Seeing blood in your urine can be alarming. Doctors call this hematuria. It can be a sign of many conditions—some minor, some more serious—so it’s important not to ignore it.
Gross vs. Microscopic Hematuria
• Gross hematuria: Blood is visible to the naked eye, turning urine red, pink, or cola-colored.
• Microscopic hematuria: Blood is present in urine but can only be seen under a microscope during a lab test.
Both need proper evaluation.
Urological vs. Nephrological Causes
Hematuria may come from anywhere along the urinary tract. Broadly, causes are divided into:
• Urological (lower tract): Kidney stones, urinary tract infections, prostate problems, bladder or kidney tumors, trauma.
• Nephrological (kidney-related): Diseases of the kidney filters (glomeruli) such as glomerulonephritis, IgA nephropathy, or genetic conditions like Alport’s syndrome.
With and Without Protein in Urine
• Hematuria with proteinuria: Often suggests a kidney (nephrological) problem, since the filters are leaking both blood and protein.
• Hematuria without proteinuria: More likely points to urological causes such as stones, infections, or tumors.
Evaluation
When someone presents with blood in urine, the doctor typically:
1. History & Examination – Check for pain, burning, family history, or risk factors.
2. Urine analysis – To look for red blood cells, protein, or infection.
3. Imaging – Ultrasound, CT scan, or cystoscopy (camera test of the bladder) to rule out stones, tumors, or obstruction.
4. Rule out urological causes first, as they can be serious but often treatable.
5. Kidney biopsy – Done only when the suspicion is high for kidney disease (especially when proteinuria is present, or other tests suggest glomerular disease).
Management
Treatment depends entirely on the cause:
• Urinary tract infection → Antibiotics.
• Kidney or bladder stones → Medications or surgical removal.
• Prostate enlargement → Medicines or surgery if severe.
• Glomerular diseases → May need immunosuppressive drugs, blood pressure control, and long-term nephrology follow-up.
• Tumors → Early detection allows surgical and oncological treatment.
Key Takeaways
• Blood in urine is never normal—even if it happens just once.
• Causes range from simple infections to serious kidney or bladder diseases.
• Doctors first look for urological causes; kidney biopsy is done only if needed.
• Treatment is tailored to the underlying problem—so don’t self-medicate.
If you notice blood in your urine, consult a doctor promptly. Early diagnosis ensures better outcomes and peace of mind.