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Test Findings

Blood on Urine Dipstick

September 10th, 2020


A urine dipstick is able to detect urinary haemoglobin (free or within red cells) as a surrogate for blood. This test also detects the presence of myoglobin.
  • A positive dipstick for blood means one of three things:
  • Haematuria - microscopic or macroscopic blood in the urine
  • Haemoglobinuria - free haemoglobin within the urine, which is a marker of intravascular haemolysis
  • Myoglobinuria - myoglobin within the urine, which is a marker of rhabdomyolysis
  • Causes of Positive Dipstick for Blood

  • Haematuria

  • Glomerulonephropathy - congenital glomerulonephropathy, primary or secondary glomerulonephritis
  • Vascular pathology - arteriovenous malformation, renal vein thrombosis, renal infarct
  • Polycystic kidney disease
  • Urinary tract infection - urethritis, cystitis, pyelonephritis, prostatitis, tuberculosis
  • Neoplasm - renal, bladder, prostate
  • Renal calculus
  • Inflammation - interstitial cystitis
  • Haemorrhagic cystitis (cyclophosphamide)
  • Trauma
  • Haemoglobinuria

  • Microangiopathic haemolytic anaemia - TTP, HUS, DIC, preeclampsia / HELLP, severe burns, brown snake bite
  • Mechanical haemolysis - valvular leak, cardiac prostheses, renal replacement, ECMO, march haemoglobinuria
  • Alloimmune haemolysis - transfusion reaction, haemolytic disease of the newborn
  • Infection-induced haemolysis - severe malaria, Clostridium toxin
  • Paroxysmal nocturnal haemoglobinuria
  • G6PD deficiency
  • Myoglobinuria

  • Immobilisation
  • Strenuous exercise
  • Limb ischaemia
  • Trauma / exposure - severe trauma, crush injury, severe burns, electrocution, heatstroke, snake bite
  • Myositis - viral, bacterial, polymyositis, dermatomyositis
  • Electrolyte disturbances - hyponatraemia, hypernatraemia, hypokalaemia, hypophosphataemia, hypocalcaemia
  • Drugs - statins, malignant hyperthermia, neuroleptic malignant syndrome
  • Hereditary - deficiency of enzymes involved in lipid / carbohydrate / purine metabolism
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