What is a Blood in Urine (Haematuria) test? 

Haematuria is defined as the presence of blood in the urine. It is a sign of a possible health problem and not a disease in itself. Hematuria is generally of two types:

Gross haematuria - when you can see the blood in the urine. The blood may be visible because it changes the colour of the urine to red or brown. There may also be blood clots seen in the urine.

Microscopic haematuria - when you cannot see the blood in the urine but it can be detected under a microscope. 

There can be many causes of haematuria. These include:

Usually, haematuria is not considered to be an alarming situation. However, your doctor will want to rule out any probable causes which may need medical attention. A urine test is performed in order to determine the underlying cause of hematuria. It will also indicate how severe the haematuria is. Later on, further blood tests and imaging studies may also be done to arrive at a conclusive diagnosis.

  1. Why is a Blood in Urine (Haematuria) test performed?
  2. How do you prepare for a Blood in Urine (Haematuria) test?
  3. How is a Blood in Urine (Haematuria) test performed?
  4. Blood in Urine (Haematuria) test results and normal range

It may be possible that you experience no symptoms except for blood in the urine. However, if there is an underlying condition that is leading to the haematuria, some additional symptoms may occur. The following symptoms prompt a doctor to order a urine test:

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No prior preparations are needed before this test. However, your doctor is likely to ask you questions related to your health and family history (especially a history of kidney disease) in order to determine the probable cause for haematuria. Inform your doctor if you are taking any medicines, such as supplements, prescription drugs or herbal medicines.

A urine sample for blood in urine test may be collected at a clinic or at home. You will be provided with a container to collect the sample. In the case of 24-hour urine collection, more than one container would be given.

Collection of the 24-hour sample should begin in the morning. The first urine of the day is not collected. After this, every urine must be collected for the next 24 hours.

Store the urine container in a cool environment or just keep it in a refrigerator. Don’t forget to label the container appropriately with your name, the date and time of collection of the sample. 

After the sample has been collected, it should be taken to the laboratory for analysis as soon as possible. 

If the test is being performed on an infant, then the area around the urethral opening must be washed thoroughly and the urine collection bag must be placed appropriately on the infant to collect the sample without any spillage. The collected sample should be delivered to the laboratory for analysis as soon as the collection is completed.

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Normal results:

Depending upon the symptoms and initial test results, your doctor will decide if your haematuria is a cause for worry or not.

As per the American Urological Association, normally, 0-3 red blood cells may be detected per high powered field in the urine.

Abnormal results:

If the results are found to be abnormal, then your doctor will perform other tests in order to evaluate the functioning of your kidneys and bladder. More than 3 red blood cells in the urine per high powered field indicate haematuria. 

Haematuria could be attributed to:

  • Kidney infections
  • Urinary tract infections
  • Strenuous physical exercise
  • Exposure to toxins
  • Physical injury to the bladder
  • Urethritis (inflammation of the urethra)
  • Kidney stones or bladder stones

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.

References

  1. American College of Radiology (ACR), the Society of Interventional Radiology (SIR), and the Society for Pediatric Radiology; Hematuria or blood in urine
  2. National Institute of Diabetes and Digestive and Kidney Diseases [internet]: US Department of Health and Human Services; Hematuria (Blood in urine)
  3. Urology Care Foundation. American Urological Association [internet]. Maryland. U.S. Repeat Urine Testing
  4. Meng MV, Stoller ML, Walsh TJ. Chapter 23. Urologic Disorders. In: Papadakis MA, McPhee SJ, Rabow MW, Eds. Current Medical Diagnosis & Treatment 2013. New York: McGraw – Hill; 2013.
  5. Shah AP. Merck Manual Professional Version [Internet]. Kenilworth (NJ): Merck & Co. Inc.; c2019. Isolated hematuria.
  6. Davis R, et al. Diagnosis, evaluation and follow up of AMH in adults. AUA guidelines. J Urol. 2012 Dec;188(6 Suppl):2473-81. PMID: 23098784.

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