Take the UTI Quiz Urinary Tract Infection (UTI) Slideshow Pictures Urinary Incontinence in Women Slideshow Pictures

Medical Author:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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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.