Blood in Urine: What You Need to Know

Blood in urine, also known as hematuria, is a condition where blood appears in the urine. There are two types of hematuria:

1. Microscopic hematuria:

• Small amounts of blood are present, not visible to the naked eye.

• Microscopic hematuria is 10 times more common than gross hematuria.

• It is detected through urine testing, with a result of ? 5 red blood cells (RBCs) per high power field (HPF) at 40x magnification.

2. Gross hematuria:

• Enough blood is present to be visible to the naked eye, with urine appearing pink or red.

• At least 1 ml of blood per liter of urine is required to detect gross hematuria.

Causes of hematuria:

• Gross hematuria:

• The most common cause is cystitis (inflammation of the bladder), accounting for about 20-25%.

• Hematuria in children:

• Wilms tumor: commonly seen in children aged 2-5.

• Post-streptococcal glomerulonephritis: commonly seen in children aged 5-15.

Distinguishing features between glomerular and non-glomerular hematuria:

| Type of Hematuria | Urine Color | Proteinuria | RBC Shape | Other Features |

|—|—|—|—|—|

| Glomerular | Brown, dark tea, coca-cola colored | ? 2+ | Deformed ? 30%, ? 5% spiky RBCs | RBC casts suggest glomerulonephritis (but do not exclude the possibility of no RBC casts) |

| Non-glomerular | Bright red, red | | | Urinary disorders, urinary retention, leukocyturia, positive nitrites, bacteriuria |

Note: Hematuria is an abnormal sign that requires prompt medical evaluation and treatment by a physician.