Blood In Urine

Medically Reviewed By William C. Lloyd III, MD, FACS

What is blood in urine?

The medical term for blood in the urine is hematuria. Blood may color the urine various shades of pink, red, orange and brown. Streaks of blood or small clots may also appear in the urine. Visible blood in the urine is called gross hematuria. Blood in the urine may also be present in such small quantities that it is not visible by the naked eye, but red blood cells in the urine are detectable with a microscope. This is microscopic hematuria. The amount of blood in the urine does not always correlate with the seriousness of the disease, disorder or condition.

Blood in urine causes often include infection, inflammation, or injury of the urinary tract (kidneys, ureters, bladder and urethra). Blood in the urine can occur in all age groups and populations, and it may or may not occur with additional symptoms. In adults over 35, new-onset hematuria heralds a significant risk of undetected cancer.

Sometimes, it is easy to mistake abnormally colored urine with blood from other sources. Women may confuse blood from the vagina for blood in the urine. In men, prostate problems can lead to bleeding, which they can mistake for blood in the urine. In addition, certain laxatives, medications and foods can cause the urine to change color. If you can’t attribute the change in urine color to a medication or something in your diet, see your doctor.

What other symptoms might occur with blood in urine?

Blood in urine with no pain is common, but infections and passing clots can be painful. Blood in the urine may be accompanied by other symptoms, depending on the underlying disease, disorder or condition:

  • Back or flank pain
  • Dribbling urine
  • Frequent nighttime urination
  • Urgent urination
  • Weight loss

Serious symptoms that might indicate a life-threatening condition

In some cases, blood in the urine can occur with other symptoms that might indicate a serious or life-threatening condition that should be immediately evaluated in an emergency setting.

Seek immediate medical care (call 911) if you, or someone you are with, are exhibiting any of these life-threatening symptoms:

  • Blood clots in urine
  • Flank pain (along your abdomen, side, or back)
  • Inability to urinate
  • Rapid pulse
  • Vomiting

What causes blood in urine?

Blood in the urine is often due to problems with the organs along the urinary tract (kidneys, ureters, bladder and urethra) and the prostate gland. However, your doctor may suspect a bleeding disorder if there is not a problem involving these organs.

Urinary tract causes of blood in urine

Causes of blood in urine related to the urinary tract include:

  • Foreign body in the urethra
  • Genital or urinary tract injury
  • Kidney stones
  • Post-streptococcal kidney damage
  • Sexually transmitted disease

Other causes of blood in urine

Blood in urine can be caused by medications and conditions including:

  • Blood-thinning medications
  • Hemophilia (rare hereditary disorder in which blood doesn't clot normally)
  • Kidney blood vessel clot
  • Leukemia (cancer of the blood or bone marrow)
  • Strenuous exercise

Serious or life-threatening causes of blood in urine

In some cases, blood in urine may accompany a serious or life-threatening condition, including:

When should you see a doctor for blood in urine?

It is best to see a doctor any time you notice blood in your urine or changes in urine color that you cannot explain. See a doctor promptly when blood in the urine or changes in color occur along with the following symptoms:

  • Frequent or urgent urination
  • Pain, burning or discomfort with urination

Call 911 or go to your nearest emergency room for blood in the urine or changes in urine color when:

  • You are passing blood clots in your urine.
  • You are unable to urinate.
  • You have fever, chills, nausea, vomiting, or pain in the belly, back or flank.

How do doctors diagnose the cause of blood in urine?

Sometimes, blood in the urine shows up as microscopic hematuria on a routine urinalysis. In other cases, it is obvious to see. Either way, to diagnose the cause of your condition, your doctor may ask you several questions related to your urine including:

  • How long have you had blood in your urine or changes in its color?
  • Do you always have blood in your urine or does it happen occasionally?
  • Do you have other symptoms, such as pain or burning?
  • Do you notice an odor to your urine?
  • How often are you urinating?
  • What, if anything, seems to make your symptoms better or worse?
  • What medications and supplements do you take?
  • Do you eat foods, such as beets or rhubarb, that can discolor urine?

Your doctor may also perform a physical exam. For men, this may involve a digital rectal exam to check the prostate. For women, it may include a pelvic exam. Depending on the results and your answers, testing may be necessary. Tests may include:

  • Urinalysis and urine culture to check for bacteria, blood cells, and minerals that may indicate a urinary stone
  • Blood tests to check blood cells counts, electrolytes, kidney function, blood clotting times, and antibodies
  • Strep test
  • 24-hour urine collection, which gives more precise information about kidney function and urine content
  • Cystoscopy, which involves threading a narrow tube with a camera through the urethra into the bladder to examine the inside of the bladder
  • Kidney biopsy to take a sample of tissue for examination in a lab

It is not always possible to diagnose an underlying cause or condition. If the problem persists and your provider is unable to determine a cause, seeking a second opinion may give you more information and answers.

How do you treat blood in urine?

Blood in urine treatment depends entirely on the underlying cause. Possible treatments may involve:

  • Antibiotics for infections and possibly a urinary tract analgesic for pain or burning
  • Medications or sound wave therapy for kidney stones

Other causes may require different treatments and sometimes, no treatment is necessary.

What are the potential complications of blood in urine?

Like treatment, the potential complications of blood in the urine will depend on the underlying cause. Because blood in urine can be due to serious diseases, failure to seek treatment can result in complications and permanent damage. Once you know the underlying cause, it is important to follow the treatment plan that you and your doctor design specifically for you to reduce the risk of potential complications.

Was this helpful?
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  3. Blood in Urine. American Kidney Fund.
  4. Blood in Urine (Hematuria). Mayo Foundation for Medical Education and Research.
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  6. How to Deal with Hemophilia. Nemours.
  7. Urine-bloody. MedlinePlus, National Library of Medicine, National Institutes of Health.
  8. Collins RD. Differential Diagnosis in Primary Care, 5th ed. Philadelphia: Lippincott, Williams & Williams, 2012.
  9. Kahan S, Miller R, Smith EG (Eds.). In A Page Signs & Symptoms, 2d ed. Philadelphia: Lippincott, Williams & Williams, 2009.
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Apr 27
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