Hematuria laboratory findings

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Steven C. Campbell, M.D., Ph.D.

Laboratory Findings

Often, the diagnosis is made on the basis of the medical history and urine and blood tests—especially in young people in whom the risk of malignancy is negligible and the symptoms are generally self-limited.

• Urinalysis for all patients
• Complete blood count (CBC)
• Calcium
• Uric acid
• Prothrombin time / Partial thromboplastin time (PT / PTT)
• Blood urea nitrogen (BUN) / creatinine

A more complete evaluation would include the following:

• C3 levels
• Red blood cells casts
• Cryoglobulins
• Presence of Hepatitis C antibodies
• Anti-glomerular basement membranes (GBM)
• Antinuclear antibodies (ANA)
• Anti-neutrophil cytoplasmic antibodies (ANCA)
• Antistreptolysin O antibodies (ASO)

• Microscopy findings
• Positive for urinary casts (suggesting renal disease)
• Positive for urinary crystals (suggesting calculous disease)
• Positive for dysmorphology of red cells (suggesting a glomerular cause of hematuria)
• Positive for atypical or malignant epithelial cells from a tumour are shed into the urine.
• Urine cytology findings
• Poorly-adhesive grossly abnormal cells (suggesting poorly differentiated tumours and carcinoma in-situ)
• Urine culture
• Detects bacterial cause of UTI
• Blood tests
  • Complete blood count (to detect anemia)
  • Coagulation studies (to detect hemoglobinopathies)
  • Antibody studies (e.g. ANA, ANCA, ASO, anti- glomerular basement membrane antibodies (to detect glomerular cause of hematuria)
  • Complement levels (to detect nephritic cause of hematuria)
  • Serum urea, creatinine and electrolytes (to detect renal impairment)