Hematuria (Blood in the Urine)

What is blood in the urine?

Blood in the urine means there are red blood cells (RBCs) in the urine. Often, the urine looks normal to the naked eye. But when checked under a microscope, it contains a high number of red blood cells. In some cases, the urine is pink, red, or the color of tea, which you can see without a microscope.

What causes blood in the urine?

Most of the causes of blood in the urine are not serious. For example, heavy exercise may cause blood in the urine, which often goes away in a day.

Other, more serious causes include:

  • Cancer
  • Kidney infection or disease
  • Urinary tract infection (UTI)
  • Enlarged prostate (men only)
  • Kidney or bladder stones
  • Certain diseases (like sickle cell anemia and cystic kidney disease)
  • Injury to the kidneys

Some medications cause blood in the urine. And many people have it without having any other related problems.

What are the symptoms of blood in the urine?

There not be enough blood in the urine to change the color, but in severe cases, the urine may look pink, red, or tea colored.

How is blood in the urine diagnosed?

Your doctor will review your medical history and do a physical exam. Other tests may include:

  • Urinalysis. Urine is tested for various cells and chemicals, such as red and white blood cells, germs, or too much protein.
  • Blood tests. Blood is checked for high levels of waste products.

If these tests aren’t clear you may need other tests, such as:

  • Intravenous pyelogram (IVP). A series of X-rays of the kidney, ureters (the tubes connecting the kidneys and bladder), and bladder is done after a contrast dye is injected into a vein. This is done to look for tumors, kidney stones, or any blockages, and to check blood flow in the kidneys.
  • Ultrasound. An imaging test that uses high-frequency sound waves to make images of the organs of the urinary tract on a computer screen.
  • Cystoscopy. A thin, flexible tube and viewing device, is put in through the urethra to examine the parts of the urinary tract for structure changes or blockages, such as tumors or stones.

How is blood in the urine treated?

If you have blood in your urine that lasts more than a day, see a health care provider, especially if you have unexplained weight loss, discomfort with urination, frequent urination, or urgent urination.

Treatment will depend on the cause of the blood in the urine.

Key points about blood in urine

  • Blood in the urine means there are red blood cells (RBCs) in the urine. Often, the urine looks normal. But when checked under a microscope, it contains a high number of red blood cells. In some cases, the urine is pink, red, or the color of tea, which can be seen without the use of a microscope.
  • Most of the causes of blood in the urine are not serious. For example, in some cases, strenuous exercise will cause blood in the urine.
  • Some more serious causes of blood in the urine are cancer, infection, enlarged prostate (men only), kidney or bladder stones, and certain diseases (like sickle cell anemia and cystic kidney disease).
  • Blood in the urine can often be diagnosed with urine tests. If these are not clear, imaging tests may be needed to look at the urinary tract.
  • Treatment depends on the cause of the blood in the urine.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

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