumin against creatinine and so corrects for how dilute the urine is. It detects the small quantities the strip misses, and it gives a number that can be tracked over time rather than a row of plus signs. If you have diabetes, high blood pressure, or a reduced eGFR, this is the test that should be done.

That ratio matters more than most people are told. In pooled data from over a hundred thousand people, albuminuria predicted mortality independently of eGFR, with no threshold below which it ceased to count.³ A trace of protein on a strip is not something to be reassured about without a proper measurement behind it.

A positive strip is not automatically disease either. Fever, vigorous exercise in the previous day or two, standing for long periods and urinary infection all produce protein that resolves. A single positive result is a reason to repeat the test properly, not a diagnosis.

What does SUGAR (glucose) in urine mean?

ABNORMAL Glucose present (Glycosuria)

Glucose in urine usually means your blood sugar is very high: the kidneys are spilling the excess out. This is common in uncontrolled diabetes. Occasionally people have a low kidney threshold for glucose and spill it even with normal blood sugar (renal glycosuria). If you have glucose in urine, your doctor will check a blood sugar (fasting and post-meal) to rule out diabetes.

What do PUS CELLS in urine mean?

ABNORMAL Pus cells > 5 per HPF (Pyuria)

Pus cells are white blood cells that enter urine when there is infection or inflammation in the urinary tract. More than 5 pus cells per high-power field usually indicates a urinary tract infection (UTI). Common symptoms of UTI include burning on urination, frequent urge to urinate, cloudy or foul-smelling urine. Your doctor will usually order a urine culture to identify the bacteria and choose the right antibiotic.

What does BLOOD (RBC) in urine mean?

ABNORMAL RBC present (Haematuria)

Red blood cells in urine (haematuria) can be visible (red/brown urine: gross haematuria) or only detectable under microscope (microscopic haematuria). Causes range from kidney stones and UTI to glomerulonephritis and rarely kidney cancer. In women, menstrual contamination should be excluded. Any confirmed haematuria needs proper evaluation by your doctor.

What do CASTS in urine mean?

ABNORMAL Cellular or granular casts

Casts are cylindrical particles formed in the kidney tubules. Hyaline casts (few) can be normal. But granular casts, RBC casts, WBC casts and waxy casts all suggest significant kidney disease and need prompt investigation. RBC casts are a classic sign of glomerulonephritis.

Questions to ask your doctor

Is the abnormal finding confirmed or could it be a contaminated sample?
Do I need a urine culture to check for infection?
Should I have a kidney function test (KFT) alongside this?
Do I need a repeat urine test in a few weeks?

References

The clinical information on this page is drawn from peer-reviewed sources indexed by the US National Library of Medicine. Links go to the source so you can read it yourself.

Proteinuria. In: StatPearls. Treasure Island (FL): StatPearls Publishing. NCBI Bookshelf NBK564390
Microalbuminuria. In: StatPearls. Treasure Island (FL): StatPearls Publishing. NCBI Bookshelf NBK563255
Teeuw HM, Amoakoh HB, Ellis CA, Lindsley K, Browne JL. Diagnostic accuracy of urine dipstick tests for proteinuria in pregnant women suspected of preeclampsia: a systematic review and meta-analysis. Pregnancy Hypertens. 2022;27:123–30. PMID 35051804 · doi:10.1016/j.preghy.2021.12.015
Chronic Kidney Disease Prognosis Consortium. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet. 2010;375(9731):2073–81. PMID 20483451 · doi:10.1016/S0140-6736(10)60674-5