Thanks for writing to us.
RBCs of 40-60 indicates significant hematuria (blood in urine).This needs to be urgently evaluated and treated.
Following possibilities can be considered:
-Urinary tract infection
-Kidney stones or ureter stones
-IgA nephropathy ("Berger's disease")
-Tumors and/or cancer in the urinary system, e.g.bladder cancer or renal cell carcinoma
-Benign familial hematuria
-Paroxysmal nocturnal hemoglobinuria
-Tuberculosis of urinary tract or kidney.
I would like to suggest USG KUB,urine examination for proteinuria,casts,WBCs,Morphology of RBCs,CT scan of KUB ,and Nephrologist
opinion for clinical correlation.
Hope this could help you.
Wish you good health.