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February 9, 2010
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Blood in Urine
(Hematuria)

Medical Authors: Gary D. Steinberg, MD, and G. Joel DeCastro, MD
Medical Editor: Melissa Conrad Stöppler, MD

Doctor to Patient

Kidney Stones: Symptoms, Causes, and Treatment

Medical Author: Melissa Stoppler, M.D.
Medical Editor: Barbara K. Hecht, Ph.D.

Kidney Stone DiagnosisOne in every 20 people develop a kidney stone at some point in their life. Kidney stones, sometimes called renal calculi, form within the kidney itself or in other parts of the urinary tract.

People who have kidney stones report the sudden onset of excruciating cramping pain in their side, groin, or abdomen. Changes in body position do not relieve this pain. It may be so severe that it is accompanied by nausea and vomiting. Kidney stones also characteristically cause blood in the urine. If infection is present in the urinary tract along with the stones, there may be fever and chills.


Doctor to Patient

What is blood in urine (hematuria)?

Hematuria, or blood in the urine, can be either gross (visible) or microscopic (as defined by more than three to five red blood cells per high power field when viewed under magnification). Gross hematuria can vary widely in appearance, from light pink to deep red with clots. Despite the quantity of blood in the urine being different, the types of conditions that can cause the problem are the same, and the workup or evaluation that is needed is identical.

People with gross hematuria usually present to their doctor with this as a primary complaint. Microscopic hematuria, on the other hand, is most commonly detected as part of a periodic checkup by a primary-care physician.

What are the causes of blood in urine?

The causes of gross and microscopic hematuria are similar and may result from bleeding anywhere along the urinary tract. One cannot readily distinguish between blood originating in the kidneys, ureters (the tubes that transport urine from the kidneys to the bladder), bladder, or urethra. Any degree of blood in the urine should be fully evaluated by a physician, even if it resolves spontaneously.

Infection of the urine, stemming either from the kidneys or bladder, is a common cause of microscopic hematuria. Kidney and bladder stones can cause irritation and abrasion of the urinary tract, leading to microscopic or gross hematuria. Trauma affecting any of the components of the urinary tract or the prostate can lead to bloody urine. Hematuria can also be associated with renal (or kidney) disease, as well as hematologic disorders involving the body's clotting system. Medications that increase the risk of bleeding, such as aspirin, warfarin (Coumadin), or clopidogrel (Plavix), may also lead to bloody urine. Lastly, cancer anywhere along the urinary tract can present with hematuria.

Picture of urinary tract


Next: How is blood in urine diagnosed? »

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Blood in Urine

The kidneys

The kidneys are a pair of organs on either side of the spine in the lower abdomen. Each kidney is about the size of a fist. Attached to the top of each kidney is an adrenal gland. A mass of fatty tissue and an outer layer of fibrous tissue (Gerota's fascia) enclose the kidneys and adrenal glands.

The kidneys are part of the urinary tract. They make urine by removing wastes and extra water from the blood. Urine collects in a hollow space (renal pelvis) in the middle of each kidney. It passes from the renal pelvis into the bladder through a tube called a ureter. Urine leaves the body through another tube (the urethra).

The kidneys also make substances that help control blood pressure and the production of red blood cells.

Understanding cancer

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