Blood in Urine: The Bare Basics of Haematuria



Haematuria is the technical term for the presence of red blood cells (RBCs) in urine. This could range from minute quantities such that it is invisible to the naked eye (occult or hidden bleeding), to frank hematuria such that the urine assumes a reddish tinge to a cola-coloured appearance.

Red blood cells abundantly present in our bloodstream happen to carry a pigment called “Haemoglobin” within them. This is what gives our blood, a red colour and lends that reddish tinge to most urine samples that have blood in it.

Please note: For Haematuria, the urine sample must contain whole red blood cells and not just the red pigment of blood.

However small the number, blood in urine is abnormal and warrants immediate medical intervention.



Not really. Let us explain.  Clinically, doctors have identified the following types of Haematuria:


Here, the blood in urine is NOT visible to the naked eye.

The urine sample “appears” clear pale yellow and the patients are oblivious of the fact that their urine contains blood. This kind of haematuria is “found out” after red blood cells are detected through a Chemical dip-strip test & a Microscopic analysis during a routine urine test for an unrelated condition.



The reddish appearance of urine is clearly visible to the naked eye.

A microscopic analysis within a routine urine test is then required to confirm the presence of red blood cells in urine. The extent of bleeding could make the urine appear orangish to a deep red as depicted in the image below. Here, patients usually go to the doctor with “red urine” as their concern.

Urine samples from patients with Haematuria arranged in decreasing order of bleeding intensity Creative Commons Licence


Hence, Hematuria does not strictly present as “red urine” as explained above.

Similarly, it is important to understand that apart from blood in urine, our urine may appear “reddish” from other reasons too. These could range from being the side-effect of certain medicines to consuming beetroot (in some people). This article focuses solely on red urine due to leakage of blood in urine.



The following conditions commonly present with Haematuria:

Non-urological causes Urinary Tract causes Glomerular and renal parenchymal causes  

It is important for your doctor to be able to identify the cause for blood in the urine. This is crucial in formulating your treatment plan.

So how do doctors proceed with zeroing-in on your site of bleeding in urine?

Click on the image below to learn:

Hematuria work-up



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