Blood in urine (hematuria) causes and treatment

Blood in your urine (pee), called hematuria doesn't always mean that you have kidney disease, but it may mean that something is wrong with your kidneys or your urinary tract. 

How will I know if I have blood in my urine?

Sometimes, you can see the blood in your urine. This is called gross hematuria, and it may look red, pink, or brown. Other times, you may not notice it at all. This is called microscopic hematuria, where blood may only show up during a urine test. Your doctor may test your urine multiple times to confirm it is an ongoing problem.

Your doctor may also check your kidney function using a blood test to calculate your estimated glomerular filtration rate (eGFR). This test shows how well your kidneys are working. Your doctor may also use a albumin-to-creatinine ratio (uACR) test to look for protein in your urine, which can be a sign of kidney damage. 

It's important to monitor your kidney health over time. That means getting tested regularly. These tests help your doctor spot any changes early and take steps to protect your kidneys.

What are the causes of blood in urine?

Finding blood in your urine can be concerning, but knowing the cause and taking the right steps can help protect your kidney health.

Many things can cause blood in your urine. Some are minor, but others may require treatment.

 Common causes include:

• An infection, such as a urinary tract infection (UTI) or kidney infection such as pyelonephritis
• Kidney stones, which happens when crystals are formed in the kidneys or bladder and become hard stones that may hurt if they cause a blockage or try to pass through the urine.
• Having your period (menstruation) may appear as blood in the urine
• Sexual activity
• Injury to the kidney, such as from contact sports or an accident
• Glomerular disease because the tiny filters of the kidneys become inflamed and damaged
• Other kidney diseases

Other, more serious problems can also cause blood in your urine, such as: 

• Kidney or bladder cancer
• Irritation or swelling in your kidneys, prostate (in men), or another part of your urinary tract
• Polycystic kidney disease
• Blood clots or diseases that cause blood clotting
• Sickle cell disease

Anyone can have blood in their urine, but it is more likely if you:

• Have a family history of kidney disease
• Have an enlarged prostate (usually in middle age or older men)
• Have had  kidney stones
• Take certain medicines, such as pain relievers, blood thinners, and antibiotics
• Have or recently had certain types of infections

What is the treatment for blood in urine?

Treatment depends on the cause of the blood in your urine. To find out the cause, your doctor may ask about your family history and do a urine test   to test for signs of an infection, kidney disease, or other problems. If an infection is causing the blood in your urine, your doctor may give you antibiotic medicine, which helps to fight bacterial infection. Other causes may need more tests or care from specialists like a nephrologist (kidney doctor) or urologist (urinary tract doctor) for different treatments.

What should I do if I have blood in my urine?

Ask your doctor about any next steps, including follow-up tests or treatment options. If you don't understand something, ask questions.

You are an important part of your care team. Talk with your doctor about what's best for you, including:

• The cause of blood in your urine and whether more tests are needed
• If you need treatment now, or if it's better to monitor the condition
• How to keep your kidneys healthy

Understanding your health and being involved in decisions about your care can help you feel more confident and in control.