Is Blood In The Urine Serious?

Blood in the urine is medically known as hematuria. It is not usually a serious condition; however, it should not be ignored because it could indicate an underlying medical condition. A doctor should be consulted immediately and he will evaluate your condition and order tests to confirm or rule out an underlying cause. The blood in urine might come from kidneys where urine is made or it could come from other structures in the urinary tract such as the ureters, bladder or urethra.^[1]

The blood in the urine may be visible to the naked eye and manifest as pink, red, brownish red or tea colored urine and this type of hematuria is known as gross hematuria.^[2] Whereas the one, which is not visible to the naked eye and can only be confirmed by a microscopic examination is known as microscopic blood in the urine.^[3] It can be caused by a number of conditions such as bladder infections (acute cystitis) where the bladder infection usually leads to burning micturition or painful urination. In children with bladder infection there may be fever; pain and burning while urination, urgency and lower belly pain. Kidney infections will cause fever, chills and flank pain (refers to pain in the lower back).

Kidney stones will cause severe abdominal pain or pelvic pain. Kidney diseases will cause weakness, high blood pressure, body swelling including puffiness around the eyes. The other causes are enlarged prostate or prostate cancer, inherited diseases such as sickle cell anemia and cystic kidney disease. Certain medications such as aspirin, penicillin, heparin, cyclophosphamide and phenazopyridine, tumor in the bladder, kidney or prostate, kidney injury and vigorous exercise all lead to blood in the urine. ^[4]Sometimes red color of urine might also be due to red pigment in food dyes, medications or excessive amounts of beets.

The first step in assessment is taking a thorough medical history and identifying the cause of blood in the urine. After this a urinalysis is done to look for possible diseases that might be affecting a person. The urine tests include urine cytology, which uses a microscope to look for abnormal cells in the urine. Blood tests are also required sometimes. If high levels of waste are present in blood then it could be an indication of kidney disease. The other tests include imaging tests such as a CT scan that will help identify bladder or kidney stones, tumors, and other abnormalities of bladder, kidneys and ureters. Kidney ultrasound uses sound waves to create a picture of the kidney’s structure. IVP/Intravenous pyelogram, cystoscopy (with the help of a small tube attached with a camera tissue samples may be obtained to look for abnormal or cancerous cells) and kidney biopsy are the other tests done.^[5]

The management involves treating the underlying cause of blood in the urine. Usually no treatment is required unless the condition leading to hematuria is serious.

Prevention of blood in the urine is important and a healthy lifestyle can foster a healthy urinary tract. If the blood in the urine is related to strenuous activity or exercise then switching to a less-intense workout program is helpful. It is important to remain well hydrated by drinking at least eight glasses of water daily and avoiding cigarettes that are known to cause urinary tract cancers. Drug related blood in the urine improves on its own once the person stops taking the drugs. Antibiotics will cure infection related blood in the urine. Kidney stones will require lithotripsy that will break the stones so they can easily pass through the urinary tract. Tumors of bladder kidney and prostate will be managed by surgery, chemotherapy, radiation therapy and immunotherapy that stimulate the body’s immune system to fight cancer. Bleeding disorders can be managed with infusions of clotting factors or fresh frozen plasma.^[6]

The prognosis of blood in the urine is good with an outlook for complete recovery if the conditions leading to it are not serious. More severe forms of disease can lead to chronic kidney failure. Early diagnosis and early treatment is the mainstay of total cure and normal livelihood.

References: