Blood in Urine (Hematuria)

Blood in your urine -- your doctor might call it hematuria -- usually isn’t a cause for major alarm.

But you shouldn’t ignore it, because it can also be a sign of a serious medical condition. Tell your doctor about it; they can order tests to look for the cause.

Hematuria is just a symptom, so treatment will focus on the condition causing it.

Where Blood in Urine Might Come From

Blood in your urine can come from your kidneys, which make urine. It also can come from other parts of your urinary tract, such as your:

• Ureters (the tubes from your kidneys to your bladder)
• Bladder (which stores urine)
• Urethra (the tube from your bladder to the outside of your body)

Hematuria-Related Symptoms

Instead of its usual pale yellow color, your urine may be pink, red, brownish- red, or tea-colored. This is what doctors call gross hematuria.

Sometimes, you can’t see the blood in your urine. Only a lab test can find the red blood cells. Doctors call this microscopic hematuria.

You may not have any other symptoms. But some of the possible causes can have other signs. These include:

• Bladder infections (acute cystitis). In adults, bladder infections usually cause burning or pain when peeing. Infants with bladder infections may have a fever, be grumpy, and feed poorly. Older children may have a fever, pain and burning while urinating, a strong urge to pee, and lower belly pain.
• Kidney infections (pyelonephritis). Symptoms may include a fever, chills, and pain in your lower back (flank).
• Kidney stones. These cause severe belly or pelvic pain.
• Kidney cancer. You may experience weight loss, loss of appetite, fatigue, or pain in your side
• Kidney diseases. Symptoms include weakness, high blood pressure, and body swelling, including puffiness around your eyes.

Hematuria Causes and Risk Factors

You might have blood in your urine because of:

• Urinary tract or kidney infections
• Bladder or kidney stones
• Certain kidney diseases, such as inflammation in the filtering system (glomerulonephritis)
• An enlarged prostate (benign prostatic hyperplasia) or prostate cancer
• Inherited diseases such as sickle cell anemia and cystic kidney disease
• Certain medications such as aspirin, cyclophosphamide, heparin, and penicillin
• Cancer in your bladder or kidney
• A kidney injury from an accident or sports
• Vigorous exercise

Your urine could also be discolored because of red pigments from things like food dyes, medications or eating a lot of beets. Doctors sometimes call this "beeturia."

Hematuria Diagnosis

Your doctor will ask about your medical history and send a sample of your pee for lab tests. This is called urinalysis. The tests might include cytology, in which a technician uses a microscope to look for unusual cells.

Your doctor might order blood tests to look for wastes that your kidneys are supposed to remove. These could be a sign of kidney disease.

You may also need other tests including:

• CT scan. A special kind of X-ray scan can help find stones, tumors, and other problems in your bladder, kidneys, and ureters.
• Kidney ultrasound. This test uses sound waves to create a picture of your kidney.
• Cystoscopy. Your doctor threads a small tube with a camera into your bladder through your urethra. They might take tissue samples (biopsy) to check for unusual or cancerous cells.
• Kidney (renal) biopsy. A technician looks at a sample of kidney tissue under a microscope for signs of kidney disease.

Hematuria Treatment

Your doctor will treat the condition that’s causing blood in your urine. Then, they’ll test you again to see if the blood is gone. If you still have blood in your urine, you may need more tests, or you may see a specialist called a urologist or nephrologist.

If your doctor can’t find a cause during the first evaluation, they might tell you to have follow-up urine testing and blood pressure monitoring every 3 to 6 months, especially if you have risk factors for bladder cancer. These include being 50 or older, smoking cigarettes, and coming into contact with certain industrial chemicals.

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