What causes epithelial cells in urine?

what causes of epithEpithelial cells in urine is a diagnostic result found during urinalysis and may raise some red flags for physicians, signifying several possibly pathological problems for the kidneys. Epithelial cells are just one type of cell that is found in the body and are important in maintaining healthy tissue. They can be found in skin, the lining of several organs, and even at the openings of numerous body cavities.

Underlying conditions affecting the urinary tract symptom, such as infection or inflammation, can lead to abnormal epithelial cell urine counts.

Causes of epithelial cells in urine

Epithelial cells have a limited lifespan, which results in them sloughing off to make room for newer cells to take their place. This shedding of cells commonly occurs to the skin and even to various organs of the urinary tract, such as the balder, leading to small amounts of epithelial cells to be found in the urine. If the level of epithelial cells was to be increased or originate from the kidneys, it could signal an abnormality that is worth investigating.


The following are possible reasons for finding epithelial cells in urine:

    • Normal sloughing: The urinary tract structures are lined by epithelial cells, which are exposed to urine on a daily basis. Over time, when these cells are in need of replacement, they just simply slough off, being carried by the urine to be excreted by the body. Finding small concentrations of epithelial cells in the urine is normal.
    • Nephrotic syndrome: A kidney disorder characterized by kidney damage and the excretion of too much protein in the urine. It is usually caused by damage to the clusters of small blood vessels in the kidneys normally responsible for filtering out waste and excess water from your blood. This condition will also lead to the accumulation of a large number of epithelial cells originating from the renal tube, which appear as round shapes having large nuclei. This helps provide physicians an additional clue toward the diagnosis of nephrotic syndrome.
    • Urinary tract infection: Typically beginning in the urethra and traveling their way up to your bladder, UTIs can irritate the bladder, leading to the sloughing of epithelial cells. Depending on the severity of the infection, epithelial cells from the kidneys may also be present. UTIs often result in inflammation, which damages cell linings.


  • Contamination: Epithelial cells may find other ways into your urine sample, like if your genitals are not clean or are using an unsterile collection cup. If you believe that your urine sample has been contaminated in any way, ask to have it repeated to get an accurate result.

Types of epithelial cells in urine

Epithelial cells are one of four basic types of animal tissue, which include connective, muscle, and nervous tissue. Epithelial tissue types generally line the cavities and surfaces of blood vessels and organs throughout the body, including the mucous membranes and urogenital tracts.

There are generally three types of epithelial cells that can be found in urinary sediment. Their shape and composition can help physicians find out where they came from and possibly why they appear in large numbers in the urine. The following are types of epithelial cells that can be found in urine.

    • Squamous: Also known as flat cells due to their shape and they typically come from vaginal or distal urethral epithelium. Finding squamous epithelial cells in urine at the normal range is generally not of any concern. However, having high levels could be indicative of possible vaginitis or urethritis.
    • Transitional: This type of epithelial cell lines the renal pelvises, ureters, proximal urethra, and the bladder. Inflammatory processes related to infection can lead to a high number being excreted in the urine.


  • Renal tubular cells: These cells are found in structures within the kidney called nephrons and play an important role in the reabsorption of water and salts. Renal tubular cells do not typically appear in the urine under normal conditions. Therefore, their presence is highly related to kidney damage such as acute tubular necrosis, viral diseases (ex. Cytomegalovirus nephritis), pyelonephritis, rejection of transplants, and toxic reactions to certain substances.

Related: Crystals in urine: Know the causes and treatment

Normal range of epithelial cells in urine

An incidental finding of epithelial cells in the urine is not of great concern and is typically attributed to contamination from outside the urinary tract. However, this is only if the number of epithelial cells is within a certain limit, as large amounts will warrant an additional look under a microscope. Typical diagnostic ranges fall into either few, moderate, or many, but can also be measured in number. A normal range is less than 15–20 per high power field (HPF).

Learn about urinalysis


A urinalysis is generally the routine test for evaluating urinary tract pathology. If an abnormality is found, further testing may be indicated. Once such additional test is to look at the urine sample under a microscope. This allows for a more detail look at the urinary sediment and the cells that reside therein. The following are some types of cells and substances that may appear upon microscopic evaluation.

  • Red blood cells (RBCs): It is normal to have a very small number of RBCs present in the urine (0-5/HPF). They are not visible to the naked eye and a positive chemical test is often needed to prove their presence. Even if a significant number of RBCs were found in the urine, this test would not be able to distinguish where they are coming from. Instead, it would only serve as a clue for the investigation of pathology somewhere in the urinary tract. Having a large number of RBCs in the urine is called hematuria, and it prompts physicians to evaluate a patient’s medical history, physical examination, and accompanying signs and symptoms, looking for a possible reason for this finding. RBCs in the urine can be a result of urinary tract or kidney diseases, medications, trauma, intense exercise, or even smoking.
  • White blood cells (WBCs): Finding a few white blood cells in the urine (0-5/HPF) is considered within normal limits and is a typical finding when contaminated with vaginal secretions. Having a considerable number of WBCs, however, may indicate an infection or inflammation somewhere in the urinary tract.
  • Epithelial cells: A few are normally found in the urine sediment of men and women. However, an increased number of epithelial cells can be found during infections, inflammation, and malignancies. Viewing the type of cell under a microscope can sometimes help identify certain conditions.
  • Bacteria, yeast, and parasites: Urine of healthy individuals is typically sterile, having no microbes when viewed under a microscope. Finding bacteria, yeast, or parasites indicates an acute infection that is often enough testing to begin treatment.
  • Casts: Cylindrical particles that form in the renal tubules and usually do not pass into the urine. Many types of casts exist and are associated with several different types of kidney diseases.
  • Crystals: Not a normal finding in the urine but can be easily identified under a microscope by their shape and color. Crystal formation in the urine can occur when solute concentration, pH, and urine temperature reach a specific range. They are also a useful diagnostic clue for several diseases and toxicities.

Related: Nitrates in urine: Causes, symptoms, and treatment

Home remedies for epithelial cells in urine

  • Fluids: Drinking plenty of water is a great solution overall to keep the kidneys running properly. Staying hydrated helps to improve urine output, which in turn can help flush out any bacteria present and clear out accumulated waste products. It is recommended to drink between eight to ten glasses of water each day.
  • Baking soda: Helps to promote an alkaline balance in the body. This is important to help balance out the acidity that is required for other bodily systems such as those carried out in the digestive tract. Also, having acidic urine will make it difficult to clear any infections that may be present. Preventing urinary tract infections will lead to reduced amounts of epithelial cells in the urine. A half teaspoon of baking soda can be added to water for consumption daily.
  • Cranberry juice: A widely used home remedy for the prevention of urinary tract infections, cranberry juice also plays a crucial role in ensuring the reduction of pH levels of your urine. It does this as a result of benzoic acid.
  • Increase your vitamin C intake: Helps to boost your immune system in the fight against infections. Vitamin C also helps the body perform several functions to maintain cellular health. It can be found in nearly any type of fruit and even most vegetables.
  • Urva ursi: Commonly known as Bearberry, this food is also known for helping stop several kinds of urinary tract infections. It contains a compound called glucoside arbutin which acts as an antiseptic and can even help reduce inflammation. Bearberry also acts as a mild diuretic, which can help detoxify your urinary tract, making it possible for you to urinate on a regular basis. Bearberry is not recommended for pregnant women.
  • Garlic: A well-known root vegetable for its natural healing properties, garlic helps to strengthen the immune system and is even considered to have antibiotic and diuretic traits.
  • Yogurt: Contain probiotics that promote the production of beneficial bacteria present in the urinary and digestive tracts. The use of antibiotics is well known for killing these bacterial colonies, but eating probiotic yogurt can help restore them.
  • Watercress: Rich in phosphorous, magnesium, calcium, and several kinds of vitamins, watercress can help promote your health and promote the formation of new cells. It also acts as a natural diuretic, helping the kidneys flush out any accumulated toxins.
  • Onions: Contain potassium, Sulphur, and flavonoids, making it have anticoagulant and antifungal properties. These attributes help to keep infections from occurring. Onions also act as a mild diuretic, which can prevent water retention and helps keep the kidneys running efficiently.
  • Basil: Containing antibacterial, antiviral, and anti-inflammatory properties, which aid in promoting health and cell formation. It also has diuretic properties, which can help prevent kidney stones and detoxify the urinary tract system.
  • Alma: Rich in vitamin C, helping to strengthen the body’s immune system. Vitamin C can also help protect against all types of bacterial infection. Alma also assists in flushing harmful toxins present in the body.
  • Coriander seeds: Contain linalool oil, which can help reduce flatulence as well as help regulate the digestive system. Coriander seeds are also great for combating both fungal and bacterial infections while also helping to relieve burning sensations caused by urinary tract infections.

Related: 6 reasons for smelly urine

Author Bio

Devon Andre has been involved in the health and dietary supplement industry for a number of years. Devon has written extensively for Bel Marra Health. He has a Bachelor of Forensic Science from the University of Windsor, and went on to complete a Juris Doctor from the University of Pittsburgh. Devon is keenly aware of trends and new developments in the area of health and wellness. He embraces an active lifestyle combining diet, exercise and healthy choices. By working to inform readers of the options available to them, he hopes to improve their health and quality of life.



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