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The body disposes of extra waste and water through the urine, which is filtered by the kidneys from the blood. Its color is usually pale yellow, due to a natural pigment (urochrome), but this color may vary, depending on the concentration of your urine.

Darker urine may mean you are not taking enough water, while a lighter color may mean you are drinking more than enough.

Other factors that may cause a change in color of your urine include certain foods and medicines. Occasionally, however, you might be surprised to see a red discoloration in the urine, which you think may be blood in your urine. If it is indeed blood, you need to find out what is causing it. If you are a woman, it is best to have your urine analyzed when you are not menstruating, because it can affect the results of the test.

Blood in the urine (hematuria) can come anywhere along the urinary tract, which consists of the kidneys, the tubes (ureters) connecting the kidneys to your bladder, the bladder (a muscular bag where urine is stored), and the urethra (where urine passes to the outside of your body). If you find that your urine is tea-colored, red, brownish-red or pink, you are having gross hematuria, which should prompt you to seek consultation. In some cases, the presence of some red blood cells is an incidental finding only during routine laboratory examination, a condition called microscopic hematuria. In any case, the cause of blood in the urine must be determined, because it may be a sign of a condition that needs treatment.

Hematuria may be accompanied by other symptoms such as pain during urination, fever, and abdominal pain, depending on the cause, but in some cases, it may occur without accompanying symptoms. Here are some of the common causes you might have blood in the urine:

  • Bladder infection or acute cystitis, which is often accompanied by burning pain that occurs during urination, cloudy, foul-smelling urine, and frequent urge to urinate.
  • Kidney infection or pyelonephritis, which is often associated with fever, chills, and pain in the lower back.
  • Kidney or bladder stones, which are often accompanied by severe abdominal pain or pelvic pain when the stones are big enough to cause obstruction to urine flow. However, kidney stones may be painless when they are very small.
  • Prostate enlargement in older men (benign prostatic hyperplasia) can cause compression of the urethra and blockage of urine flow. It is often accompanied by difficulty urinating, urgency or increased need to urinate, and infection of the prostate (prostatitis).
  • Kidney disease, which may be accompanied by high blood pressure, body swelling, puffiness around the eyes, and weakness. Inflammation of the filtering system of the kidneys (glomerulonephritis) may occur on its own or may be a complication of another chronic disease such as diabetes.
  • Advanced stage cancer of the kidney, bladder or prostate may be accompanied by blood in the urine as well as various urinary symptoms.
  • Kidney injury caused by a blunt or penetrating injury can cause blood to appear in your urine.
  • Certain medications such as cyclophosphamide (Cytoxan), an anticancer drug, anticoagulants such as aspirin, blood thinners like heparin, and penicillin can cause urinary bleeding.
  • Strenuous exercise can cause gross hematuria, which may be due to trauma, dehydration or breakdown of red blood cells after intense workouts.
  • Inherited disorders such as sickle cell anemia and Alport syndrome can be the cause of blood in urine.
Hematuria must never be ignored.

Contact your doctor right away if you see blood in your urine or if you see any changes in your urine, especially if accompanied by other signs and symptoms.

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