Having a large number of epithelial cells in your urine can signal an infection such as a UTI. It can also occur due to a serious condition, such as kidney or liver problems or certain types of cancer.
What are epithelial cells?
Epithelial cells are cells that come from surfaces of your body, such as your skin, blood vessels, urinary tract, or organs. They serve as a barrier between the inside and outside of your body, and protect it from viruses.
A small number of epithelial cells in your urine is normal. A large number may be a sign of infection, kidney disease, or another serious medical condition. For that reason, your doctor may order a urine test or urinalysis to view your urine under a microscope.
Epithelial cells differ by size, shape, and appearance. There are three types of epithelial cells that can be found in your urine, depending on their origin:
- Renal tubular. These are the most important of the epithelial cells. An increased number can mean a kidney disorder. They’re also called renal cells.
- Squamous. This is the largest type. They come from the vagin* and urethra. This type is most often found in female urine.
- Transitional. They can come from anywhere between the male urethra and the renal pelvis. They’re sometimes called bladder cells, and are more common in older adults.
A urine test may show that you have “few,” “moderate,” or “many” epithelial cells in your urine.
Epithelial cells naturally slough off from your body. It’s normal to have one to five squamous epithelial cells per high power field (HPF) in your urine. Having a moderate number or many cells may indicate:
- a yeast or urinary tract infection (UTI)
- kidney or liver disease
- certain kinds of cancer
The type of epithelial cells in the urine may also signal certain conditions. For instance, epithelial cells that contain a large amount of hemoglobin, or blood particles, may mean that you recently had red blood cells or hemoglobin in the urine, even if they weren’t there during the urinalysis.
More than 15 renal tubular epithelial cells per HPF may mean your kidney isn’t working properly.
Squamous epithelial cells in your urine may just mean the sample is contaminated.
A urinalysis that finds squamous epithelial cells in the urine isn’t the norm, William Winter, MD, a clinical chemist for Shands Hospital and professor of pathology and pediatrics at the University of Florida, told Healthline.
That’s because the clean catch method of obtaining a urine sample usually prevents squamous epithelial cells from turning up in the urine. When using the clean catch technique, you’ll be given a sterilizing cloth to wipe the area around the vagin* or penis before giving your urine sample. This prevents contaminants from your skin, like epithelial cells, from showing up in your sample.
Your doctor can help you understand your test results and whether you have a medical condition requiring treatment. To find a cause, the doctor may also order further testing.
You may be at increased risk for high counts of epithelial cells if you:
- have kidney stones
- have a weakened immune system
- have diabetes
- have high blood pressure
- have a family history of chronic kidney disease
- have an enlarged prostate
- are pregnant
- are of African, Hispanic, Asian, and American Indian descent
Treatment will depend on the cause of the abnormal number of epithelial cells. Most UTIs are bacterial and can be treated with an antibiotic. Drinking more water can also speed healing. For viral UTIs, doctors may prescribe medication called antivirals.
Treatment for kidney disease means managing the underlying cause of the disease, including blood pressure, blood sugar, and cholesterol levels. Your doctor may prescribe a blood pressure medication to slow the progression of the disease or preserve kidney function, even if you don’t have high blood pressure. Healthy dietary and lifestyle changes are also important.
Your doctor may advise you to:
- control diabetes through insulin injections
- cut back on foods high in cholesterol
- cut back on salt
- increase physical activity
- limit alcohol
- lose weight
- start a heart-healthy diet that includes fresh fruits, vegetables, and whole grains
- quit smoking
Keeping hydrated is one of the easiest way to prevent urinary infections and kidney disease. You should drink several glasses of a water a day, but your doctor can advise what’s best for you.
Drinking cranberry juice or eating cranberries may help lower the risk of developing UTIs. Cranberries contain a chemical that may guard against bacteria attaching to the lining of your bladder. However, there’s still debate about this remedy’s efficacy in the medical community.
If a urinalysis finds epithelial cells in your urine, it’s typically not cause for alarm. It may be the result of a contaminated sample. Epithelial cells may also reveal underlying conditions, such as a UTI or kidney disorder.
Only your doctor can interpret your test results and decide your best course of action. Even then, further testing may be needed.
