Hematuria (Blood in urine)

Seeing blood in your urine can cause anxiety. While in many instances there are benign causes, blood in urine (hematuria) can also indicate a serious disorder.

​Blood that you can see is called gross hematuria. Urinary blood that’s visible only under a microscope is known as microscopic hematuria and is found when we test your urine. Either way, it’s important to determine the reason for the bleeding. Treatment depends on the underlying cause.

​The visible sign of hematuria is pink, red or cola-colored urine — the result of the presence of red blood cells. It takes very little blood to produce red urine, and the bleeding usually isn’t painful. If you’re also passing blood clots in your urine, that can be painful. Bloody urine often occurs without other signs or symptoms. It’s possible to have blood in your urine that’s visible only under a microscope (microscopic hematuria).

Make an appointment to see Dr. Portera anytime you notice blood in your urine.

Some medications and certain foods, including beets, rhubarb and berries, can cause your urine to turn red. However, blood in the urine looks distinctly different.

A change in urine color caused by drugs, food or exercise may go away within a few days. But you can’t automatically attribute red or bloody urine to medications or exercise; that’s why it’s best to see us anytime you see blood in your urine.

Causes

In hematuria, your kidneys or other parts of your urinary tract allow blood cells to leak into urine. A number of problems can cause this leakage, including:

Urinary tract infections – Urinary tract infections often occur when bacteria enter your body through the urethra and begin to multiply in your bladder. Symptoms can include a persistent urge to urinate, pain and burning with urination, and extremely strong-smelling urine. For some people, especially older adults, the only sign of illness may be microscopic blood.

Kidney infections – Kidney infections (pyelonephritis) can occur when bacteria move up from your bladder through your ureters and into your kidney(s).  Signs and symptoms are often similar to bladder infections, though kidney infections are more likely to cause fever and flank pain as well as nausea and vomiting.

A bladder or kidney stone – The minerals in concentrated urine sometimes precipitate out, forming crystals on the walls of your kidneys or bladder. Over time, the crystals can become small, hard stones. The stones are generally painless, and you probably won’t know you have them unless they cause a blockage or are being passed. Then there’s usually no mistaking the symptoms. Kidney stones, especially, can cause excruciating pain. Bladder or kidney stones can also cause both gross and microscopic bleeding.

Kidney disease – Microscopic urinary bleeding is a common symptom of glomerulonephritis, which causes inflammation of the kidneys’ filtering system. Glomerulonephritis may be part of a systemic disease, such as diabetes, or it can occur on its own. It can be triggered by viral or strep infections, blood vessel diseases (vasculitis), and immune problems such as IgA nephropathy, which affects the small capillaries that filter blood in the kidneys (glomeruli).

Cancer – Visible urinary bleeding may be a sign of advanced kidney or bladder cancer. Unfortunately, you may not have signs or symptoms in the early stages, when these cancers are more treatable.

Inherited disorders – Sickle cell anemia, a hereditary defect of hemoglobin in red blood cells, can be the cause of blood in urine, both visible and microscopic hematuria. So can Alport syndrome, which affects the filtering membranes in the glomeruli of the kidneys.

Kidney injury – A blow or other injury to your kidneys from an accident or contact sports can cause visible blood in your urine.

Medications – The anti-cancer drug cyclophosphamide (Cytoxan) and penicillin can cause urinary bleeding. Visible urinary blood sometimes occurs if you take an anticoagulant, such as aspirin and the blood thinner heparin, and you also have a condition that causes your bladder to bleed. 

Strenuous exercise – Although it rarely happens, it’s not quite clear why strenuous exercise may lead to gross hematuria. It may be linked to trauma to the bladder, dehydration or the breakdown of red blood cells that occurs with sustained aerobic exercise. Runners are most often affected, although almost any athlete can develop visible urinary bleeding after an intense workout.

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Center for Urinary and Pelvic Disorders
6215 Humphreys Blvd.
Suite 110
Memphis, TN 38120

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