The Kidney Clinic

Blood in Urine (Hematuria)

Hematuria describes the condition in which blood is present in the urine. Hematuria can be either gross or microscopic. Gross hematuria refers to the urine appearing pink, red, or brown, and that the blood can be seen with the naked eye. Microscopic hematuria, on the other hand, means that the urine appears normal but is found to contain blood when tested in a laboratory.

Blood in the urine can be a sign of a more serious underlying condition, so it is important to see a healthcare provider for proper evaluation and diagnosis. Some possible causes of hematuria can be severe, such as cancer or kidney disease. In contrast, others may be less serious, such as kidney stones or a urinary tract infections. 

Some causes of hematuria can lead to serious complications without proper treatment, so it is essential to get a prompt and accurate diagnosis. However, it is also important to keep in mind that hematuria can sometimes have no apparent cause and may resolve on its own without treatment.


Symptoms of Hematuria

Hematuria, or blood in the urine, is often a symptomless condition. In some cases, the blood may be visible in the urine, causing it to appear a different colour. However, in many cases, the blood is present in such small amounts that it can only be detected through laboratory testing.

If you do experience symptoms in addition to having blood in your urine, they may vary depending on the underlying cause of the condition. Some possible symptoms that may occur with hematuria include:

  •  Pain or burning sensation during urination
  •  Frequent urination
  •  Urgency to urinate
  •  Lower abdominal pain or pressure
  •  Blood in the semen


It is essential to see a healthcare provider if you experience any of these symptoms, as they may be a sign of a more serious underlying condition.


Causes of Blood in Urine

There are various possible causes of hematuria, including:

  •  Urinary tract infections: Infections in the urinary tract (including the bladder, kidneys, and urethra) can cause blood to appear in the urine.
  •  Kidney stones: Kidney stones can cause blood in the urine as they pass through the urinary tract.
  •  Kidney inflammation or infection: These affect the urethra, bladder or prostate and are more prevalent in men, resulting in blood in urine.
  •  Bladder or prostate infections: Infections of the bladder or prostate can cause blood to appear in the urine.
  •  Enlarged prostate: An enlarged prostate (a common condition in men) can cause blood to appear in the urine.
  •  Certain medications: Some medications, such as blood thinners, can result in blood appearing in the urine.
  •  Cancer: Blood in the urine can be a sign of bladder, kidney, or prostate cancer.
  •  Other conditions: Other conditions that can cause hematuria include sickle cell anaemia, glomerulonephritis, vascular abnormalities, and trauma to the urinary tract. Some of these can arise from hereditary factors.


In some cases, the cause of hematuria may not be found. This is referred to as idiopathic haematuria. Therefore, seeing a healthcare provider for proper evaluation and diagnosis is essential.

Treatment Options

A thorough investigation of the cause is required. This includes laboratory tests for blood and urine tests, an ultrasound scan, CT or MRI scan of the kidneys, ureters and bladder. Results may indicate the need for a kidney biopsy, in which the diagnosis obtained from the tests will determine the subsequent course of treatment.

The treatment for hematuria (blood in the urine) will depend on the underlying cause of the condition. However, some possible treatment options may include the following:

  •  Antibiotics: If a urinary tract infection is causing hematuria, antibiotics may be prescribed to clear the infection.
  •  Medications: If an enlarged prostate or certain medications are causing the hematuria, medicines may be prescribed to shrink the prostate or to stop the bleeding.
  •  Surgery: If kidney stones or specific abnormalities in the urinary tract are causing the hematuria, surgery may be necessary to remove the stones or to correct the abnormalities.
  •  Other treatments: If cancer is causing hematuria, treatment may involve chemotherapy, radiation, or surgery.


Working with a healthcare provider to determine the most appropriate treatment plan for your needs is crucial.

Do you have a question about your kidney or medical condition?

Reach out to us for a consultation with Dr Alvin Ng. 

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