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.

Facts

  • There are certain situations when blood in urine (hematuria) shouldn’t be treated as a major health concern – taking aspirin or consuming beets and rhubarb.
  • Usually blood in urine occurs as a result of UTIs (urinary tract infections) or bladder stones.

Facts

  • Smokers are 4-5 times more likely to develop bladder cancer and 2 times more to develop kidney cancer when compared to non-smokers.
  • Hematuria can occur in two forms – Gross (blood in urine is visible) and Microscopic (blood is visible only under microscope.

Facts

  • People with an enlarged prostate, family history of kidney malfunction, and multiple-organ disease are more likely to experience hematuria.

Related Conditions

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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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Liver Function Test – LFT LFT or Liver Function Test is a blood test used to determine the levels of hepatic enzymes which…
Vitamin-D-blood-test
25-Hydroxy Vitamin D test 25-hydroxy Vitamin D test is a blood test used to measure the level of vitamin D in the…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
Rubella IgM test
Rubella IgM Test The Rubella IgM test is a blood test that is performed to diagnose the presence of the rubella…
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…
Thyroid disorders
Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
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),…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
lose weight fast
12 easy and instant steps to successful weight loss Do you want to lose weight without losing your mind? Does weight loss always mean saying goodbye to…
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…
nutritional yeast bread
Nutritional Yeast : How can a fungi culture be good for your body? Nutritional yeast: How a simple culture of fungi can transform your skin, digestion, immunity , and much more.…
How seitan proved to be a blessing in disguise for vegans worldwide Can only meat-eaters enjoy delicious juicy steaks and burgers? With seitan, the best meat substitute available today,even vegans…
General adaptation syndrome: Understanding stress, one step at a time The struggle of the body to produce hormones during a stressful situation is the main theme of general…
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
Unbelievable health benefits of gooseberries (and a few tasty recipes) Gooseberries are antioxidant-rich tasty fruits that can be easily added in daily diet to improve overall health and…
piles fissure fistula
Allopathy vs homeopathy vs ayurveda treatment for piles, fissures, and fistula Read to know the best form of treatment among allopathy, homeopathy,or ayurveda for piles, fissures, and fistula
Optavia diet
The features of an Optavia diet The Optavia diet endorses pre-packaged meals and snacks called "fuelings" that are tasty, low in calorie, and incorporates…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
High Fiber Diet – Fire up your fiber intake for these health benefits! Regular bowels, healthy detox, higher immunity, and guaranteed weight loss - a high fiber diet can bring all…