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What do Urinary Leukocytes Indicate?

By Amanda Livingstone
Updated May 17, 2024
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A common culprit for the presence of nitrites and leukocytes in urine is a urinary tract infection (UTI) that invades the kidneys and bladder. The detection of urinary leukocytes during urinalysis might also indicate serious medical conditions, such as systemic lupus erythematosus (SLE), prostate issues and urinary obstructions. Pregnant women might occasionally secrete trace amounts of leukocytes and protein in the urine without much concern.

Leukocytes are white blood cells that protect the body from infections and certain diseases. White blood cells in the urine are detected by measuring the amount of leukocyte esterase in the urine. Esterase is an enzyme that is produced by white blood cells, and it is the identifying factor in detecting leukocytes. Positive leukocyte esterase tests are usually indicators of an UTI.

Women are far more likely to experience UTIs than men. Common UTIs that cause urinary leukocytes in both genders are cystitis and an intestinal bacterium called Escherichia coli. Cystitis is a bladder infection; sometimes the term is referred to bladder inflammation caused by a bacterial infection. Pyelonephritis is a UTI that affects the kidneys and has the potential to become life-threatening if left untreated. These UTIs usually are treated with antibiotics until the infection is no longer present.

Some men might experience acute or chronic prostatitis, which is the inflammation of the prostate gland leading to difficulty urinating and pain. In both cases, leukocytes are found during urinalysis. Acute and chronic bacterial prostatitis is likely caused by any number of bacteria that cause a UTI or sexually transmitted disease (STD). The cause of chronic nonbacterial prostatitis is not entirely known, but some experts have speculated that an inflammatory condition might be to blame.

In the absence of an UTI, urinary leukocytes combined with protein and erythrocytes might indicate lupus nephritis which is a complication of SLE. Lupus nephritis is a chronic inflammatory disease of the kidneys that might damage the kidneys and eventually lead to kidney failure. A urinalysis and kidney biopsy is necessary to properly diagnose the condition. Treatment involves immunosuppressant drugs such as corticosteroids and dietary restrictions limiting the consumption of protein, potassium and sodium.

Other underlying causes of leukocytes that do not involve a UTI are urinary obstructions and pregnancy. Urinary obstructions can take the form of a tumor or kidney stones. In the case of kidney stones, the presence of urinary leukocytes indicates inflammation rather than infection. Trace amounts of leukocytes in pregnant women, in the absence of cystitis or other UTI conditions, might indicate contamination of vaginal secretion.

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Discussion Comments

By anon319520 — On Feb 13, 2013

@Oceana: I have never been able to fix a UTI with cranberry juice because of the acid in the juice. Try D-Mannose powder(the sugar that is found in Cranberries). 1 Tsp every two to three hours. Kicks out those UTIs right away.

By Oceana — On Jul 09, 2012

@kylee07drg – Have you tried drinking cranberry juice? If you drink a glass of this stuff a day, you can help prevent urinary tract infections.

I used to get them often, too. I have found that drinking two glasses of cranberry juice right after I start experiencing symptoms and doing this every day until they go away can get rid of the infection. Also, I take two cranberry extract pills while I'm feeling sick to really help my body fight off the bacteria.

The acidity of cranberry juice keeps the bacteria from clinging to the urinary tract, and if you drink plenty of fluids like water while you have an infection, you can flush out the bacteria. It also helps to eat yogurt and pineapple, because both are acidic.

However, sometimes, this doesn't work. I have had severe infections that wouldn't go away with this treatment, and I had to go get tested for leukocytes in my urine. If an infection is just starting out, though, chances are that you can beat it with cranberry juice.

By kylee07drg — On Jul 08, 2012

I get bacterial urinary tract infections often, and my doctor always tests my urine for leukocytes before giving me medication. I am really tired of having to take antibiotics several times a year to get rid of my UTI's, and that seems to be the only way to get rid of them.

Is there a way that I can prevent them or treat them as soon as I notice the symptoms? I am getting sick of having to urinate in a cup every time I get bladder cramps and start having to urinate every 30 minutes or so. I really would love to be able to prevent these infections or treat them without having to see a doctor.

By shell4life — On Jul 08, 2012

@seag47 – They usually do both. Yes, leukocytes could indicate a renal infection, a bladder infection, and several other things, so he would need an x-ray to be certain that the person had kidney stones.

My uncle has had severe problems with kidney stones. He gets an abdominal x-ray when he goes to the emergency room, but they also do a urinalysis.

My aunt also had kidney stones, and she had them while pregnant. She had to have an ultrasound instead of an x-ray, because it was safer for her and the baby. A urinalysis is just a standard part of the exam, and everyone who comes in complaining of kidney or urinary trouble gets one.

By seag47 — On Jul 07, 2012

I understand why a doctor would test for leukocytes for a urinary tract infection, but would he really need to do this if a person had kidney stones? Generally, you figure out you have them when you start writhing in pain on the floor, unable to move.

It would seem to me that a doctor would be more likely to do some sort of x-ray to see the stones than to rely on a urinalysis that might only be able to indicate a UTI. If he saw leukocytes, that wouldn't necessarily mean that kidney stones were present, right?

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