THE IMPORTANCE of detecting occult blood in urine is well established. The appearance of minute quantities of blood in urine may be among the earliest signs of renal disease, infarction, tumors of the urogenital system, and hemorrhagic diseases. Occult hematuria may signal renal damage resulting from trauma or from ingestion of toxic chemicals or drugs. It may also be a sign of inadequately controlled anticoagulant therapy.
Common methods for the detection of occult blood in urine include microscopic examination and the benzidine test. In microscopic examination, the number of red blood cells per high power field is counted. This method, although in use for many years, suffers from a disadvantage if the blood in the urine becomes hemolyzed. The stromata of hemolyzed red blood cells are almost impossible to see, and hemolyzed blood may be missed by microscopic examination. The benzidine test reacts in the presence of hemoglobin whether free
Leonards JR. Simple Test for Hematuria Compared with Established Tests. JAMA. 1962;179(10):807–808. doi:10.1001/jama.1962.03050100061015a
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