Haematuria is one type of hematuria. In this case, blood - more specifically red blood cells - is also present in the urine, but the urine does not turn brown or red. In the case of hematuria, blood can only be detected by laboratory tests. Find out what the causes of hematuria are.

Haematuriaindicates the presence of red blood cells in the urine.Haematuriais one of the two types of hematuria. The first type of hematuria is macroscopic hematuria (macrohematuria). In this case, the red blood cells are visible in the urine as the urine turns brown or red. The second type of hematuria is microscopic hematuria, also known as microhematuria or hematuria. In this case, the red blood cells are only visible on microscopic examination of the urine sediment. It is assumed that in one field of view, under the high magnification of the microscope, there may be 2-3 erythrocytes under normal conditions. Exceeding this value is already known as hematuria. Red blood cells in the urine can come from any part of the urinary system, from the kidneys to the urethra.

Haematuria - causes

1) Glomerular conditions

In the vast majority of cases, hematuria is caused by diseases of the glomeruli.

  • IgA nephropathy - This is the most common form of glomerulonephritis. The natural course of the disease is hematuria, which lasts up to several days, followed by hematuria with accompanying proteinuria
  • "thin membrane" disease (familial mild hematuria)
  • Vasculitis is a group of systemic connective tissue diseases that cause inflammation of the vessel walls and their necrosis.
  • collagenosis - connective tissue diseases
  • Alport syndrome is a genetic disease that damages the glomeruli
  • chronic glomerulonephritis (membranous-proliferative, focal, segmental glomerulosclerosis)

2) Disorders of the upper urinary tract:

  • nephrolithiasis may be manifested by renal colic, hematuria, urge to bladder or be symptomless

The appearance of hematuria in patients, especially over 50 years of age, without clinical symptoms, may be caused bycancer of the kidney or urinary tract.

  • kidney cancer - apart from hematuria, there is pain that accompanies the disease, it may resemble colic or be dull and appear in the lumbar region. Patients have low fever or fever, night sweats, weight loss, increased blood pressure
  • polycystic kidney disease - is a genetic disease that leads to kidney failure. Most often, patients require a transplant. Symptoms of the disease include arterial hypertension, weakness, pains in the abdominal and lumbar region (the pains can be sharp and short, as well as long and blunt), urinary tract infections, headaches
  • spongy medullary kidney - is a developmental disorder of the kidneys of unknown cause. The first symptoms may appear at the age of 40-50 and be associated with kidney stones, hematuria or kidney infection
  • hypercalciuria - is a medical condition involving the increased excretion of calcium in the urine. It is the most common cause of urolithiasis

The appearance of persistent or recurrent hematuria in a young person with hypertension is most often caused by IgA nephropathy.

  • hyperoxaluria A disease state characterized by an excessively, chronically increased urinary oxalate excretion. It can also cause urolithiasis
  • renal tuberculosis is very dangerous because it does not cause any symptoms for a long time. The first is hematuria, pain when urinating, and a burning sensation in the urethra, but this means that the mycobacteria have attacked the entire system. The end of such an infection is death from kidney failure

3) Lower urinary tract diseases:

Each patient should have their urine sediment examined under a microscope, and the serum creatinine concentration should be determined and the amount of glomerular filtration should be estimated.

  • cystitis - the first symptoms of the disease are a slight burning sensation when urinating. Then pollakiuria occurs (even if you don't drink much), but the patient can hardly squeeze a few drops. It is accompanied by severe burning and pain in the urethra area
  • prostatitis - acute, infectious prostatitis is manifested by fever and chills, as well as pain in the perineum and lower abdomen. The patient feels increased pressure, burning and pain while urinating, the stream of urine is interrupted. The chronic form of the disease is manifested by pains in the lower back, in the lower abdomen, around the perineum and scrotum
  • urethritis - characterized by hyaline, watery oryellow (purulent) discharge from the urethra, sometimes so profuse that the foreskin sticks to the underwear. There is also redness around the opening of the urethra.
  • bladder polyps and neoplasms - the most common symptom of bladder cancer is bleeding in the urine, or hematuria. It may or may not be painful when urinating, or it may be painless, and may subside over time
  • polyps and cancers of the urinary tract
  • prostate cancer - frequent urination, also at night, difficulties in urinating (difficulties in starting urination, weak or intermittent stream) feeling of incomplete emptying of the bladder

4) Other causes of hematuria

  • exercise hematuria - post-exercise hematuria occurs especially in athletes
  • bleeding disorders - bleeding from the genitourinary tract is one of the symptoms of blood clotting disorder
  • overdose of anticoagulants (acenocoumarol, warfarin)
  • pseudo-hematuria (blood does not come from the urinary tract, but from the genital tract and is associated with diseases of this part of the body)

Bibliography: Nowicki M., Biedunkiewicz B., Krwinkomocz, Nephrological Forum 2009, vol. 2, no. 1

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