Urine test (urine R/E): what pus cells, protein and sugar in urine mean
How to read a urine routine examination (urine R/E or complete urine test): pus cells, red cells, protein, sugar, ketones, crystals, how to give a clean sample, and when a culture is needed.
2 min readUpdated 31 October 2026
This is general information only, not medical advice. Please always confirm with your medical consultant or a certified doctor before using any medicine, test or treatment.
A urine routine examination (urine R/E, CUE or urine detailed report) is a cheap, quick test that tells your doctor a lot about the kidneys, bladder and blood sugar. It is ordered for burning urine, fever, back pain, pregnancy check-ups, diabetes and routine medicals.
Compare urine R/E prices at labs near you.
How to give a good sample
A wrong sample is the most common reason for a confusing report.
- Use the sterile container from the lab.
- Wash your hands and clean the genital area with water.
- Pass the first part of the urine into the toilet, then collect the middle part (a "midstream" sample) in the container.
- Close the lid and give it to the lab within an hour. The first urine of the morning is often preferred.
Women should tell the lab if they are on their period, because blood can mix with the sample.
What the report shows
Physical: colour, clarity and specific gravity (how concentrated the urine is). Dark yellow urine often just means you need more water.
Chemical (dipstick):
- Protein: small amounts can come after exercise or fever; persistent protein can point to kidney disease, diabetes or high blood pressure.
- Glucose (sugar): usually means blood sugar is high. Check fasting sugar or HbA1c.
- Ketones: fasting, vomiting or uncontrolled diabetes.
- Blood: infection, stones, or kidney problems; also contamination during periods.
- Nitrite and leukocyte esterase: signs of a urinary infection.
Microscopy:
| Finding | Usual result | What a high count can mean |
|---|---|---|
| Pus cells (WBC) | 0 to 5 per high-power field | Urinary tract infection or inflammation |
| Red cells (RBC) | 0 to 2 per high-power field | Stones, infection, kidney disease |
| Epithelial cells | few | Many cells often mean the sample was contaminated |
| Casts | none or a few hyaline | Kidney disease (some types) |
| Crystals | may be present | Sometimes linked to stones; often not important |
Urine infection (UTI)
Burning, frequent urination, lower stomach pain or cloudy, smelly urine with many pus cells suggest a urinary infection. Your doctor may order a urine culture before starting an antibiotic, especially for repeated infections, pregnancy, children, men, or fever. The culture shows which antibiotic will work, which matters because resistance is common in Pakistan.
Commonly used antibiotics include nitrofurantoin and others, but only a doctor should choose the antibiotic and the number of days. Drink plenty of water.
Other urine tests
- Urine ACR (albumin to creatinine ratio): finds early kidney damage, recommended yearly for people with diabetes. Read our kidney function test guide.
- Urine pregnancy test.
See a doctor quickly if
- Fever with chills and back or side pain (a kidney infection).
- Blood in the urine, or you cannot pass urine.
- Burning urine in pregnancy, in a child, or in a man.
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This is general information only, not medical advice. Please always confirm with your medical consultant or a certified doctor before using any medicine, test or treatment.