Hematuria means blood in the urine. Normally, urine does not contain any blood.

There are two kinds of hematuria:

• Microscopic hematuria – Urine contains a very small amount of blood, which is not visible to the naked eye.

• Gross hematuria – Urine is visibly discolored by blood, appearing red or tea-colored.

Causes

In some cases, the cause of hematuria is never found. The list of known causes is lengthy, some more common causes include:

• Injury to the abdomen, pelvis, or internal organs of urinary tract

• Vigorous exercise (resolves with rest)

• Urinary tract infection

• Cancer of the prostate, kidney, or bladder

• Kidney disease

• Kidney stones

• Bleeding disorders (eg, hemophilia)

• Certain congenital diseases (eg, polycystic kidneys)

• Certain medications

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

• Smoking

• Medications (eg, certain antibiotics and pain medications)

• Radiation of the pelvis (for cancer treatment)

• Acute or chronic urinary tract infection

• Recent upper respiratory tract infection

• Family history of kidney problems

Symptoms

Hematuria itself does not cause symptoms. However, it is often a sign of an underlying condition, which may cause symptoms. For example, kidney stones cause severe pain in the flank, abdomen, or groin and can result in hematuria.

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. You may be referred to a doctor who specializes in kidney disease (nephrologist) or the urinary system (urologist).

Tests may include:

• Urine Tests – tests to confirm the presence of blood and look for protein, bacteria, or cancer cells in the urine

• Blood Tests – tests to check how well the kidneys are functioning and to look for medical conditions that cause hematuria

• X-ray – performed with contrast material injected into a vein to look at the function and structure of the kidneys, ureters, and bladder

• Ultrasound – a test that uses sound waves to create images of the kidneys and urinary tract

• CT Scan – a type of x-ray that uses a computer to create images of the kidneys and urinary tract

• MRI Scan – a test that uses powerful magnets and radio waves to create images of the kidneys and urinary tract

• Cystoscopy – a thin tube inserted through the urethra and into the bladder to look at its lining

Treatment

Treatment will depend on the underlying cause of hematuria. Some causes of hematuria are benign and require no treatment (exercise-induced) or will resolve on their own (passage of a kidney stone). Other causes will respond to medication. For example, successfully treating a urinary tract infection with antibiotics will stop the hematuria. Still other causes may require surgery, such as the removal of a bladder or prostate cancer.

Prevention

Treating the underlying conditions that cause hematuria will help prevent it from occurring.

RESOURCES:

American Academy of Family Physicians
http://www.aafp.org

Mayo Clinic
http://www.MayoClinic.com

National Kidney Foundation
http://www.kidney.org

CANADIAN RESOURCES:

BC Health Guide
http://www.bchealthguide.org

The Kidney Foundation of Canada
http://www.kidney.ca

References:

A to Z health guide: hematuria in children. National Kidney Foundation website. Available at: http://www.kidney.org/atoz/atozPrint.cfm?id=154. Accessed August 10, 2005.

Blood in urine. Mayo Clinic website. Available at: http://www.mayoclinic.com/invoke.cfm?id=AN00321. Accessed August 12, 2005.

Dambro MR. Griffith’s 5-minute Clinical Consult. 13th ed. Lippincott Williams and Wilkins; 2005.

Hematuria. DynaMed website. Available at: http://www.dynamicmedical.com/dynamed.nsf?opendatabase. Accessed August 13, 2005.

Microscopic hematuria. American Family Physician website. Available at: http://www.aafp.org/afp/990915ap/990915b.html. Accessed August 10, 2005.