Hematuria Blood in the Urine

What is hematuria?

Urinary System

Hematuria is the presence of blood or blood cells in the urine. Hematuria can be called either gross or microscopic.

  • Gross hematuria occurs when there is enough blood present in the urine that it is visible to the naked eye. Can turn toilet water color pale pink or bright red.
  • Microscopic hematuria is a result of there being an amount of blood in the urine that can only be seen through a microscope.

What are the symptoms of hematuria?

Although blood in the urine is not always a significant symptom of disease, it can be an important warning sign to a possible health problem.

Bloody urine should never be ignored. Contact your doctor right away if there is blood in your urine, especially if you are also suffering from:

  • Frequent, painful or urgent urination
  • Nausea, vomiting, fever, or pain in your abdomen

What are the causes of hematuria?

There can be a number of different causes of hematuria, some more serious than others. These conditions include, but are not limited to:

  • Urinary tract infection (UTI)
  • Pyelonephritis (UTI that has reached as far as the kidney)
  • Urinary stone disease
  • Enlarged prostate (benign prostatic hypertrophy)
  • Injury to the urinary tract
  • Kidney (renal) disease
  • Bladder cancer
  • Kidney cancer
  • Prostate cancer

Please note that urine can also change colors due to food choices. Foods such as beets, blackberries, and rhubarb, as well as food with a lot of dyes, can cause your urine to change color.

When should I contact a medical professional?

Blood in the urine should never be ignored. It is very important to contact your doctor or health care provider if you see blood in your urine or if you have other symptoms related to hematuria.

How is hematuria diagnosed?

During the visit to your doctor, he or she will take a medical history and perform a physical examination. This will help your doctor to better understand your symptoms. Your doctor may order other tests. These tests may include:

  • Urinalysis: a test on a urine sample
  • Complete blood count (CBC): a test on a blood sample that measures red and white blood cell levels, platelet levels, and iron levels
  • Cystoscopy: a test that uses a device called a cytoscope to look at the inside of the bladder and urethra
  • Computed tomography (CT) scan: a test that uses X-rays and computers to make cross-sectional images of the abdomen and pelvis
  • Abdominal ultrasound: a test that uses sound waves to make an image of the abdomen, including the kidneys

How is hematuria treated?

The treatment of hematuria depends strongly on the actual cause of blood in the urine. The information collected from the medical history, physical exam, and any test results will be used to determine the best treatment option.

For hematuria that is caused by a UTI, for example, a common treatment is the use of antibiotics. These antibiotics work to kill the bacteria causing the UTI, which should stop the bleeding.

Who is at risk for hematuria?

People who are most likely to have blood in their urine are those with existing diseases that are known to cause hematuria, such as the ones listed in the section related to causes of hematuria. However, certain actions may increase a person’s chances of having blood in their urine. These include:

  • Smoking
  • Overuse of pain medications
  • Exposure to certain chemicals
  • Exposure to radiation
  • Running or jogging for long distances

Avoiding these actions may decrease the chances of having blood in your urine.


  • National Kidney & Urologic Disease Information Clearinghouse. Hematuria (Blood in the Urine). Accessed 6/4/2013.
  • Urology Care Foundation: The Official Foundation of the American Urological Association. Hematuria. Accessed 6/4/2013.
  • Meng MV, Stoller ML, Walsh TJ. Chapter 23. Urologic Disorders. In: Papadakis MA, McPhee SJ, Rabow MW, eds. CURRENT Medical Diagnosis & Treatment 2013. New York: McGraw-Hill; 2013. www.accessmedicine.com. Accessed 6/4/2013.
  • Rao, P. K. & Jones, J. S. (2008) How to evaluate 'dipstick hematuria': what to do before you refer. Cleveland Clinic Journal of Medicine75, 227–233.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 6/4/2013…#15234