Hematuria

Noticing that your urine might have blood in it – a condition called hematuria – can be startling. Our doctors at Atrium Health Floyd and Harbin Clinic will help you sort through any risk factors you have and diagnose any conditions that might be related to hematuria.

What is hematuria?

Having hematuria means you have the symptom of blood in your urine. Two types of blood in the urine exist. Blood that can be seen in the urine is called gross hematuria. Blood that can’t be seen in the urine, except when examined with a microscope, is called microscopic hematuria.

What does hematuria or blood in the urine look like?

People with gross hematuria have urine that is pink, red or cola-colored due to the presence of red blood cells. Even a small amount of blood in the urine can cause it to change color. In most cases, people with gross hematuria don’t have other symptoms. However, people with gross hematuria that includes blood clots in the urine may have pain.

People whose hematuria is related to an underlying condition such as cancer or kidney disease may also have other symptoms related to the disease.

Risk factors for hematuria

Almost anyone, including children and teens, can have hematuria. Factors that increase the chance a person will have hematuria include:

• Family history of kidney disease
• Enlarged prostate, which typically occurs in men age 50 or older
• Urinary stone disease
• Certain medications including aspirin and other pain relievers, blood thinners and antibiotics
• Strenuous exercise such as long-distance running
• Recent bacterial or viral infection
• Menstruation
• Sexual activity
• Trauma

Can hematuria or blood in the urine be a symptom of something else?

Hematuria can be a symptom of another condition such as:

• Blood clots
• Blood clotting disorders, such as hemophilia
• Cancer of the kidney or bladder
• Inflammation of the kidney, urethra, bladder or prostate
• Polycystic kidney disease – an inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time, taking over and destroying working kidney tissue
• Sickle cell disease – an inherited disorder in which red blood cells form an abnormal crescent shape, resulting in less oxygen being delivered to the body’s tissues, clogging of small blood vessels and disruption of healthy blood flow
• Urinary tract infection (UTI)

Diagnosis of hematuria

When you have hematuria, your health care provider will take a thorough medical history. They may order one or more of the following tests:

• Urinalysis: Basic testing of a urine sample. Further testing of the urine may be done to check for problems that can cause hematuria, such as infection, kidney disease or cancer.
• Blood test: A blood test involves drawing blood and sending the sample to a lab for analysis. A blood test can show the presence of high levels of creatinine, a waste product of normal muscle breakdown, which may indicate kidney disease.
• Biopsy: A biopsy is a procedure that involves taking a piece of kidney tissue for examination with a microscope. A biopsy is performed in a hospital with light sedation and local anesthetic. Testing the sample helps diagnose the type of kidney disease causing hematuria.
• Cystoscopy: Cystoscopy is a procedure that uses a tubelike instrument to look inside the urethra and bladder. Cystoscopy may be used to look for cancer cells in the bladder, particularly if cancer cells are found with urinalysis.
• Kidney imaging tests: Intravenous pyelogram (IVP) is an X-ray of the urinary tract. When a small mass is found after an intravenous pyelogram, another imaging test such as an ultrasound, CT scan or MRI can be used to further study the mass. Imaging tests may show a tumor, a kidney or bladder stone, an enlarged prostate or other blockage of the normal flow of urine.

Hematuria treatment

Hematuria is treated by treating its underlying cause.

Hematuria caused by a urinary tract infection is treated with antibiotics. Urinalysis should be repeated six weeks after antibiotic treatment ends to be sure the infection has gone away.