It's not so simple: Everyone has a little bit of blood in the urine. A runner usually has mild hematuria from the mechanics of running with a full bladder. Further, someone who has hemolysis that's not intravascular (i.e., autoimmune hemolysis, spherocytosis) won't spill hemoglobin, and somone with mild ongoing hemolysis (sickle cell) with enough haptoglobin to trap the hemoglobin won't spill it either.
Answered 5/9/2018
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