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Test Findings
 
 

Blood on Urine Dipstick

 
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Overview

  • 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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