Hematuria

Hematuria kidney

Last Updated December 20th, 2021

Overview of Hematuria

Diseases due to kidney malfunctions are becoming very common especially in the low and middle-income countries lacking substantial knowledge related to hygienic urinary habits. According to the reports of the National Kidney Foundation, nearly 10% of the global population suffers from chronic kidney diseases. Million fatalities are reported annually due to lack of proper treatment leading to renal failure. Among the numerous kidney dysfunctions, the most threatening one is “Hematuria” or “blood in urine”. It has been observed that most patients (especially women) suffering from urinary tract infections are prone to hematuria at some point in time.

 

What is hematuria?

Hematuria urine sampleHematuria is defined as the clinical condition where excess red blood cells (RBC) are present in urine, giving it a reddish-brown coloration. According to the American Urological Association, the presence of 3 or more RBCs per high power field (HPF) microscopic analysis of 2 or 3 collected samples of urine can be termed as “Hematuria”. The disease is an indicator of urological dysfunctions of severe nature. Typically, this disease has two subtypes- Microscopic and Macroscopic. Excerpts from National Kidney Foundation Reports show that 4% of patients suffering from Microscopic Hematuria and 40% of patients suffering from Macroscopic Hematuria could grow malignancy at some later stage.

 

What are the causes of Hematuria?

Hematuria is mainly caused due to the presence of red blood cells in the urine due to various clinical factors or diseases of the kidney. The generalized etiological factors are as follows-

  • Cystitis: It is caused due to the formation of cysts in kidneys and few other vital organs like the liver, pancreas, and ovaries. Cystitis leads to the destruction of the renal parenchyma with the gradual enlargement of the cyst. This is a genetic disorder and is more common in women. It is characterized by a burning sensation during urination and the urge to urinate frequently.
  • Kidney stones: Presence of kidney stones can cause blood in urine especially when these stones (the large ones) try to pass through the urine. An acute pain extending from the loin to the groin can occur in this case.
  • Bladder/kidney tumors: This is more evident in people above 40 and is caused due to tumor outgrowths, cysts, inflammations, and stones in the bladder or kidney. In this case, the urine is unclear and has an obnoxious odor.
  • Glomerular diseases: Erosion and thinning of the glomerular basement membrane produce gaps in the membrane which allows the RBCs to escape, which are then passed into the urine. Hematuria is also caused by glomerular bleeding due to deformed (dysmorphic) RBCs, which lead to glomerulonephritis. These conditions are caused by low serum levels. This can eventually lead to inflammation of the kidney and kidney failure and may be accompanied by High Blood Pressure.
  • Polycystic Kidney Disease: It is usually present at birth and manifests itself at a later stage.
  • Coagulation disorders: Few inherited diseases like Haemophilia or few anti-coagulant drugs impede normal blood coagulation mechanism and cause blood in urine.
  • Sickle cell disease: It is caused by degeneration of RBCs in the renal medulla that leads to renal disorders. This condition is normally hereditary and is more prominent in a few ethnic groups.
  • Intravascular Haemolysis: It is caused by the breakdown of Red Blood Cells into the bloodstream that finally passes via urine. This condition arises due to genetic disorders like paroxysmal hemoglobinuria.
  • Malignancy: Malignancies due to renal masses (simple or complex cyst) can cause internal bleeding and hematuria.
  • Bacterial infection: Urinary infections mediated by Escherichia coli bacteria can cause Hematuria.
  • Diet: At times the intake of foods like beet can cause a reddish discoloration of urine.
  • Rigorous exercise
  • Surgical instrumentation
  • Excessive intake of tobacco or alcohol
  • Benign Prostatic Hyperplasia (BPH) in men
  • Menstrual cycle

              

What are the symptoms of Hematuria?

Hematuria kidneySymptoms of Hematuria may not be very prominent in the initial stages (or for Microscopic Hematuria) but are clearly manifested in the advanced stages (or for Macroscopic Hematuria). These are as follows-

  • Reddish or brownish discoloration of urine
  • Urine turns cloudy and unclear
  • An obnoxious odor of urine
  • Urine leakage (due to lack of bladder control)
  • Burning sensation while urinating
  • Frequent need to urinate
  • Difficulty passing urine
  • Passing inadequate urine despite intense urge to urinate
  • Persistent pain and feeling of pressure in the lower abdomen, pelvic region and lower back
  • Mild fever and occasional chills
  • Nausea and vomiting

 

What are the types of Hematuria?

Depending on the amount of blood present in urine, Hematuria can be classified into two categories-

  • Microscopic Hematuria: It is characterized by the presence of trace amount of blood in the urine (2-3 RBCs per hpf of the urine sample) and is normally detected with a microscope.
  • Macroscopic Hematuria: Significant quantity of blood in the urine (>10 RBCs per hpf of the urine sample) is observed and is characterized by dark-brown urine with occasional blood clots.

Depending on the origin, Hematuria can be classified into two categories-

  • Glomerular Hematuria: It normally originates from the kidney and is caused by deformed RBCs, renal parenchyma destruction and presence of excess protein in the urine.
  • Non-glomerular Hematuria: It is caused by Upper and Lower urinary tract infection and is characterized by the formation of urinary tract stones, prostate enlargement or renal malignancies.

 

Diagnosis

An abdominal X-ray is essential for the determination of the cause of Hematuria in the first place. An MR or CT Urography can be conducted to fully examine the bladders, ureters, and kidneys. Intravenous Pyelogram (IVP) is recommended in a few cases to investigate any abnormal functioning of the kidney.

 

Treatment & Prevention

HematuriaThe treatment of hematuria depends on the exact cause. There are several reasons that could result in blood appearing in the urine. Most common ones include kidney stones, enlarged prostate, urinary tract infections, bladder stones, bladder cancer, Lupus nephritis, high blood pressure and many more.  The main treatment methods are:

  • Antibiotic medications in case of infections such as UTIs or urethritis.
  • Medications that help in shrinking stones (bladder or kidney).
  • Shockwave therapy to break the bladder or kidney stones.
  • In many cases, treatment might not be even necessary.

Hematuria can be prevented by:

  • Drink plenty of water to flush out the toxins from your system.
  • Urinate immediately after sexual intercourse.
  • Practice proper hygiene.
  • Refrain from eating foods with high acidic and salt content.
  • Refrain from smoking or any other form of tobacco consumption. This is the leading cause of bladder cancer.
  • Limit exposure to environmental toxins and carcinogens such as toxic metals, harmful radiations, and harsh chemicals.

 

Dos and Don'ts

Dos
  • Cranberries and pomegranates are much beneficial in treating this condition, especially when consumed in juice form.
  • Consume healthy diuretics such as coconut water & spinach juice to treat bladder infections.
Don'ts
  • Consume refined eatables, sugary, and salty foods.
  • Perform high intensity physical work-outs and sporting activities.
  • Panic if the doctor doesn’t prescribe you any medications or treatment procedures. In many cases treatment of hematuria is not necessary.

 

 

 

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CBC (Hemogram 6-part diff) blood test CBC (Hemogram 6-part diff) blood test refers to the test that measures the number of RBCs, WBCs, etc…
Aphasia brain scans
Neuroendoscopy Neuroendoscopy is a minimally-invasive surgery used to treat disorders of brain, spine, head, etc.
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
Thyroid disorders
Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
cystatin C
Cystatin C Test Cystatin C is a specific single-chain protein that is found in body fluids and is a biomarker for…
Gynecomastia or male breast enlargement
Gynecomastia Gynecomastia is the enlargement of the male breasts. Learn about the treatment options, surgeries, and post-op care for…
Ear pain model
Easy and safe tips for ear wax removal you can do at home Cerumen impaction generally occurs when an external object like cotton swabs are used to remove the ear wax.…
Nootropics: How safe are these drugs that make you smarter? Nootropics is a group of cognition-enhancing substances that facilitate better learning, memory, and other executive functions pertaining to…
Low carb diet
8 appetizing and mouth-watering recipes that every low-carb dieter should try Looking for delicious recipes that will fix your hunger pang without adding those pesky carbs? Look no further…
Cellphones and Human Brain
Cellphones and Human Brain – Are Cellphones a Slow Poison to Our Brains? Cellphones have become an intricate part of our lives but they can be highly addictive and overuse can…
Dragon Fruit – Blessing from Nature’s Basket Dragon fruit is packed with nutrients but low on calories. It is the dream food that can help…
Hepatitis A virus infected liver
Hepatitis A Virus (HAV) Total Blood test to look for IgM antibodies to know if you are infected with Hepatitis A virus (HAV),…
Rheumatoid Arthritis xray
Arthritis Profile Arthritis profile is a panel of primarily blood tests used to detect the presence of arthritis or check…
Splenda
Splenda Splenda is an artificial sweetener derived from Stevia plant extracts. It is low in calories and a popular…
cytomegalovirus igm test
Cytomegalo Virus (CMV) – IgM Test The CMV antibodies include both IgM and IgG antibodies which are the immune system's response to a CMV…
Urologist: When should you visit one and why? A urologist can treat not only genitourinary problems of both men and women but also can treat various…
Juice Plus: Can you really replace actual fruits with pills?  Juice Plus supplements intend to fill nutritional gaps present in our daily diet. But how successful have they…
6 arguments in favour of glucosamine and where can you find it Studies have shown that glucosamine works by preventing the breakdown of cartilage of the joints. This is usually…
black seed oil benefits
Black Seed Oil: What secret benefits could it bestow on your health? Black seeds or nigella seeds are tiny packets of health brimming with amazing benefits. Find out why should…
Is bronchitis contagious? And how to prevent this infection? It is acute bronchitis that is contagious which means you can contract it from another person or you…
gallbladder diet tomato
Gallbladder surgery :Tips on post-operative care and diet What to eat post a gallbladder surgery? What are the key things to avoid if you had a…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
Proteinuria and blood pressure
Hypertension Profile Hypertension profile is a panel of blood tests done to analyse the cause of hypertension or high blood…
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
antiHEV IgM test
Anti hepatitis E virus (Anti HEV) IgM Test Anti HEV IgM test determines the level of the IgM antibodies in the blood, The disease is often…
Vitamin b12
Vitamin B12 Test Vitamin b12 is an essential nutrient required for healthy functioning of the nervous system and also development of…
These are the top foods to increase your hemoglobin count It is important to add iron-rich foods into your diet in order to increase hemoglobin. Deficiency of hemoglobin could…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
HSV-1_IGG
Herpes Simplex Virus I (HSV)-IgG Test Herpes simplex virus I(HSV)-IgG is an Immunoglobulin protein that acts as an antibody & stays in the blood…
liver detox facts
7 liver detox facts and why ignoring these could kill you! Are you taking care of this organ that handles over 500 different vital functions in your body? Your…
social media adddiction
Your health in the age of Social Media: Why is digital detox a necessity? Did you know that more than 400 million people are dangerously addicted to social media? Are you one…
Salt dangers
Sodium chloride: The wonders and dangers of the simple table salt Sodium chloride is a salt containing sodium and chlorine ions at a 1:1 ratio. It is edible and…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…

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