What does leucocytes plus nitrites mean?

Together they strongly suggest a bacterial urinary tract infection, classically from nitrite-forming Gram-negative organisms like E. coli. Leucocytes alone may indicate a nitrite-negative organism or sterile pyuria, so the tool flags those combinations separately.

How does it tell glomerular from urological bleeding?

It uses the microscopy fields. Dysmorphic red cells or red cell casts point to a glomerular source such as glomerulonephritis, while isomorphic red cells suggest a lower-tract cause like stones, infection, or malignancy. Without microscopy it flags haematuria as source-unclear.

What do white cell casts indicate?

White cell casts localise inflammation to the kidney itself, classically pyelonephritis or interstitial nephritis. They help distinguish an upper-tract infection from a simple lower urinary tract infection.

Does glucose in urine always mean diabetes?

Usually it means blood glucose has crossed the renal threshold near 10 mmol/L, as in diabetes, and glucose with ketones raises concern for poor control or ketoacidosis when unwell. Rarely a low renal threshold causes glycosuria with normal blood glucose, so confirm with a blood test.

No. It is an educational pattern matcher that surfaces what findings classically suggest. Urinalysis must always be read alongside symptoms, history, and other tests, and infection must be confirmed by culture before treatment decisions.

What is the Urinalysis Result Interpreter?

Takes urinalysis dipstick results for protein, glucose, blood, nitrites, leucocytes, ketones, pH, and specific gravity plus microscopy findings, then outputs a structured list of classic clinical patterns such as UTI, glomerular haematuria, and ketonuria. Runs in your browser. It runs free in your browser on Gera Tools, with nothing uploaded.

Urinalysis Result Interpreter

Name: Urinalysis Result Interpreter
Creator: Gera Tools
License: https://creativecommons.org/licenses/by/4.0/

A urine dipstick and microscopy together pack a remarkable amount of clinical information into a few squares of colour and a slide. This interpreter takes those results and surfaces the classic patterns and differentials they point to, including the combinations that change the meaning of an individual finding.

What each dipstick field detects

Understanding what the chemistry behind each pad is measuring helps interpret unexpected results:

Dipstick field	What it detects	Common false results
Leucocyte esterase	Enzyme from white blood cells	False positive: vaginal contamination
Nitrites	Reduction of dietary nitrate by certain bacteria	False negative: non-nitrite-forming organisms (Enterococcus, Staph saprophyticus)
Blood	Haem group (RBCs, haemoglobin, myoglobin)	False positive: myoglobinuria after muscle injury
Protein	Mainly albumin	False negative: Bence-Jones (light chain) protein
Glucose	Glucose oxidase reaction	False negative: Vitamin C in high dose
Ketones	Acetoacetate (not beta-hydroxybutyrate)	False negative: BOHB-predominant ketosis
pH	Acid-base of urine	Affected by standing (alkalinises) and diet
Specific gravity	Solute concentration	Falsely elevated: IV contrast agents

How it works

The tool applies the standard rule logic clinicians use at the bedside. Each parameter has well-established associations, and several only become meaningful in combination:

leucocytes + nitrites      -> likely bacterial UTI
blood + dysmorphic RBCs    -> glomerular source
blood + isomorphic RBCs    -> lower-tract / urological source
protein + RBC casts        -> nephritic picture
glucose + ketones          -> uncontrolled diabetes / DKA concern
WBC casts                  -> pyelonephritis / interstitial nephritis
alkaline pH + pyuria       -> consider urea-splitting Proteus / struvite

Microscopy fields, when entered, refine the dipstick. Red cell morphology and cast type are what separate a kidney problem from a bladder one, so the output shifts accordingly.

Reading casts: the most specific microscopy finding

Casts form in renal tubules when protein or cells are trapped in a cylindrical mould made from Tamm-Horsfall mucoprotein. Because they can only form in the kidney, any cast — even a plain hyaline cast — localises pathology to the renal parenchyma:

Hyaline casts — normal in small numbers, or concentrated urine; no specific pathology.
Granular / “muddy brown” casts — classically acute tubular necrosis (ATN).
Red cell casts — glomerulonephritis until proven otherwise.
White cell casts — pyelonephritis or acute interstitial nephritis.
Waxy / broad casts — chronic kidney disease with tubular atrophy.

No casts in a urine sample with heavy proteinuria and microscopic haematuria still warrants glomerulonephritis workup — casts can be missed if the sample is not centrifuged promptly or the microscopy is superficial.

Tips and clinical context

A positive blood dipstick is not always red cells: haemoglobin and myoglobin trigger it too, which is why microscopy confirmation matters. Trace proteinuria is frequently benign and transient after fever or exercise, while persistent or heavy proteinuria warrants quantification with a protein-to-creatinine ratio. Bacteria seen without leucocytes often signal contamination or asymptomatic bacteriuria rather than infection needing treatment.

This tool is a teaching aid that flags classic patterns; it does not diagnose. Infection should always be confirmed by culture in the appropriate clinical context before antibiotics are prescribed.