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Urine Leukocytes

Leukocytes are white blood cells: they are part of the immune system and help the body protect itself against foreign invaders. When the kidneys, the bladder or the urinary tract are inflamed, more of them pass into the urine, while the urine of a healthy person holds so few that a test strip does not detect them.

An inflammation of the urinary tract can cause pain when passing urine, cloudy urine or needing to go more often, but according to the UK primary-care guidance, in women under 65 no single symptom or combination of symptoms is completely reliable for the diagnosis. A urine test is needed to find out whether immune cells are in the urine.

The result for leukocytes in urine is a score on a test strip: negative, trace, +, ++ or +++. Laboratories list negative as the expected result.

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Urine Leukocytes: co mierzy to badanie

The leukocyte strip measures leukocyte esterase, an enzyme made by neutrophils; neutrophils are one kind of white blood cell. A pad on the strip changes colour when the enzyme is in the urine, and that colour is read as a score from negative to +++.

A urine sediment counts the leukocytes themselves: the laboratory looks at the urine under a microscope and counts the cells per field of view. The strip usually comes first, and the laboratory only looks at a sediment when a pad on the strip is positive.

Urine Leukocytes: dlaczego ta wartość ma znaczenie

A positive leukocyte strip gains meaning from the other pads on the same strip, because the strip is not a diagnosis on its own.

Nitrite forms when certain bacteria convert the nitrate in urine. The UK primary-care guidance uses the strip in women under 65 with urinary symptoms but at most one of three key symptoms: pain when passing urine, cloudy urine or new night-time urination. In those women under 65, a urinary tract infection is likely when nitrite is positive, or when leukocytes and blood are both positive. When only the leukocytes are positive in those women under 65, a urinary tract infection is as likely as another explanation, and a urine culture gives more certainty.

Urine Leukocytes: jak przebiega badanie krwi

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Urine Leukocytes: kiedy warto wykonać badanie?

Leukocytes in urine are tested when there are symptoms that can fit a urinary tract infection. For women under 65, the UK guidance advises a urine test strip with only one of the symptoms pain when passing urine, cloudy urine or newly getting up at night to pass urine. In women under 65, the same guidance also names the strip for other symptoms, such as needing to go often or urgently, visible blood in the urine or tenderness above the pubic bone.

Urine Leukocytes: objawy przy zbyt wysokiej lub niskiej wartości

Niski poziom

A negative leukocyte strip is the expected result: the sample held too little leukocyte esterase to detect. An infection is not fully ruled out by it, because antibiotics, a lot of glucose or protein in the urine, very concentrated urine and vitamin C can keep the pad falsely negative.

The UK guidance calls the strip unreliable for ruling out an infection in men under 65 with a suspected urinary tract infection, a low risk of complications and no urinary catheter.

Wysoki poziom

A positive leukocyte strip causes no symptoms of its own; symptoms come from the cause. A bladder infection can bring pain when passing urine, needing to go often and urgently, and cloudy urine.

According to the UK guidance, a kidney infection is usually diagnosed on flank pain, fever, shivering, a raised CRP or ESR (two inflammation values in the blood) and signs of infection in a midstream urine sample. Signs of a kidney infection are a reason to contact a doctor.

Urine Leukocytes: styl życia a ta wartość

With a positive leukocyte strip from a urinary tract infection, the UK guidance names as self-care paracetamol for the pain, or ibuprofen if preferred and suitable, and drinking enough fluid to avoid dehydration. After a consultation, the same guidance advises seeking advice again when symptoms get worse, have not improved after 48 hours, or when there are signs of a kidney infection or of sepsis.

Urine Leukocytes: często zadawane pytania

What does a positive result for leukocytes in urine mean?

A positive result for leukocytes in urine means the test strip found leukocyte esterase, an enzyme from white blood cells. That can fit an inflammation of the kidneys, the bladder or the urinary tract, and also contamination of the sample. A urine culture, in which the laboratory checks whether bacteria grow from the urine, then gives more certainty.

Can a negative test strip miss a bladder infection?

Yes, a negative leukocyte strip can miss a bladder infection. In studies, the strip was positive in 72 to 97 percent of urinary tract infections that a culture had proven.

What is sterile pyuria?

Sterile pyuria means leukocytes in the urine while a urine culture grows no bacteria. Possible explanations are earlier treatment with antibiotics, a catheter, stones in the urinary tract, a bladder tumour, a sexually transmitted infection such as chlamydia, or tuberculosis of the kidney, among other causes.

Is the result read differently in older people?

Yes, above 65 the leukocyte strip is less reliable: according to the UK guidance, bacteria in the urine without infection become more common with age, and by 80 about half of care-home residents can carry bacteria in the urine without infection. According to that guidance such bacteria are not harmful, and treatment with antibiotics then brings no benefit and can cause harm.

Urine Leukocytes: źródła

  1. Hitzeman N, Greer D, Carpio E. Office-Based Urinalysis: A Comprehensive Review. Am Fam Physician 2022;106(1):27-35B. (pobrano 2026) aafp.org
  2. Simerville JA, Maxted WC, Pahira JJ. Urinalysis: a comprehensive review. Am Fam Physician 2005;71(6):1153-1162. (pobrano 2026) aafp.org
  3. UK Health Security Agency. Diagnosis of urinary tract infections: quick reference tools for primary care, updated 7 July 2025. (pobrano 2026) gov.uk

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