Haematuria (Blood in the Urine)

What is haematuria?

Haematuria is the presence of red blood cells (RBCs) in the urine. Often, the urine appears normal to the naked eye, but examination under a microscope shows a high number of RBCs. In gross haematuria, the urine is red or the color of cola, which can be seen with the naked eye.

Before Treatment	After Treatment
(RBC’s – 300-400/HPF)	(RBC’s – 0-1/HPF)
(13-Sept-2008)	(04-Oct-2008)

Causes:

Common causes of macroscopic hematuria/ haematuria (i.e. blood visible in the urine) include:

• Benign familial hematuria
• Urinary Schistosomiasis (caused by Schistosoma haematobium) – a major cause for hematuria in many African and Middle-Eastern countries;
• IgA nephropathy (“Berger’s disease”) – occurs during viral infections in predisposed patients;
• Kidney stones (or bladder stones);
• Bladder cancer;
• Renal cell carcinoma – occasionally presents with bleeding;
• Paroxysmal nocturnal hemoglobinuria – a rare disease where hemoglobin of hemolysed cells is passed into the urine.
• Urinary tract infection with some bacterial species including strains of EPEC and Staphylococcus saprophyticus
• Sickle cell trait can precipitate large amounts of red blood cell discharge, but only a small number of individuals endure this problem
• Arteriovenous malformation of the kidney (rare, but may impress like renal cell carcinoma on scans as both are highly vascular)
• Nephritic syndrome (a condition associated with post-streptococcal and rapidly progressing glomerulonephritis).
• Fibrinoid necrosis of the Glomeruli ( as a result of malignant hypertension)
• Ureteral Pelvic Junction Obstruction (UPJ) is a rare condition beginning from birth in which the ureter is blocked between the kidney and bladder. This condition may cause blood in the urine.
• Very prolonged exercise, notably long-distance horseback riding