Urine RBC Count
Urine Red Blood Cell Count (Microscopy)
A urine red blood cell count checks for blood cells under a microscope. It can find blood that is too small to see. Reports often use RBC/HPF, meaning red blood cells per high-power field.
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What does an increased count mean?
Red blood cells can come from anywhere along the urinary tract. Infection, stones and several other conditions can cause them, and menstrual blood can contaminate a sample. The count alone does not identify the cause.
A clinical threshold for microscopic blood
- Microscopic blood in urine
- 3 or more RBC per high-power field (RBC/HPF)
The 2025 AUA guideline uses this threshold for a properly collected sample examined by microscopy. A result reported in cells per microliter is not directly interchangeable. Further assessment depends on symptoms, persistence and individual risk.
Sources: American Urological Association
What can change this result?
Why red cells may appear
- Menstrual blood mixing with the sample.
- Strenuous exercise shortly before the test.
- Infection, stones or other kidney or urinary tract conditions.
What helps clarify the cause
- A properly collected repeat sample, when your clinician recommends it.
- Checking again after a treated infection or temporary cause has resolved.
- Discussing medicines and symptoms; do not stop blood thinners on your own.
Blood thinners do not remove the need to investigate persistent blood in urine. A lower repeat count is useful, but follow-up depends on the whole picture.
What should I do next?
- Check the units and ask whether a repeat sample is needed.
- If an infection was treated, ask whether the urine should be checked again afterward.
- Review persistent blood with your clinician, even if you feel well. Visible blood or difficulty urinating needs prompt medical attention.
How this test works
A high-power field is the small area seen through a microscope at a particular magnification. Automated cell counts may use different units. The dipstick blood result and microscopic count are related but are not the same test.