Blood in Urine: The Bare Basics of Haematuria


Haematuria

WHAT IS HAEMATURIA?

Haematuria is the technical term for the presence of red blood cells (RBCs) in urine. This could range from minute quantities such that it is invisible to the naked eye (occult or hidden bleeding), to frank hematuria such that the urine assumes a reddish tinge to a cola-coloured appearance.

Red blood cells abundantly present in our bloodstream happen to carry a pigment called “Haemoglobin” within them. This is what gives our blood, a red colour and lends that reddish tinge to most urine samples that have blood in it.

Please note: For Haematuria, the urine sample must contain whole red blood cells and not just the red pigment of blood.

However small the number, blood in urine is abnormal and warrants immediate medical intervention.



 

DOES HAEMATURIA AUTOMATICALLY MEAN “RED URINE”?

Not really. Let us explain.  Clinically, doctors have identified the following types of Haematuria:

“MICROSCOPIC” HEMATURIA

Here, the blood in urine is NOT visible to the naked eye.

The urine sample “appears” clear pale yellow and the patients are oblivious of the fact that their urine contains blood. This kind of haematuria is “found out” after red blood cells are detected through a Chemical dip-strip test & a Microscopic analysis during a routine urine test for an unrelated condition.

“GROSS” OR “FRANK” HEMATURIA

The reddish appearance of urine is clearly visible to the naked eye.

A microscopic analysis within a routine urine test is then required to confirm the presence of red blood cells in urine. The extent of bleeding could make the urine appear orangish to a deep red as depicted in the image below. Here, patients usually go to the doctor with “red urine” as their concern.

Hematuria

 

Hence, Hematuria does not strictly present as “red urine” as explained above.

Similarly, it is important to understand that there are other reasons too, for our urine to appear “reddish” apart from blood in urine. These could range from being the side-effect of certain medicines to beetroot consumption in people. Discussing the other causes of red urine is beyond the scope of this article.



 

WHICH CONDITIONS CAUSE HAEMATURIA?

The following conditions commonly present with Haematuria:

Non-urological causes Urinary Tract causes Glomerular and renal parenchymal causes  


Wondering how doctors “begin to guess” the cause for blood in the urine? This is what helps them roughly formulate your treatment plan after all.

Click on the image below to learn.

Hematuria work-up

 


 

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