Health Q&A: blood traces in urine

Dr Mark Porter / 15 February 2018

Dr Mark Porter answers a reader’s question about traces of blood in a routine urine test.



Q: A routine medical at work has turned up traces of blood in my urine and I have been referred to my GP. I feel well and haven’t noticed any blood or any other symptoms.

A: Obvious blood in the urine (haematuria) should never be ignored and always warrants further investigation as, in the absence of obvious infection or stones, it can be a sign of kidney and bladder cancer. But the best way to manage  traces which are invisible to the naked eye and only detected on testing with a dipstick is less clear. And this microscopic haematuria is a common finding, occurring in as many as 1 in 20 healthy individuals tested during medicals such as those done routinely for life insurance and licences to race, fly or dive.

The first thing to do is repeat the test. If positive again then it warrants further investigation in people over 40 (and sometimes under this age depending on circumstances) - particularly if they smoke, bladdder and kidney cancers being more common in smokers).

Assuming infection has been ruled out, the next step is typically  referral to a urologist to check the kidneys (scan) and bladder (cystoscopy). If this is all clear - as it normally is - further blood pressure checks, blood and urine tests are generally done to check the kidneys are working OK. Assuming they too are fine, you can relax. Some people have slightly leaky kidneys and it is normal for them to get tiny traces of blood in their urine.


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