A clean-catch (midstream) urine sample is needed. The clean-catch method is used to prevent germs from the penis or vagina from getting into a urine sample. To collect your urine, you may get a special clean-catch kit from your health care provider that contains a cleansing solution and sterile wipes. Follow instructions exactly so that the results are accurate.

No special preparation is necessary for this test. If the collection is being taken from an infant, a couple of extra collection bags may be necessary.

The test involves only normal urination. There is no discomfort.

Hemoglobin is a molecule contained within red blood cells. Hemoglobin helps move oxygen through the body.

Red blood cells have an average life span of 120 days. After this time, they are broken down into parts that can make a new red blood cell. This breakdown takes place in the spleen, bone marrow, and liver. If the red blood cells break down in the blood vessels, their parts move freely in the bloodstream.

If the level of hemoglobin in the blood rises too high, then hemoglobin begins to appear in the urine. This is called hemoglobinuria.

This test may be used to help diagnose causes of hemoglobinuria.

Normally, hemoglobin does not appear in the urine.

Hemoglobinuria may be a result of any of the following:

• Burns
• Crushing injury
• Hemolytic uremic syndrome (HUS), a disorder that occurs when an infection in the digestive system produces toxic substances
• Kidney infection
• Kidney inflammation or injury including glomerulonephritis
• Kidney tumor
• Malaria
• Paroxysmal nocturnal hemoglobinuria, disease in which red blood cells break down earlier than normal
• Paroxysmal cold hemoglobinuria, disease in which the body's immune system produces antibodies that destroy red blood cells
• Sickle cell anemia
• Thalassemia, disease in which the body makes an abnormal form or inadequate amount of hemoglobin
• Thrombotic thrombocytopenic purpura (TTP)
• Transfusion reaction
• Tuberculosis

Urine - hemoglobin

Gharavi AG, Landry DW. Approach to the patient with renal disease. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2023:chap 100.

Riley RS, McPherson RA. Basic examination of urine. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 29.

Updated by: Jacob Berman, MD, MPH, Clinical Assistant Professor of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.