Bloody urine: Hematuria

Hematuria, defined as the presence of blood in the urine, is a symptom that can indicate a wide range of medical conditions, some of which can be serious. Understanding the causes, symptoms, diagnoses, and treatment options of hematuria is essential to manage this condition effectively.

Causes of hematuria

Common causes of hematuria include:

Kidney disease: Glomerulonephritis, acute or chronic renal failure, pyelonephritis, polycystic kidney disease, and renal tumors can cause hematuria.
Kidney stones: Kidney stones can damage kidney tissue and cause bleeding.
Urinary infections: Infection of the bladder (cystitis) or kidneys (pyelonephritis) can cause hematuria.
Trauma or injury: Accidents or injuries to the urinary tract, including the kidneys and bladder, can cause bleeding in the urine.
Urinary tract tumors: Tumors of the bladder, kidney, or urethra can cause hematuria, often associated with other symptoms such as pain or frequent urination.
Lower urinary tract diseases: Conditions such as benign prostatic hyperplasia (BPH), prostate inflammation (prostatitis), or urinary tract infection can cause hematuria.
Circulatory system diseases: Some diseases that affect the circulatory system, such as coagulopathies or vasculitis, can cause hematuria.
Drugs or toxic substances: Prolonged use of some medications, such as aspirin, or exposure to harmful substances can damage the kidneys and cause hematuria.
Hereditary diseases: Conditions such as Alport disease or Goodpasture syndrome are inherited kidney diseases that can cause hematuria.
Intense exercise: In some cases, extreme exercise can cause micro-trauma to the kidneys and cause temporary hematuria.

Diagnosics in hematuria

Here are some of the diagnostic tests commonly used to evaluate hematuria:

Urinalysis: This is the first diagnostic step. Urinalysis may reveal the presence of blood, white blood cells, protein, or other signs of infection or kidney disease.
Blood tests: Blood tests evaluate kidney function, electrolyte levels, complete blood count, and markers of inflammation or blood disease.

Imaging tests:

Ultrasound: we may use it to evaluate the kidneys, bladder, and urinary tract for the presence of stones, masses, or other structural abnormalities.
Computed tomography (CT): This test provides detailed images of the kidneys and upper urinary tract, allowing visualization of any stones, tumors, or other abnormalities.
Magnetic resonance imaging (MRI): It helps obtain more detailed images of soft tissues, including the kidneys and surrounding structures, and is often used to evaluate kidney tumors.
Cystoscopy: This test involves inserting a flexible tube with a camera through the urethra to inspect the inside of the bladder. We can use cystoscopy to detect tumors, stones, or other abnormalities.
Biopsy: In some cases, we need a biopsy of kidney or bladder tissue to confirm a suspected diagnosis, especially if signs of cancer are present.
Additional diagnostic tests: Depending on the results of previous tests and the patient's symptoms, the doctor may order additional specific diagnostic tests to exclude or confirm certain conditions.

Prevention

Prevention means avoiding risky behavior and carrying out periodic checks

Prevention of hematuria depends on the underlying cause. However, some general measures may help maintain urinary tract health and reduce the risk of developing hematuria:

Adequate hydration: Drinking plenty of water can dilute your urine and reduce the risk of kidney stone formation, which can cause hematuria.
Balanced diet: Eating a diet rich in fruits, vegetables, whole grains, and lean proteins can help maintain kidney health and reduce the risk of urinary tract disease.
Avoid smoking: Smoking can increase the risk of developing urinary tract cancers, so quitting smoking can help prevent hematuria associated with cancers.
Limit alcohol consumption: Excessive alcohol consumption can damage your kidneys and increase your risk of developing kidney disease, so it is advisable to limit your alcohol intake.
Avoid injury and trauma: Take precautions to avoid kidney or bladder injury during physical activity or other activities that pose trauma risks.
Manage underlying health conditions: If you have conditions such as hypertension, diabetes, or kidney failure, it is essential to manage them appropriately to reduce the risk of complications that can cause hematuria.
Regular health monitoring: Undergo regular check-ups. See your doctor to monitor your kidney and urinary health, especially if you have risk factors for specific conditions.
Avoid overuse of medications: Overuse of non-prescribed drugs or prolonged taking of medicines without medical supervision can damage the kidneys and increase the risk of hematuria.
Regular screenings: If you have a family history of kidney disease or other urinary tract problems, it is advisable to have regular screenings to identify any issues early.

When to consult a doctor

Consult a doctor immediately if hematuria occurs or if you notice changes in the color of your urine. It is important not to underestimate the presence of blood in the urine, as it can be a sign of severe medical conditions that require immediate evaluation and treatment. Here are some cases in which you need to consult a doctor:

Visible hematuria: If you notice blood in your urine, which may appear red, pink, brown, or cloudy, it is essential to see a doctor immediately.
Intermittent hematuria: Even if blood in the urine only appears occasionally or in small amounts, it is still advisable to see a doctor to evaluate the underlying cause.
Presence of blood clots: If you notice blood clots in your urine, it may indicate more significant bleeding and require immediate attention from a doctor.
Presence of other symptoms: If hematuria is accompanied by pain or burning when urinating, frequent urination, fever, lower back pain, or abdominal swelling, it is essential to see a doctor for a complete evaluation.
Medical history: If you have a history of kidney disease, recurrent urinary infections, kidney stones, urinary tract tumors, or other medical conditions, you should consult your doctor to monitor any changes in your urinary health.
Hematuria in children or older adults: In children or older adults, hematuria may be a sign of different medical conditions than in adults and requires immediate evaluation by a doctor.
Hematuria after trauma or surgery: If you develop hematuria after trauma or surgery to the kidneys or bladder, it is essential to see a doctor immediately to rule out injury or complications.