Year: 2026 | Month: March | Volume: 16 | Issue: 3 | Pages: 26-35
DOI: https://doi.org/10.52403/ijhsr.20260304
Etiological Profile and Diagnostic Utility of Urine Microscopy in Microhematuria - A Hospital-Based Study
Pooja. P. S1, Sandeep B Kokate2, Sunanda Shrikhande (Zodpey)3
1Senior Resident, Department of Microbiology, Government Medical College, Nagpur, Maharashtra, India
2Professor, Department of Microbiology, Government Medical College, Nagpur, Maharashtra, India
3Professor and Head, Department of Microbiology, Government Medical College, Nagpur, Maharashtra, India
Corresponding Author: Pooja. P. S
ABSTRACT
Background: Microhematuria is a common clinical finding that may indicate various renal or urological conditions. While often detected incidentally, its etiological distribution varies, and the diagnostic role of urine microscopy remains a critical, cost-effective tool for distinguishing glomerular from non-glomerular causes.
Objective: To describe the etiological profile and evaluate the diagnostic performance of urine microscopy in patients presenting with microhematuria in a tertiary care setting.
Materials & Methods: A cross-sectional hospital-based study was conducted at a Government Medical College in Nagpur, India, from January to December 2025. The study included 192 participants (aged ≥18 years) with microhematuria, defined as ≥3 RBCs per high-power field (HPF). Midstream clean-catch urine samples were centrifuged and examined under light microscopy to evaluate RBC morphology, casts, and other parameters.
Results: Out of 1748 samples, microhematuria was detected in 192 (10.98%), with the highest prevalence in the 41–50 age group (26%) and a male predominance (1.59:1). While 30.73% of patients were asymptomatic, common symptoms included dysuria (23.96%) and flank pain (19.27%). Lower urinary tract pathology was the leading etiology (34.37%), followed by glomerular causes (29.17%) and non-glomerular renal pathologies (25%). Dysmorphic RBCs were observed in 81.36% of glomerular cases. The presence of RBC casts showed a highly significant statistical association with glomerular disease (p < 0.00001).
Conclusion: Urine microscopy is a powerful diagnostic modality, not merely a screening tool. The strong correlation between dysmorphic RBCs, RBC casts, and glomerular pathology allows for high diagnostic accuracy in differentiating the origin of hematuria. Incorporating detailed microscopy into routine protocols is essential for early detection and guided management, particularly in resource-limited settings.
Key words: Microhematuria; Urine Microscopy; Dysmorphic Red Blood Cells; RBC Casts