Blood in Urine · high result
Blood in urine (hematuria): what it means, causes and how it is evaluated
Short answer
Blood in the urine is confirmed by microscopy — three or more red cells per high-power field — because menstruation, hard exercise and infection account for many positive dipsticks. Infection, kidney stones, an enlarged prostate and exercise are the common causes; kidney disease is suggested when protein, misshapen red cells or red-cell casts accompany it; and the risk-based AUA evaluation with cystoscopy and imaging exists to find the minority with a urinary-tract cancer.
Medically reviewed by Youmna DiStefano, MD · Last reviewed November 2026
When does this result need same-day care?
- Visible blood with clots, or difficulty passing urine — same-day care
- Blood with fever, chills and flank or back pain — a kidney infection or an infected, obstructed stone; same-day care
- Blood after an injury, or blood with swelling, rising blood pressure or very little urine — emergency assessment
What is the normal range for Blood in Urine?
Blood detected on the urine dipstick (hemoglobin or intact red cells). Normally negative; confirmed by microscopy, where 3 or more red cells per high-power field is microscopic hematuria.
Menstrual contamination, hard exercise, a urinary infection or a kidney stone are the common explanations; persistent microscopic hematuria is evaluated for kidney and urinary-tract causes, with risk-based imaging and cystoscopy per AUA guidance.
Full reference table, citations and testing options: Blood in Urine biomarker page.
What are the common causes of high Blood in Urine?
- Urinary tract infection, cystitis, prostatitis and urethritis — the most common cause, usually with burning, frequency and white cells
- Kidney and ureteral stones — often with flank pain radiating to the groin; sometimes painless microscopic blood
- Menstrual or other contamination of the sample, recent sexual intercourse, a catheter, cystoscopy or prostate biopsy
- Vigorous exercise — running, contact sports and heavy workouts; resolves within 72 hours
- Benign prostatic enlargement in men over 50; urethral stricture; radiation or cyclophosphamide cystitis
- Glomerular kidney disease — IgA nephropathy (often flaring with a sore throat), thin basement membrane disease, Alport syndrome (with hearing loss), post-infectious glomerulonephritis, lupus nephritis, vasculitis; dysmorphic red cells, red-cell casts and protein
- Other kidney sources — polycystic kidney disease, sickle cell trait and disease, renal vein thrombosis, papillary necrosis (diabetes, NSAIDs, sickle cell)
- Cancers of the bladder, kidney and upper urinary tract — risk rises with age over 60, male sex, smoking, chemical exposures and gross hematuria
- Heme without red cells — hemoglobin from hemolysis or myoglobin from muscle breakdown turns the dipstick positive with no cells on microscopy; false red urine without heme from beets, rifampin, phenazopyridine or porphyria
What symptoms go with high Blood in Urine?
- None — microscopic hematuria is usually found on a routine test
- Pink, red or cola-colored urine, with or without clots, in gross hematuria
- Burning, urgency and frequency with infection; severe flank-to-groin pain with a stone
- Swelling, rising blood pressure, foamy urine or reduced urine output when the source is the kidney's filters
What do clinicians usually check next?
- Confirm with a repeat urinalysis and microscopy after any menstruation, exercise or infection has passed; three or more red cells per high-power field is microscopic hematuria
- If there was an infection, treat it and repeat the urinalysis about six weeks later — blood that persists afterwards still needs evaluation
- Serum creatinine and eGFR, a urine albumin-to-creatinine ratio and blood pressure; protein, dysmorphic red cells or casts mean a nephrology referral
- Risk-stratify per the AUA/SUFU 2020 guideline: low risk (women under 50, men under 40, fewer than 10 pack-years, 3–10 RBC/hpf) — repeat urinalysis in six months or cystoscopy with kidney ultrasound; intermediate risk — cystoscopy and kidney ultrasound; high risk (age 60 or over, more than 30 pack-years, more than 25 RBC/hpf, or any gross hematuria) — cystoscopy and CT urography
- Urine cytology for irritative symptoms, a smoking history or persistent blood after a negative evaluation; a repeat urinalysis a year after a negative work-up
- Do not attribute blood to a blood thinner — anticoagulated patients are evaluated the same way, without stopping the drug unless the prescriber says so
How do you recheck Blood in Urine?
Prices are cash-pay; every order adds one $6 lab processing fee. Physician authorization is included; no insurance or referral needed.
| Test or panel | Type | Price | Fasting | Results |
|---|---|---|---|---|
| Kidney Health Panel | Panel · 4 tests | $64.99 | Yes | 2–4 business days |
| Early Pregnancy Panel | Panel · 9 tests | $249.99 | No | 3–5 business days |
| Men's Total Body Advanced Panel | Panel · 65 tests | $999.99 | Yes | 5–10 business days |
| Complete Urinalysis Test | Test · 14 biomarkers | $17.99 | No | 1–3 business days |
Common questions
What does blood in urine mean?
Most often a urinary infection, a kidney stone, hard exercise in the last three days, menstrual contamination or, in men over 50, an enlarged prostate. Three or more red cells per high-power field on microscopy confirms it; a repeat after any infection, exercise or period has passed is the first step. Persistent blood is evaluated for kidney disease (protein, casts, creatinine) and, scaled to age and smoking history, for cancers of the bladder and kidney.
How much blood in urine is abnormal?
Three or more red blood cells per high-power field on urine microscopy, on a properly collected sample, is the AUA definition of microscopic hematuria. A dipstick trace with 0–2 cells is within normal limits. Visible (gross) hematuria needs only about a milliliter of blood per liter of urine and is evaluated in every case, even if it was a single episode.
Can a UTI cause blood in urine?
Yes — infection inflames the bladder lining and is the most common cause of hematuria, usually alongside burning, frequency, white cells and nitrite. Treat the infection and repeat the urinalysis about six weeks later; if the blood has gone, the infection was the cause, and if it persists it needs its own evaluation.
Is blood in urine a sign of cancer?
Usually not, but it can be, which is why persistent hematuria is evaluated. The risk rises with age over 60, male sex, smoking, occupational exposure to dyes and chemicals, a higher red-cell count and especially visible blood — painless gross hematuria in an older smoker is bladder cancer until excluded. Younger non-smokers with a low count are at low risk and may simply repeat the test in six months.
Educational content, not a diagnosis. Lab results are one input; a clinician interprets them with your history and exam.