Hematuria

Overview

What is hematuria?

Hematuria is the presence of 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. It can turn toilet water a pale pink or bright red color.
  • Microscopic hematuria is a result of there being an amount of blood in the urine that can only be seen through a microscope.
  • Dipstick hematuria results when oxidation of the urine test strip causes a color change. It does not always mean that blood cells are present in the urine.

Symptoms and Causes

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:

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.

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:

Diagnosis and Tests

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.
  • Urine culture: A urine test that checks for an infection.
  • Urine cytology: A urine test that checks for any abnormal appearing cells.
  • Cystoscopy: A test that uses a device called a cystoscope 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.

Management and Treatment

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.

Prevention

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.

Living With

When should I contact my doctor?

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

Last reviewed by a Cleveland Clinic medical professional on 06/13/2018.

References

  • National Institute of Diabetes and Digestive and Kidney Diseases. Hematuria (Blood in the Urine). (https://www.niddk.nih.gov/health-information/urologic-diseases/hematuria-blood-urine) Accessed 6/15/2018.
  • 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.
  • 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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