Red Blood Cells in Urine

Medically termed as hematuria, red blood cells (RBCs) in the urine is considered to be normal if they are less in amount. Generally about 2.5 million red blood cells are excreted in the urine everyday as part of the body's normal process to get rid of old and inefficient cells. There are mainly two types of hematuria: microscopic and macroscopic haematuria. Microscopic haematuria is a condition in which an abnormal amount of red blood cells are present in the urine, which are not visible to naked eye and can be examined only under a microscope. In macroscopic or gross haematuria, the number of cells are sufficient enough to change the urine color from yellow to pink or red.

Causes

Although it is not a life-threatening health syndrome, there are various contributing factors for presence of red blood cells in the urine which are explained below.

• Urinary Tract Infections: Urinary tract infection (UTI) is the most common cause for red blood cells in the urine. It occurs due to bacterial invasion of the urinary tract that may cause tissue damage, that may eventually spread up to the urethra, bladder, and sometimes kidneys also.
• Kidney Stones: Over the course of time, the kidneys and other parts of the urinary tract can get blocked by stones, tumors or inflammation, that lead to a narrowing of the opening. Kidney stones are tiny deposits of chemicals, made of calcium, phosphate and oxalate. They can cause sever pain and discomfort while urinating and can even lead to blood in the urine.
• Medications: Consumption of prescribed medications like quinine, rifampin, warfarin, aspirin, phenytoin, etc. may help in relieving symptoms of an existing illness but can lead to harmful side effects like red blood cells present in the urine.
• Diseases: There are various diseases that can contribute to blood in urine like diabetes which is a health ailment, that affects the secretion of insulin hormone from the pancreas and can also inflame the capillaries in the kidneys responsible for filtering the blood. Similarly, sickle cell anemia is a genetic blood disease that can also lead to red blood cells in the urine. It occurs due to presence of abnormal form of hemoglobin (a molecule in the red blood cells) or shortage of red blood cells in the body.
• Enlarged Prostate: Enlarged prostate or benign prostatic hypertrophy, which is commonly seen in older men can be another cause for blood in urine. It is a non-cancerous condition of the prostate gland, where there are abnormal cell divisions that lead to gradual enlargement of the prostate gland.
• Other factors: Kidney infections, strenuous exercise, accident or trauma causing bruised kidneys or bladder damage can also lead to high amount of red blood cells in the urine.

Symptoms

Here are some other symptoms besides blood in urine that a hematuria patient may suffer.

• Small blood clots in the urine
• Pain in the flank (side of the body between the ribs and the hips) or groin
• Burning sensation or pain while urinating
• Nausea or vomiting
• Decreased appetite
• Loss of weight

Treatment

Treatment for hematuria primarily depends on its underlying cause. Urinalysis, blood tests, and ultrasound scan of the kidneys or cystoscopy are some diagnostic tests that are conducted to detect the actual cause behind the problem. If the blood in urine is due to kidney stones, the patient should drink enough fluids and can take some pain relief medications. For urinary tract infection or kidney infection, the patient can be given antibiotics but only under a doctor's supervision. Likewise, if a medication is causing hematuria, it should be stopped or its dosage can be reduced, but under a doctor's recommendation.

Sometimes, no definite cause is diagnosed. Such cases where there is no sign of serious illness, it is advisable for the patient to have an occasional monitoring of the urine, blood tests and blood pressure, at least once in six months. This is to determine the rare cases where the hematuria in the urine can be an early sign of a health ailment, that may develop later in life.