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

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.



• Menstrual blood



• Liver diseases: These may also be very serious causes of discolored urine.

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