What Does Blood in Urine Mean?

Blood in the urine (hematuria) happens when any amount of blood is detected in a person’s urine. People with gross hematuria can see blood in their urine because the urine appears red, pink, or brown. With microscopic hematuria, blood cannot be seen in the urine but can be found with a urine test. 

As many as 1 in 5 people who see a urologist are diagnosed with hematuria. There are several causes of hematuria, ranging from benign to serious. Blood in the urine can come from anywhere in the urinary tract, including the kidneys, ureters, bladder, or urethra. 

This article discusses blood in the urine, including the causes, treatment options, and how it is diagnosed. 

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What Does Blood in the Urine Look Like?

Blood in the urine is typically microscopic and can only be detected with a urine test (urinalysis). When blood is visible in the urine, it often turns the urine pink, red, or brown. You may notice just a very light tinge of pink color or deep red, depending on how much blood is present. 

Where Does the Blood in the Urine Come From?

Blood in the urine can come from any area of the urinary tract. Urine is produced in the kidneys to remove waste and fluid from the body. It then flows through the ureters to the bladder to be stored. When released, the urethra takes the urine outside of the body. 

Types of Hematuria

There are two types of hematuria, and they have their unique causes. They are:

  • Gross hematuria: A large amount of blood in the urine; appears as pink, red, or brown urine
  • Microscopic hematuria: A tiny amount of blood in the urine; the urine appears normal

Other Common Symptoms With Blood in the Urine

People with blood in their urine may experience other symptoms depending on the underlying cause. Common symptoms include:

  • Urine that appears pink, red, or brown
  • Pain with urination
  • Frequent urination 
  • Back pain
  • Abdominal pain

What Causes Blood in the Urine?

There are several possible causes of blood in the urine. The cause could be benign, like vigorous exercise or side effects from medication. It could also be a sign of a serious condition like cancer or kidney disease. 

Possible causes of blood in the urine include:

  • Urinary tract infection (UTI): A UTI is an infection in any area of the urinary tract, which may lead to inflammation and bleeding. 
  • Bladder or kidney stones: Bladder or kidney stones are deposits of minerals that may damage the urinary tract (may lead to bleeding) as they move through it.
  • Bladder inflammation: Inflammation in the bladder can lead to bleeding.
  • Certain kidney diseases: Chronic kidney diseases like glomerulonephritis cause inflammation and kidney damage, which may lead to bleeding. 
  • Vigorous exercise: Strenuous exercise, such as high-intensity interval training or long-distance running, may cause irritation and bleeding in the urinary tract.
  • Urinary tract trauma: If you experience trauma to any area of the urinary tract, you may notice blood in the urine. Trauma could come from a motor vehicle or bicycle accident, or sports injuries.
  • Medication side effects: Antibiotics, blood thinners, aspirin, and certain pain relievers may cause bleeding in the urinary tract. 

Less common causes of blood in the urine may include: 

  • Benign prostatic hyperplasia (BPH): An enlarged and swollen prostate gland may cause bleeding in the urinary tract in people assigned males at birth.  
  • Cancer: Cancer of the prostate, kidney, or bladder may cause blood in the urine. 
  • Endometriosis: This chronic condition occurs when the tissue that lines the uterus grows in other body areas. If the tissue grows into the bladder, it may cause bleeding. 
  • Blood-clotting disorder: People with a disease that causes problems with blood-clotting, such as hemophilia, are more likely to experience blood in the urine. 
  • Sickle cell disease: Sickle cell disease is a group of blood disorders that cause the blood cells to change shape, from round to sickle, or crescent, shaped, preventing them from easily  moving through blood vessels. It often causes severe pain and may lead to blood in the urine.

How Is the Cause of Blood in the Urine Diagnosed?

Once you and your healthcare provider determine that you have blood in your urine, the next step is determining what is causing it. It is essential to see a provider when you notice blood in your urine. 

Your provider will likely start with a physical exam and medical history. Other diagnostic tests include:

  • Blood tests: Complete blood count (CBC) to check for infection or low red blood cells (anemia) and creatinine to test for kidney function
  • Urine test: To detect blood, protein, calcium, and bacteria in the urine
  • Digital rectal exam: To examine the prostate gland in people assigned male at birth
  • Pelvic exam: To study the reproductive system in people assigned female at birth
  • Computed tomography (CT) scan: To explore the urinary tract
  • Magnetic resonance imaging (MRI): To examine the bladder and kidneys 
  • Ultrasound: To look for cysts, tumors, or stones in the kidneys and bladder
  • Cystoscopy: To visualize the urethra and bladder for signs of inflammation or damage
  • Kidney biopsy: To examine the kidney for signs of cancer or damage 

Your healthcare provider may recommend a urine test (urinalysis) to detect blood in the urine. This type of test can show blood, blood cells, chemicals, and other substances in the urine.

To obtain a “clean catch” sample, you will be asked to wash your hands, cleanse the area with a special wipe, and urinate into a small cup. 

How Blood in the Urine Is Treated

The treatment for blood in the urine depends on the underlying cause. Treatment options may include: 

  • Antibiotics: To treat a urinary tract infection
  • Diet changes: To lower the amount of salt in the diet and increase the amount of water
  • Rest: To heal from trauma to the urinary tract 
  • Pain medications: To relieve pain associated with kidney stones 

About 1 in 4 people with blood in their urine have an unknown cause. When this happens, your healthcare provider will likely recommend regular checkups to monitor the hematuria and look for signs of a problem.

How to Prevent Blood in Urine

It may not always be possible to prevent blood in the urine. It is often a sign of a health condition that needs to be treated. 

To promote a healthy urinary tract, consider the following habits:

  • Drink water throughout the day.
  • Do not smoke or drink heavily.
  • Urinate after sexual intercourse to prevent UTIs.
  • Avoid excess salt in your diet.
  • Limit your exposure to chemicals as often as possible.

Complications from Blood in the Urine

When blood is present in your urine, it may be a sign of an underlying health condition. It is important to see your healthcare provider to determine the cause and find the right treatment plan. If you do not treat hematuria's underlying cause, it may worsen. 

An untreated urinary tract infection can lead to urinary tract damage, inflammation, and incontinence problems. If the infection spreads to the blood, it could lead to a life-threatening condition called sepsis.

Untreated kidney disease may lead to permanent kidney damage. Untreated cancer may lead to cancer spread (metastasis). See a healthcare provider if you are unsure if there is blood in your urine.

When to Contact a Healthcare Provider

Some causes of hematuria are serious and require immediate treatment. Even a small amount of blood could indicate a significant problem.

See a healthcare provider immediately if you develop blood in the urine along with abdominal pain, low-back pain, side pain, painful urination, or trouble urinating. Consider seeking immediate treatment if you also develop a high fever, chills, nausea and vomiting, or an inability to urinate. 

Summary

Blood in the urine (hematuria) occurs for various reasons. Blood may be visible in the urine as pink, red, or brown. It may also be microscopic and only detected by a urine test (urinalysis). Possible causes of blood in the urine include infection, kidney stones, kidney disease, vigorous exercise, medication side effects, and cancer.

Blood in the urine can come from anywhere in the urinary tract, including the kidneys, ureters, bladder, or urethra. Because blood in the urine can indicate a serious health condition, see your healthcare provider immediately.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Carrie Madormo, RN, MPH
Carrie Madormo, RN, MPH, is a health writer with over a decade of experience working as a registered nurse. She has practiced in a variety of settings including pediatrics, oncology, chronic pain, and public health.