Blood in the urine, known medically as hematuria, can be an unsettling discovery. While sometimes harmless and transient, hematuria can also signal serious health concerns that require prompt medical attention. It may occur visibly (gross hematuria) or microscopically, detectable only through lab testing. Causes range from urinary tract infections (UTIs) and kidney stones to chronic conditions such as kidney disease or cancers. Here’s a comprehensive overview of hematuria, including what causes it, how it’s diagnosed, and how it’s managed.*

Types, Causes, and Who’s at Risk

Hematuria is categorized into three main types:

• Gross.  Blood is visible in urine, often turning it pink, red, or cola-colored.
• Microscopic.  Blood is present but only detectable under a microscope.
• Dipstick. Detected via chemical strips in a lab, but often requires confirmation due to false positives.

Triggers for hematuria range from intense exercise and sexual activity to injury, menstruation, and genetic conditions like sickle cell disease. Some of the most common causes, however, are:

• Urinary tract infections (UTIs)
• Kidney infections
• Bladder or kidney stones 
• Chronic kidney disease (CKD)
• Enlarged prostate
• Cancers of the urinary tract (e.g., bladder, kidney, or prostate cancer)

Other risk factors include being over age 50, having a history of urinary problems, using certain medications (like NSAIDs or blood thinners), smoking, and working with chemicals or in contact sports.

Signs, Complications, and When to Seek Help

Although hematuria can be asymptomatic, additional signs may include:

• Pain or burning during urination
• Frequent or urgent need to pee
• Lower back or abdominal pain
• Fever, chills, or nausea (if infection is involved)

While not always dangerous, ignoring hematuria can delay diagnosis of serious issues, such as cancers or kidney disease. Complications vary depending on the underlying cause and may worsen if untreated. That’s why even a single instance of blood in your urine warrants medical evaluation. You should see a healthcare provider if:

• Your urine looks red or pink
• You experience painful or frequent urination
• You have unexplained flank or abdominal pain
• You show signs of infection or feel unwell

Diagnosis, Treatment, and Prevention

Diagnosing hematuria  typically involves a combination of:

• Urinalysis and blood work
• Imaging tests (ultrasound, CT, MRI)
• Cystoscopy (to visualize the bladder)
• In some cases, a biopsy

Your treatment depends entirely on the cause. Some options that your doctor may discuss with you include:

• Antibiotics for infections
• Medications like alpha-blockers or hormone therapy
• Surgical interventions for prostate issues or tumors
• Multidisciplinary care for cancer or chronic conditions

Preventing hematuria from occurring in the first place can include strategies such as staying adequately hydrated, avoiding smoking and exposure to toxins, and eating a kidney-friendly diet that’s low in salt and animal proteins.

Ultimately, while hematuria may not always point to a dangerous condition, it is a critical early warning sign your body shouldn’t ignore. Prompt evaluation and tailored treatment offer the best path to protecting your urinary and overall health.

*Cleveland Clinic. (2025, January 14). Hematuria. https://my.clevelandclinic.org/health/diseases/15234-hematuria 

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