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Blood in Urine

Call your doctor if you have symptoms such as:

What Causes Leukocytes in Urine?

If your doctor tests your urine and finds too many leukocytes, it could be a sign of infection.

Leukocytes are white blood cells that help your body fight germs. When you have more of these than usual in your urine, it’s often a sign of a problem somewhere in your urinary tract.

Some of the most common reasons for leukocytes in urine, and other symptoms you might see with them, include:

Urinary Tract Infection (UTI)

Your urinary tract includes your kidneys, bladder, and ureters (tubes that carry urine from the kidneys to the bladder). An infection in your urinary tract is the most likely cause of leukocytes in your urine. Any time you have an infection, your immune system ramps up production of these cells to fight off the bacteria.

More than half of women and about 1 in 5 men will get a UTI at some point in their lives. Signs that you have one are:

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  • Pain or burning when you pee
  • You need to go more often than usual
  • Cloudy or foul-smelling urine
  • Pain in your belly, back, or side
  • Nausea and vomiting

Your doctor can treat a UTI with antibiotics. A few days to a week on these drugs should clear up the infection.

How long you stay on the medicine depends on how severe your infection is, how often you get UTIs, and any other medical problems you have. To help ease pain while the infection clears, take an over-the-counter pain reliever or put a heating pad on your back or belly.

Make sure to take the whole antibiotic dose that your doctor prescribed. Otherwise, you could leave some bacteria alive, and they could reinfect you. That new infection could be harder to knock out with antibiotics. If your UTIs keep coming back, your doctor might put you on low-dose antibiotics for several months.

Call your doctor if you have symptoms such as:

  • Pain or burning when you pee
  • Blood in your urine
  • Severe pain in your belly, side, or back
  • Fever and chills

If you still have symptoms after antibiotics, check in with your doctor again. You may need more treatment.

Kidney Stones

Kidney stones are crystals that form when calcium and other minerals build up in your urine. They can be as small as a pea or as big as a golf ball. Larger kidney stones can block the flow of urine.

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Kidney stones cause symptoms such as:

  • Sharp pain in your belly, side, back, or groin
  • Blood in your urine that looks red, pink, or brown
  • An urgent need to pee
  • Pain when you pee
  • Cloudy or foul-smelling urine

Call your doctor right away if you think you have a kidney stone or if the pain is severe.

A small kidney stone might pass on its own. Drinking extra water can help flush it from your system. Over-the-counter pain relievers will help make you more comfortable until the stone is gone.

A urologist can remove bigger stones. A treatment that aims powerful waves at the stone from a machine outside your body can break it up. Afterward, the smaller pieces pass in your urine.

Another stone removal method passes a scope into the kidney through your bladder, or through a small opening in your back or side. The doctor will use special tools to break up the stone and remove it from your body.

Inflammation

Inflammation in your body triggers the release of leukocytes. That inflammation can come from an injury, infection, or disease.

Interstitial nephritis and cystitis are two conditions that cause inflammation in your urinary tract. Interstitial nephritis is a disease where inflammation involving the kidney causes that organ to not work as well. Cystitis is inflammation of your bladder, often from a urinary tract infection, but the bladder can also be inflamed without infection (interstitial cystitis).

If you have either one of these problems, you may notice symptoms like:

  • Increased urge to pee
  • Peeing more often than usual
  • Blood in your urine
  • Fever
  • Nausea and vomiting
  • Swelling on the feet

Keep in mind that if you have interstitial nephritis, there often aren’t any symptoms until the disease is very advanced.

Call your doctor if you have these symptoms. If an infection is to blame, you’ll get antibiotics. Other causes may need treatment with corticosteroids or other medicines.

Show Sources

Computational Surgery and Dual Training: “Modeling and Role of Leukocytes in Inflammation.”

FamilyDoctor.org: “Interstitial Nephritis.”

Lab Tests Online: “Urinalysis.”

Mayo Clinic: “Cystitis,” “High white blood cell count,” “Urinary Tract Infection (UTI).”

National Kidney Foundation: “Do You Have Symptoms of a Kidney Stone?” “Urinary Tract Infections.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Bladder Infection. Treatment,” “Definition & Facts for Kidney Stones,” “Symptoms & Causes of Kidney Stones,” “Treatment for Kidney Stones.”

Unity Point Health: “Can UTIs Go Away On Their Own?”

University of Rochester Medical Center: “What Are White Blood Cells?”

Urology Care Foundation: “Urinary Tract Infections – Learn How to Spot and Treat Them,” “What are Kidney Stones?” “What is a Urinary Tract Infection (UTI) in Adults?”

Blood in Urine

A test called a urinalysis checks a sample of your urine (pee) to see if there’s blood in it. In some cases, you can see blood in your urine. It may make your urine red or reddish brown. But you can have small amounts of blood in your urine that you can’t see. A urinalysis can find a small amount of blood cells in your urine as well as other types of cells, chemicals, and substances.

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Having blood in your urine usually isn’t serious. But in some cases, red or white blood cells in your urine may mean that you have a medical condition that needs treatment, such as a urinary tract infection (UTI), kidney disease, or liver disease.

Other names: microscopic urine analysis, microscopic examination of urine, urine test, urine analysis, UA, urine microscopy

What is it used for?

A urinalysis, which includes a test for blood in urine, is used to check your general health, including the health of your urinary tract, kidneys, and liver. The test can also be used to check for other health problems besides blood in urine.

Why do I need a blood in urine test?

Your health care provider may order a urinalysis as part of a routine exam. You may also need this test if you have seen blood in your urine or have other symptoms that could be caused by a problem with your kidneys or urinary tract. These symptoms include:

  • Painful urination
  • Frequent urination
  • Back pain
  • Abdominal (belly) pain

What happens during a blood in urine test?

You will need to give a urine sample for the test. A health care professional may give you a cleansing wipe, a small container, and instructions for how to use the “clean catch” method to collect your urine sample. It’s important to follow these instructions so that germs from your skin don’t get into the sample:

  1. Wash your hands with soap and water and dry them.
  2. Open the container without touching the inside.
  3. Clean your genital area with the cleansing wipe:
    • For a penis, wipe the entire head (end) of the penis. If you have a foreskin, pull it back first.
    • For a vagina, separate the labia (the folds of skin around the vagina) and wipe the inner sides from front to back.
  4. Urinate into the toilet for a few seconds and then stop the flow. Start urinating again, this time into the container. Don’t let the container touch your body.
  5. Collect at least an ounce or two of urine into the container. The container should have markings to show how much urine is needed.
  6. Finish urinating into the toilet.
  7. Put the cap on the container and return it as instructed.

If you have hemorrhoids that bleed or are having your menstrual period, tell your provider before your test. Outside blood could get into your urine sample and affect your test results.

Will I need to do anything to prepare for the test?

You don’t need any special preparations before getting a test for blood in your urine. If your provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your provider will let you know if there are any special instructions to follow.

Are there any risks to the test?

There is no known risk to having a urinalysis or a blood in urine test.

What do the results mean?

Many things can cause blood in urine. Most of them aren’t serious. The blood may be caused by taking certain medicines, intense exercise, sexual activity, or menstruation (having a period).

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But blood in your urine may be a sign of a more serious problem, such as:

  • Infection in the bladder, kidney, or prostate
  • Bladder or kidney stones
  • Kidney injury from an accident or sports
  • A viral infection, including hepatitis (a disease of the liver causing inflammation)
  • Cancer of the bladder, kidney, or prostate
  • Enlarged prostate (BPH)
  • Inflammation of the kidney, urethra, or bladder
  • A blood disorder
  • Polycystic kidney disease
  • Disorders of the ureters (tubes that connect your kidneys to your bladder)

If your test result shows blood in your urine, you may need more tests to find out why. To learn what your results mean, talk with your provider.

Is there anything else I need to know about a blood in urine test?

A blood in urine test is usually part of a routine urinalysis. A urinalysis also measures other substances in the urine, including proteins, acid and sugar levels, cell fragments, and crystals.

References

  1. Hinkle J, Cheever K. Brunner & Suddarth’s Handbook of Laboratory and Diagnostic Tests. 2nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Hemoglobin, Urine; p. 325.
  2. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c2022. Urinalysis [cited 2022 Feb 18]; [about 6 screens]. Available from: https://www.mayoclinic.org/tests-procedures/urinalysis/about/pac-20384907
  3. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998-2022. Blood in urine (hematuria); [cited 2022 Feb 18]; [about 6 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/blood-in-urine/symptoms-causes/syc-20353432
  4. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co., Inc.; c2022. Blood in Urine. [reviewed 2021 May; cited 2022 Feb 18]; [about 4 screens]. Available from: https://www.merckmanuals.com/home/kidney-and-urinary-tract-disorders/symptoms-of-kidney-and-urinary-tract-disorders/urine-blood-in
  5. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co., Inc.; c2022. Urinalysis and Urine Culture; [reviewed 2020 May; cited 2022 Feb 18]; [about 3 screens]. Available from: https://www.merckmanuals.com/home/kidney-and-urinary-tract-disorders/diagnosis-of-kidney-and-urinary-tract-disorders/urinalysis-and-urine-culture
  6. Minemura M, Tajiri K, Shimizu Y. Systemic abnormalities in liver diease. World J Gastroenterol [Internet]. 2009 June 28 [cited 2022 Mar 8]; 15(24);2960-2974. Available from: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC2702103/
  7. National Institute of Diabetes and Digestive and Kidney Diseases [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Hematuria (Blood in the Urine); 2016 Jul [cited 2017 Mar 14]; [about 3 screens]. Available from: https://www.niddk.nih.gov/health-information/urologic-diseases/hematuria-blood-urine
  8. Saint Francis Health System [Internet]. Tulsa (OK): Saint Francis Health System; c2010. Patient Information: Collecting a Clean Catch Urine Sample; [cited 2022 Feb 18]; [about 1 screens]. Available from: https://www.saintfrancis.com/assets/documents/lab/collecting-a-clean-catch-urine.pdf
  9. Testing.com [Internet]. Seattle (WA): OneCare Media; c2022. Urinalysis: The Test; [modified 2022 Jan 1; ; cited 2022 Feb 18]; [about 12 screens]. Available from: https://www.testing.com/tests/urinalysis/
  10. The Johns Hopkins Lupus Center [Internet]. Johns Hopkins Medicine; c2022. Urinalysis; [cited 2022 Feb 18]; [about 10 screens]. Available from: https://www.hopkinslupus.org/lupus-tests/screening-laboratory-tests/urinalysis/
  11. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2022. Health Encyclopedia: Blood in the Urine; [cited 2022 Feb 18]; [about 5 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=85&contentid=P01479
  12. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2022. Health Encyclopedia: Microscopic Urinalysis; [cited 2022 Feb 18]; [about 4 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=urinanalysis_microscopic_exam
  • Bladder Diseases
  • Kidney Diseases
  • Prostate Diseases
  • Urinalysis
  • Urinary Tract Infections
  • Urine and Urination

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