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May 26, 2013
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Blood in the Urine (cont.)

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Causes of Blood in the Urine

Hematuria has many different causes.

  • Blood in the urine can come from any condition that results in infection, inflammation, or injury to the urinary system.
  • Typically, microscopic hematuria indicates damage to the upper urinary tract (kidneys), while visible blood indicates damage to the lower tract (ureters, bladder, or urethra). But this is not always the case.
  • The most common causes in people younger than 40 years of age are kidney stones or urinary tract infections.
  • These may also cause hematuria in older people, but cancers of the kidney, bladder, and prostate become a more common concern in people older than 40 years of age.
  • Several conditions causing hematuria may exist at the same time.
  • Some causes of hematuria are serious, others are not. Your health-care provider will perform tests to help tell the difference.

The well-known causes of blood in the urine include the following:

  • Kidney stones
  • Infections of the urinary tract (UTIs) or genitals
  • Blockage of the urinary tract, usually the urethra: by a stone, a tumor, a narrowing of the opening (stricture), or a compression from surrounding structures
  • Cancer of the kidney, bladder, or prostate
  • Kidney disease
  • Blood-clotting disorders
  • Injury to the upper or lower urinary tract, as in a car accident or a bad fall (especially falls onto your back)
  • Medications: antibiotics (for example, rifampin [Rifadin]), analgesics such as aspirin, anticoagulants (blood thinners such as warfarin, [Coumadin]), phenytoin (Dilantin), quinine (Quinerva, Quinite, QM-260)
  • Benign (noncancerous) enlargement of the prostate known as benign prostatic hypertrophy (BPH), a common condition in older men
  • Chronic diseases such as diabetes, hypertension, and sickle cell anemia
  • Viral infections
  • Inflammation of the kidney, usually of unknown cause
  • Strenuous exercise, especially running, results from repeated jarring of the bladder. In one study, 24% of runners who competed in an ultra-long-distance marathon had hematuria after the race. The hematuria disappeared within seven days. A 20% incidence has been found in marathon runners.

Sometimes no cause is found for blood in the urine.

  • If serious conditions such as cancer, kidney disease, and other chronic diseases that cause kidney damage or bleeding are ruled out, the cause is usually not serious.
  • The hematuria will probably go away by itself or continue as a chronic condition without doing harm. Any changes should immediately trigger a return visit and evaluation by your health-care provider.

Urine can be colored pink, red, or brown for reasons that have nothing to do with bleeding in the urinary tract:

  • Foods: beets, berries, and rhubarb in large amounts
  • Food colorings
  • Medications: Different medications can change your urine color (Phenazopyridine [Pyridium], a pain reliever affecting the lower urinary tract, can change urine color to orange.).
  • Menstrual blood or vaginal bleeding that is mistaken for hematuria
  • Liver diseases: These may also be very serious causes of discolored urine.

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Read What Your Physician is Reading on Medscape

Hematuria »

Hematuria is one of the most common urinary findings that result in children presenting to pediatric nephrologists.

Read More on Medscape Reference »


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