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Tareq Abadl: Hematuria vs Hemoglobinuria vs Myoglobinuria
Dr. Tareq Abadl/LinkedIn
Feb 11, 2026, 09:13

Tareq Abadl: Hematuria vs Hemoglobinuria vs Myoglobinuria

Tareq Abadl, Medical Laboratory Specialist and Director of the Blood Bank at Dr. Abdelkader Al-Mutawakkil Hospital, shared a post on LinkedIn:

”Hematuria vs Hemoglobinuria vs Myoglobinuria – Made Simple

1. Hematuria – Blood in the Urine

Definition:
Presence of intact red blood cells (RBCs) in urine.

Mechanism:
Bleeding from any part of the urinary tract or kidneys (glomeruli, renal pelvis, ureters, bladder).

Urine Color:
Dark red, often cloudy.

Common Causes:
Kidney stones
Glomerulonephritis
Pyelonephritis / UTI
Tumors
Trauma
Chemical exposure
Anticoagulant therapy
Strenuous exercise

Lab Clue:
RBCs visible on urine microscopy

2. Hemoglobinuria – Free Hemoglobin in Urine

Definition:
Presence of free hemoglobin in urine without RBCs.

Mechanism:
Occurs due to intravascular hemolysis → free hemoglobin exceeds haptoglobin capacity → filtered by glomeruli.

Urine Color:
Red or cola-colored, clear.

Common Causes:
Acute transfusion reactions
Hemolytic anemias
Severe burns
Infections (e.g., malaria)
March hemoglobinuria (repetitive trauma to RBCs)
Brown recluse spider bite

Lab Clues:
– Positive blood on dipstick
– No RBCs on microscopy
– Low haptoglobin

3. Myoglobinuria – Muscle Pigment in Urine

Definition:
Presence of myoglobin in urine due to muscle breakdown (rhabdomyolysis).

Mechanism:
Muscle injury → myoglobin released → filtered by kidneys.
High levels are toxic to renal tubules → risk of acute kidney injury.

Urine Color:
Reddish-brown / tea-colored.

Common Causes:
Muscle trauma
Crush injuries
Prolonged immobilization or coma
Seizures
Muscular dystrophies
Alcohol abuse or overdose
Drug abuse
Extreme exercise
Statins

Lab Clues:
– Positive blood on dipstick
– No RBCs on microscopy
– Creatine kinase (CK) markedly elevated

Easy Memory Trick (Never Forget!)

Hematuria: Whole blood to RBCs present

Hemoglobinuria: Blood without cells to Free hemoglobin

Myoglobinuria: Muscle-related to Free myoglobin, brown urine

Important Note:
Urine color alone is not diagnostic.
Laboratory analysis is essential to confirm the underlying cause. ”

Hematuria

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Dr. Abdelkader Al-Mutawakkil Hospital Health Hematology Hematuria Hemoglobinuria Hemostasis Hemostasis Today Medicine Myoglobinuria Nephrology Tareq Abadl thrombosis
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