Red Blood Cells in Urine

Red blood cells are what make your blood look red.You need your red blood cells for oxygen transportation in the blood stream. They also help take carbon dioxide from the tissues of the body, sending it to the lungs for exhalation. Most people have about four RBCs per high power field in the urine. More red blood cells in urine than that may be abnormal, especially if the blood can be seen with the naked eye.

Red Blood Cells in Urine: Hematuria

This condition is medically known as hematuria. There are two major types of hematuria you should know about. These include the following:

1.   Gross Hematuria

This is the type of red blood cells in the urine that you can actually see in your urine. It means that there are enough red blood cells that you don't need a microscope to identify the fact that there are more red blood cells.The urine may be pink, brownish-red, red, tea-colored, or purplish-red. This is not normal and means you should seek medical advice.

2.   Microscopic Hematuria

This is the type of red blood cells in the urine that can't be seen by looking at the urine. Only a microscopic evaluation or a urine dipstick test can identify this type of hematuria. If the dipstick test shows blood, the urine is evaluated under the microscope to verify that there really are red blood cells. Microscopic hematuria can be just as dangerous as gross hematuria and even more dangerous because it can be present for a long period of time without ever finding out about it.

What Causes Red Blood Cells in Urine?

There can be several reasons why you have too many red blood in urine. Here are the top reasons you should consider before worrying about some of the more rare ones:

1.   Infection

An infection of the urinary tract often causes increased red blood cells in your urine. This infection can be related with any part of the urinary tract, including the kidneys, ureter, or bladder. The bacteria enter the urethra from the outside and can then get into the urinary tract. This causes increased discomfort, burning on urination, and frequency of urination. Gross or microscopic hematuria can occur with this.

2.   Stones in the Urinary Tract

Stones that come from minerals can crystalize within the urinary tract. You can find stones in the kidney, ureters, or bladder. If they are very big, they can block the flow of urine, irritate the urinary tract lining, and cause hematuria from the irritation.

3.   Enlargement of the Prostate

This only occurs in men who are at least of middle age. The enlarged prostate causes irritation of the urethra, which is surrounded by the urethra. You can have difficulty voiding, get up at night to void, and can have blood cells in the urine.

4.   Kidney Diseases

This is not as common as the other reasons that causes red blood cells in urine. The kidneys can suffer from inflammation, which causes bleeding into the urinary tract. You can have primary kidney disease or secondary kidney diseases, such as those caused by diabetes mellitus. Kids can get post-streptococcal glomerulonephritis, which starts as a case of strep throat that is not treated. It can cause inflammation of the kidneys and blood in the urine.

5.   Urinary Cancer

There can be cancer of the prostate, kidneys or bladder that can result in bleeding into the urinary tract. This usually happens in severe cases of cancer and may be the first evidence of cancer of the urinary tract.

6.   Medications

Some medications can lead to red blood cells that are found in urine. These include medications that thin the blood like warfarin and heparin, aspirin, cyclophosphamide, and penicillin.

7.   Uncommon Causes

There are uncommon diseases such as Alport syndrome, hemophilia, and sickle cell anemia that can also lead to this condition. If you exercise too much or experience trauma to the kidneys, this can also result in hematuria.

Should You See a Doctor for It?

Any time you can see red blood in urine, you should see a doctor and have a urinalysis done so that you can see how severe the problem is. The doctor will question you about the symptoms, do an examination and run some studies to see why you have red blood cell in urine. The tests may involve a urinalysis, various blood tests, cystoscopy, renal ultrasound, renal biopsy, and a CT scan of the urinary tract. Not all tests will be necessary.

What You Can Do for Red Blood Cells in Urine?

There is no particular treatment for hematuria. Instead, the doctor will identify the cause and treat that condition. You may need antibiotic medicines to prevent a large prostate gland, or shock wave lithotripsy to dissolve stones in the urinary tract. In the more rare causes, you may need to see a specialist, such as an oncologist or a specialist for people with blood disorders.

If nothing serious is found, there will be no treatment. The doctor will monitor the condition and check your blood pressure every 3-6 months, particularly if the problem might be due to bladder cancer. 

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