Type

Urine

Part of

Urinalysis

Part of

Urinalysis

Blood biomarker

Part of

Urinalysis

Red Blood Cells (Urine)

Red blood cells in urine can indicate bleeding in the urinary tract.

Red Blood Cells (Urine)

Normal range

Negative

Normal range

Negative

Normal range

Red Blood Cells (Urine)

Red blood cells in urine can indicate bleeding in the urinary tract.

Red Blood Cells (Urine)

Normal range

Negative

Normal range

Negative

Normal range

Red Blood Cells (Urine)

Red blood cells in urine can indicate bleeding in the urinary tract.

Red Blood Cells (Urine)

Normal range

Negative

Normal range

Negative

Normal range

Red Blood Cells (Urine)

Dr. Daniel McNally

MBBS

The Bleeding Signal

Red blood cells in your urine are like finding drops of blood where they shouldn't be—they indicate bleeding somewhere in your urinary tract, from your kidneys down to your bladder. While small numbers might occasionally appear in healthy people, persistent red blood cells in urine require medical investigation to identify the source and cause.

Your urinary tract normally acts as a closed system where blood stays within blood vessels and doesn't mix with urine. When red blood cells appear in your urine, it means bleeding has occurred somewhere along this pathway, ranging from minor irritation to serious underlying conditions.

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Where the Bleeding Comes From

Discover the different parts of your urinary system that can bleed and what causes red blood cells to appear in urine.

When Blood in Urine Signals Problems

Learn about kidney stones, infections, and cancers that cause concerning levels of red blood cells in urine.

Invisible vs. Visible Blood in Urine

Find out the difference between microscopic blood you can't see and visible blood that requires immediate attention.

Understanding Your Results

Understand how doctors interpret blood cell counts and what additional tests might be needed.

Where the Bleeding Comes From

Red blood cells in urine can originate from anywhere in your urinary tract, and identifying the source helps determine the underlying cause and appropriate treatment.

Urethra irritation: The tube that carries urine out of the body can bleed due to infections, trauma, or irritation from catheters or sexual activity.
Contamination factors: In women, menstrual blood can sometimes contaminate urine samples, leading to false-positive results.
Kidney bleeding: Blood from the kidneys often indicates glomerulonephritis (kidney filter inflammation), kidney stones, or more rarely, kidney cancer. Kidney bleeding may be accompanied by protein in urine and changes in kidney function.
Bladder sources: Bladder infections, bladder stones, or bladder cancer can cause red blood cells to appear in urine. Bladder bleeding is often accompanied by symptoms like burning during urination, frequency, or urgency.
Ureter involvement: The tubes connecting kidneys to the bladder can bleed due to kidney stones passing through, infections, or rarely tumours. This bleeding is often associated with severe flank pain.
Prostate issues: In men, prostate enlargement, infections, or cancer can cause bleeding that appears as red blood cells in urine. This may be accompanied by difficulty urinating or a weak stream.

Understanding the potential sources helps explain why doctors often need additional tests to pinpoint the exact cause of red blood cells in urine.

Where the Bleeding Comes From

Red blood cells in urine can originate from anywhere in your urinary tract, and identifying the source helps determine the underlying cause and appropriate treatment.

Urethra irritation: The tube that carries urine out of the body can bleed due to infections, trauma, or irritation from catheters or sexual activity.
Contamination factors: In women, menstrual blood can sometimes contaminate urine samples, leading to false-positive results.
Kidney bleeding: Blood from the kidneys often indicates glomerulonephritis (kidney filter inflammation), kidney stones, or more rarely, kidney cancer. Kidney bleeding may be accompanied by protein in urine and changes in kidney function.
Bladder sources: Bladder infections, bladder stones, or bladder cancer can cause red blood cells to appear in urine. Bladder bleeding is often accompanied by symptoms like burning during urination, frequency, or urgency.
Ureter involvement: The tubes connecting kidneys to the bladder can bleed due to kidney stones passing through, infections, or rarely tumours. This bleeding is often associated with severe flank pain.
Prostate issues: In men, prostate enlargement, infections, or cancer can cause bleeding that appears as red blood cells in urine. This may be accompanied by difficulty urinating or a weak stream.

Understanding the potential sources helps explain why doctors often need additional tests to pinpoint the exact cause of red blood cells in urine.

Where the Bleeding Comes From

Red blood cells in urine can originate from anywhere in your urinary tract, and identifying the source helps determine the underlying cause and appropriate treatment.

Urethra irritation: The tube that carries urine out of the body can bleed due to infections, trauma, or irritation from catheters or sexual activity.
Contamination factors: In women, menstrual blood can sometimes contaminate urine samples, leading to false-positive results.
Kidney bleeding: Blood from the kidneys often indicates glomerulonephritis (kidney filter inflammation), kidney stones, or more rarely, kidney cancer. Kidney bleeding may be accompanied by protein in urine and changes in kidney function.
Bladder sources: Bladder infections, bladder stones, or bladder cancer can cause red blood cells to appear in urine. Bladder bleeding is often accompanied by symptoms like burning during urination, frequency, or urgency.
Ureter involvement: The tubes connecting kidneys to the bladder can bleed due to kidney stones passing through, infections, or rarely tumours. This bleeding is often associated with severe flank pain.
Prostate issues: In men, prostate enlargement, infections, or cancer can cause bleeding that appears as red blood cells in urine. This may be accompanied by difficulty urinating or a weak stream.

Understanding the potential sources helps explain why doctors often need additional tests to pinpoint the exact cause of red blood cells in urine.

When Blood in Urine Signals Problems

Whilst many causes of red blood cells in urine are benign, some indicate serious conditions requiring immediate medical attention and treatment.

Kidney stones: These hard deposits can scratch or tear urinary tract tissue as they move, causing bleeding, pain, nausea, and vomiting. Large stones may require surgical removal.
Urinary tract infections: Bacterial infections can cause inflammation and bleeding throughout the urinary system. Kidney infections are particularly serious and can lead to sepsis if untreated.
Glomerulonephritis: Inflammation of your kidney’s glomeruli leads to bleeding and often proteinuria, plus potential decline in kidney function. Early treatment can prevent further damage.
Urinary tract cancers: Bladder, kidney, or prostate cancers can cause persistent bleeding. Early detection significantly improves outcomes, making investigation of unexplained blood crucial.
Injuries: Accidents affecting the abdomen, pelvis, or lower back can damage urinary tract structures causing blood in the urine. Medical procedures involving the urinary tract, such as catheters or camera tests, can also slightly injure the urinary tract.
Blood clotting effects: Conditions affecting blood clotting can cause bleeding throughout the body, including the urinary tract. Blood-thinning medications can also increase bleeding risk throughout the urinary tract when combined with an irritation such as a kidney stone or urinary procedure.

When Blood in Urine Signals Problems

Whilst many causes of red blood cells in urine are benign, some indicate serious conditions requiring immediate medical attention and treatment.

Kidney stones: These hard deposits can scratch or tear urinary tract tissue as they move, causing bleeding, pain, nausea, and vomiting. Large stones may require surgical removal.
Urinary tract infections: Bacterial infections can cause inflammation and bleeding throughout the urinary system. Kidney infections are particularly serious and can lead to sepsis if untreated.
Glomerulonephritis: Inflammation of your kidney’s glomeruli leads to bleeding and often proteinuria, plus potential decline in kidney function. Early treatment can prevent further damage.
Urinary tract cancers: Bladder, kidney, or prostate cancers can cause persistent bleeding. Early detection significantly improves outcomes, making investigation of unexplained blood crucial.
Injuries: Accidents affecting the abdomen, pelvis, or lower back can damage urinary tract structures causing blood in the urine. Medical procedures involving the urinary tract, such as catheters or camera tests, can also slightly injure the urinary tract.
Blood clotting effects: Conditions affecting blood clotting can cause bleeding throughout the body, including the urinary tract. Blood-thinning medications can also increase bleeding risk throughout the urinary tract when combined with an irritation such as a kidney stone or urinary procedure.

When Blood in Urine Signals Problems

Whilst many causes of red blood cells in urine are benign, some indicate serious conditions requiring immediate medical attention and treatment.

Kidney stones: These hard deposits can scratch or tear urinary tract tissue as they move, causing bleeding, pain, nausea, and vomiting. Large stones may require surgical removal.
Urinary tract infections: Bacterial infections can cause inflammation and bleeding throughout the urinary system. Kidney infections are particularly serious and can lead to sepsis if untreated.
Glomerulonephritis: Inflammation of your kidney’s glomeruli leads to bleeding and often proteinuria, plus potential decline in kidney function. Early treatment can prevent further damage.
Urinary tract cancers: Bladder, kidney, or prostate cancers can cause persistent bleeding. Early detection significantly improves outcomes, making investigation of unexplained blood crucial.
Injuries: Accidents affecting the abdomen, pelvis, or lower back can damage urinary tract structures causing blood in the urine. Medical procedures involving the urinary tract, such as catheters or camera tests, can also slightly injure the urinary tract.
Blood clotting effects: Conditions affecting blood clotting can cause bleeding throughout the body, including the urinary tract. Blood-thinning medications can also increase bleeding risk throughout the urinary tract when combined with an irritation such as a kidney stone or urinary procedure.

Invisible vs. Visible Blood in Urine

Understanding the difference between microscopic and visible blood in urine helps determine urgency and guide appropriate medical response.

Microscopic haematuria: This refers to red blood cells detected only in small amounts, not visible to the naked eye. While concerning, it's often less urgent than visible bleeding and may indicate early-stage problems, and should be monitored.

Gross haematuria: This means blood is visible in urine, appearing pink, red, or brown. Visible blood always requires immediate medical attention as it indicates significant bleeding.

Associated symptoms: Visible blood accompanied by pain, fever, or difficulty urinating suggests infection or stones requiring immediate treatment.

Painless bleeding: Persistent blood in urine without pain or a known established cause can be concerning as it may indicate growths or tumours and should be further investigated.

Invisible vs. Visible Blood in Urine

Understanding the difference between microscopic and visible blood in urine helps determine urgency and guide appropriate medical response.

Gross haematuria: This means blood is visible in urine, appearing pink, red, or brown. Visible blood always requires immediate medical attention as it indicates significant bleeding.

Associated symptoms: Visible blood accompanied by pain, fever, or difficulty urinating suggests infection or stones requiring immediate treatment.

Painless bleeding: Persistent blood in urine without pain or a known established cause can be concerning as it may indicate growths or tumours and should be further investigated.

Invisible vs. Visible Blood in Urine

Understanding the difference between microscopic and visible blood in urine helps determine urgency and guide appropriate medical response.

Gross haematuria: This means blood is visible in urine, appearing pink, red, or brown. Visible blood always requires immediate medical attention as it indicates significant bleeding.

Associated symptoms: Visible blood accompanied by pain, fever, or difficulty urinating suggests infection or stones requiring immediate treatment.

Painless bleeding: Persistent blood in urine without pain or a known established cause can be concerning as it may indicate growths or tumours and should be further investigated.

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Understanding Your Results

Understanding red blood cell test interpretation helps you better comprehend what your results indicate and what steps might follow.

Normal results: Healthy urine should show "negative" or "trace" amounts of blood on urinalysis testing. This means no significant bleeding is detected in your urinary tract.
Mild elevation: Results showing "1+" or "small" amounts of blood may indicate minor irritation, early infection, or the beginning of more significant problems. These findings typically warrant monitoring and follow-up testing.
Large elevation: Results showing "2+/3+" or "moderate/severe" amounts of blood suggest more significant presence of blood and typically require further evaluation, if there is no cause established.

Single abnormal results are often repeated to confirm findings and establish patterns, as temporary elevations can occur with exercise, menstruation, or minor trauma. If persistent presence of microscopic blood is found in the urine over several months without a known cause, more investigation is usually required.

Understanding Your Results

Understanding red blood cell test interpretation helps you better comprehend what your results indicate and what steps might follow.

Normal results: Healthy urine should show "negative" or "trace" amounts of blood on urinalysis testing. This means no significant bleeding is detected in your urinary tract.
Mild elevation: Results showing "1+" or "small" amounts of blood may indicate minor irritation, early infection, or the beginning of more significant problems. These findings typically warrant monitoring and follow-up testing.
Large elevation: Results showing "2+/3+" or "moderate/severe" amounts of blood suggest more significant presence of blood and typically require further evaluation, if there is no cause established.

Understanding Your Results

Understanding red blood cell test interpretation helps you better comprehend what your results indicate and what steps might follow.

Normal results: Healthy urine should show "negative" or "trace" amounts of blood on urinalysis testing. This means no significant bleeding is detected in your urinary tract.
Mild elevation: Results showing "1+" or "small" amounts of blood may indicate minor irritation, early infection, or the beginning of more significant problems. These findings typically warrant monitoring and follow-up testing.
Large elevation: Results showing "2+/3+" or "moderate/severe" amounts of blood suggest more significant presence of blood and typically require further evaluation, if there is no cause established.

The Takeaway

Red blood cells in urine serve as an important warning sign of bleeding in your urinary tract. While some causes are minor and easily treated, others can indicate serious conditions requiring immediate medical attention.

Never ignore visible blood in urine, and don’t dismiss microscopic blood on routine testing. Early investigation of urinary bleeding can prevent complications and ensure optimal outcomes.

Understanding the significance of hematuria helps you appreciate why this finding prompts thorough medical evaluation and the importance of following through with recommended tests and treatments.

The Takeaway

Never ignore visible blood in urine, and don’t dismiss microscopic blood on routine testing. Early investigation of urinary bleeding can prevent complications and ensure optimal outcomes.

Understanding the significance of hematuria helps you appreciate why this finding prompts thorough medical evaluation and the importance of following through with recommended tests and treatments.

The Takeaway

Never ignore visible blood in urine, and don’t dismiss microscopic blood on routine testing. Early investigation of urinary bleeding can prevent complications and ensure optimal outcomes.

Understanding the significance of hematuria helps you appreciate why this finding prompts thorough medical evaluation and the importance of following through with recommended tests and treatments.

References

British Association of Urological Surgeons. (2020). Guidelines for the management of haematuria. BAUS Clinical Guidelines.
National Institute for Health and Care Excellence. (2018). Urological cancer: recognition and referral. NICE Clinical Guideline.
Kidney Research UK. (2019). Glomerulonephritis: diagnosis and management. Clinical Practice Guidelines.

References

British Association of Urological Surgeons. (2020). Guidelines for the management of haematuria. BAUS Clinical Guidelines.
National Institute for Health and Care Excellence. (2018). Urological cancer: recognition and referral. NICE Clinical Guideline.
Kidney Research UK. (2019). Glomerulonephritis: diagnosis and management. Clinical Practice Guidelines.

References

British Association of Urological Surgeons. (2020). Guidelines for the management of haematuria. BAUS Clinical Guidelines.
National Institute for Health and Care Excellence. (2018). Urological cancer: recognition and referral. NICE Clinical Guideline.
Kidney Research UK. (2019). Glomerulonephritis: diagnosis and management. Clinical Practice Guidelines.