Intended for healthcare professionals

Practice 10-Minute Consultation


BMJ 2009; 338 doi: (Published 17 April 2009) Cite this as: BMJ 2009;338:b1324
  1. Martijn Bakker, general practitioner1,
  2. Diederik Boon, specialist registrar2
  1. 1EMGO Institute, VU University Medical Center, Postbus 7057, 1007 MB Amsterdam, The Netherlands
  2. 2Department of Nephrology, Westfriesgasthuis, Postbus 600, 1620 AR Hoorn, The Netherlands
  1. Correspondence to: M Bakker mbakker72{at}
  • Accepted 31 March 2008

A 40 year old woman complains of frequency without dysuria. The dipstick shows a score of 3+ on the haematuria test. The woman is fit and healthy and has no major medical history.

What issues you should cover

Haematuria is defined as ≥3 red blood cells in the urine per high power field. Macroscopic haematuria means that the urine is visibly red. However, red, pink, tea coloured, brown, or black urine may, on microscopic examination, contain no red blood cells. Although usually benign and associated with urinary tract infection or kidney stones, and often self limiting and not having any identifiable cause, haematuria may also be a sign of malignancy or kidney disease.


Does she have a history of kidney stones? Is there a relevant family history, for example of adult polycystic kidney disease? Smoking …

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