Approach to Red Urine

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Approach to Red Urine

• Helen Healy
• Department of Renal Medicine
• Royal Brisbane Hospital

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Mr MC b 4 May 1946

• insisted on an urgent consultation with a history
  of a single episode of red urine

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Mr MC b 4 May 1946

• insisted on an urgent consultation with a history
  of a single episode of red urine

His GP saw him the same day. A urine specimen
was not red and a dipstick was negative for blood
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KOM
- dipstick testing

• may be microscopic or macroscopic
• as little as 1 ml of RBC in 1 L of urine will
  cause colouration
• approximately 5,000 RBC/ml urine or 50 RBC/?l

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Mr MC b 4 May 1946

• insisted on an urgent consultation with a history
  of a single episode of red urine

His GP saw him the same day. A urine specimen
was not red and a dipstick was negative for blood
Microscopy did not reveal an increase in RBC count
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Hematuria - RBC in the urine

• It is normal for RBC to be excreted in the urine
  - up to 10 RBC/?l
• Abnormal hematuria
• up to 4 of children 1-13 of adults
• more common in populations followed over time -
  38.7 men over t15y and 16.1 on gt 1 examination
  within 5 y

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Microscopic evidence of an increased number of
RBC in the urine discriminates
Not all urine that is red is hematuria
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Mr TF b 6 May 1931

• insisted on an urgent consultation with a history
  of a single episode of macroscopic hematuria