Haematuria (Blood in Urine)
Blood in the urine is always a finding that deserves a proper explanation. Sometimes the cause is harmless. Sometimes it is the first sign of a treatable condition that should not be missed. Either way, structured investigation is the right response. Trying to brush it off or assume it is nothing can lead to delayed diagnosis of serious conditions.
Dr Rory McQuillan provides thorough specialist assessment of haematuria, with focus on identifying the underlying cause and excluding kidney and urological conditions that need treatment.
Visible versus non-visible haematuria
Visible haematuria means blood that can be seen in the urine. Non-visible haematuria (sometimes called microscopic haematuria) means blood detected only on a urine test or dipstick. Both deserve investigation, although visible haematuria is more urgent.
Causes of haematuria
- Urinary tract infection
- Kidney stones
- Glomerulonephritis (most often IgA nephropathy)
- Bladder, kidney, or prostate cancer
- Benign prostatic enlargement
- Anticoagulant medications
- Vigorous exercise (transient)
- Trauma
- Inherited conditions such as thin basement membrane disease or Alport syndrome
Investigation
A structured work-up typically includes:
- Urinalysis and urine microscopy
- Urine cytology in selected cases
- Blood tests for kidney function and clotting
- Imaging of the urinary tract (ultrasound, CT urogram in selected cases)
- Cystoscopy by a urologist for visible haematuria or other indications
- Specialist nephrology tests including immunology and kidney biopsy where indicated
When to refer to nephrology
Nephrology referral is appropriate when haematuria is accompanied by proteinuria, reduced kidney function, hypertension, or a family history of kidney disease, or when urology assessment has not identified a cause. The role of the nephrologist is to identify medical causes (typically glomerular disease) that urology assessment does not detect.
Appointments
Appointments are arranged through GP referral.
Frequently Asked Questions
No. The causes range from minor infections to serious conditions, and many are easily treatable. Proper investigation is the only way to know.
Yes. Vigorous exercise can cause transient haematuria. This is usually harmless but should be confirmed by repeat testing.
Cystoscopy is generally recommended for visible haematuria and for non-visible haematuria with risk factors. It is a urological investigation rather than a nephrological one.
The combination of haematuria and proteinuria, especially with reduced kidney function, raises the possibility of glomerulonephritis and warrants specialist nephrology assessment, sometimes including kidney biopsy.
Have a Question?
If you’d like more information about Dr. McQuillan’s services or need assistance from the practice team, please get in touch below.
Please note: Appointments are arranged via GP referral.