Hematuria: Tests and Diagnosis

What tests are used to diagnose hematuria?

Hematuria is diagnosed by a urinalysis, a test that determines if there is blood found in the urine. In most doctors’ offices, a testing strip is used to check the urine for possible blood and that test strip or dipstick can indicate the possibility of blood in the urine, even though you can’t see it. However, a positive strip test needs to be verified by analysis of the urine under a microscope, because the strips are capable of giving false positives.

Once hematuria is verified, blood tests are done to make sure the kidneys are working well. Finding more than blood (for example, protein) in the urine is another sign of hematuria.

In complicated cases, children with hematuria may be referred to a pediatric nephrologist, who will order other special tests to determine the cause, especially if the disease involves more that the kidneys:

  • Sometimes a kidney specialist may recommend an ultrasound of the kidneys just to make sure they look normal. This isn’t always necessary, but is very helpful if the doctor believes the blood is from the urinary collecting system, and not the kidneys.
  • If the nephrologist feels it is necessary to look at the filters themselves, a tiny piece of kidney needs to be removed with a needle and looked at with a microscope. This procedure is called a renal (kidney) biopsy.