Acute Hematuria

What is acute hematuria?

When more blood or blood cells are found in your urine than normal, it is called hematuria. The word acute is used to describe problems that start suddenly, worsen quickly, and last a short time. Hematuria may come and go.

What are types of acute hematuria?

There are two types of acute hematuria:

Symptomatic:

When there is too much blood in your urine, the color change may be seen easily. Your urine may be bright pink to brownish-red or cola-colored. Urinary tract infections, kidney stones, and tumors (lumps) are conditions where you may have this type of hematuria.

Asymptomatic:

The color of your urine is normal with this type of hematuria. Blood is found when your urine is sent for tests and looked at using a microscope. A microscope is an instrument which makes very small objects look bigger.

What causes acute hematuria?

Acute hematuria may be caused by conditions affecting the glomerulus. The glomerulus is that part of your kidney which filters blood. Diseases that affect other parts of the kidney or the urinary tract may also cause hematuria. These conditions include the following:

Inflammation (swelling) of both the tissues and the membrane covering your kidneys.

Inflammation of your bladder from infection.

Kidney stones.

Cancer, or urinary or reproductive system damage.

Other causes of hematuria may include:

Swelling of your bladder after radiation therapy.

Blood diseases where you have decreased platelets (cells that help stop bleeding when you are cut or hurt). This includes sickle cell anemia or von Willebrand's disease.

Swelling of the prostate or when the prostate gland is bigger than normal.

Strenuous (hard) exercise.

Medicine such as blood thinners, diuretics, certain antibiotics and anti-inflammatory drugs.

What causes hematuria in children?

Most cases of hematuria in children are autoimmune. This is when the body produces antibodies that directly affect the kidneys or damage any part of it. Other common causes may include:

Swelling of your child's kidneys after an infection.

Polycystic renal disease. This is when cysts (growths) grow in your child's kidneys.

Calcium salt found in your child's kidneys, or too much calcium in his urine.

Kidney transplant.

Trauma or infection of the urinary tract.

Lump made up of blood vessels or a swollen mass in your child's urinary tract.

Bleeding from the urethra for an unknown reason.

How can I tell caregivers about my hematuria?

Tell your caregiver the color of your urine, and if there are changes in its color. Tell him if the change in color is at the beginning, end, or while you are urinating. Tell him if you have pain or trouble passing urine. Tell him if you have a sudden need to urinate. Tell him if you have other signs or symptoms, such as a fever or chills.

Tell him about medicine you have taken or are taking at present. Medicine used to treat swelling and some antibiotics may cause hematuria. Tell him if you or your family has had disorders or infections of the urinary tract in the past. Tell him if you had pelvic radiation therapy or other procedures. He needs to know if you smoke or work around leather, rubber, benzene, or dyes. Tell him if you do hard exercise or have recently lost weight.

What signs and symptoms may be related to my acute hematuria?

You may have any of the following:

Fever.

High blood pressure or your heart feels like it is beating too fast.

Nausea (upset stomach), vomiting (throwing up), or hemoptysis (coughing up blood).

Pain, or a growth that you can feel in your abdomen (stomach).

Rashes, pinpoint red marks, or bluish-black spots on your skin, and joint pain.

Swelling in your arms or legs.

Hearing loss.

How may my acute hematuria be treated?

You may need one or more of the following treatments:

Medicines:

Antibiotics:

Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.

Diuretics:

This medicine is often called "water pills". Diuretics help your body get rid of extra fluid (edema) in your legs and ankles. This medicine may also help get rid of extra fluid in your lungs or around your heart. It may also decrease your blood pressure. You may urinate more often when taking diuretics.

Immune suppressing medicines:

This medicine may be given to slow down your immune system. The immune system protects your body from infections and diseases. The immune system may see normal cells as abnormal. This medicine may help keep the immune system from harming your kidneys or urinary bladder. Do not stop taking these medicines without your caregivers OK. Stopping on your own can cause problems.

Medicines for pain, swelling, or fever:

These medicines may be given to treat your pain, swelling, or fever. These are safe for most people to use. However, they can cause serious problems when used by people with certain medical conditions. Tell caregivers if you have liver or kidney disease, a history of bleeding in your stomach, or any other medical problems. Also tell your caregiver about any allergies you have to medicines.

Steroids:

Steroid medicine may be given to decrease inflammation, which is redness, pain, and swelling.

Treatments and procedures:

Percutaneous kidney biopsy:

A percutaneous kidney biopsy is when a very small piece of your kidney is taken out and tested. For this procedure, you will need to lie face-down and hold very still. You may get medicine to help you relax before the biopsy. You may also get medicine to make the area numb (lose feeling) before the needle is put in. Caregivers put a needle into your back and through to your kidney. The needle has a sharp edge that will cut out a tiny piece of your kidney. The needle may have to be put in two or more times. After the needle is taken out, a bandage will be put over the area.

Cystoscopy:

A cystoscopy allows caregivers to look for problems inside your bladder. A cystoscope is put into your bladder through your urethra. The urethra is the tube that urine flows through when you urinate. The cystoscope is a long tube with a lens and a light on the end. The scope may be hooked to a camera or monitor, and pictures may be taken. A tissue sample may also be taken during your cystoscopy. During this test, small tumors may be removed or bleeding may be stopped.

Lithotripsy:

During lithotripsy, shock waves are used to break apart stones in your kidney. You may be placed in a water bath or on a water-filled cushion. You may be given medicine to make you drowsy before the procedure. Shock waves are sent through the water and toward the stone or stones. The stones may break apart when the shock waves hit them. Pieces of the stones may then pass out of your body when you use the toilet.

Plasma exchange:

This treatment may be used if you have glomerulonephritis that is getting worse. It removes unhealthy antibodies from your blood. Ask caregivers for more information about this treatment.

Surgery:

Surgery may be done to repair an injured organ. Bleeding from blood vessels may be stopped by applying heat or closing them with sutures. A ureter that is cut into two may have its ends reattached. All or part of an injured kidney, ureter, or bladder may need to be removed. Surgery to remove tumors or lumps in the kidney or bladder may be done to treat acute hematuria.

What can I do to prevent or treat my acute hematuria?

Avoid being around certain substances or chemicals. Working around leather, rubber, benzene or dyes may lead to hematuria from bladder cancer. Ask caregivers what to do if you work with any of these.

Avoid going to high altitude places. High altitude places have less oxygen in the air. If you have sickle-cell trait, avoid places such as mountains to help prevent kidney damage.

Drink more fluids. If you have sickle-cell trait, drink enough liquid to prevent dehydration (losing too much body fluid). Drinking more may also help prevent stones from forming in your kidneys or bladder. Men 19 years old and older should drink about 3.0 Liters of liquid each day (close to 13 eight-ounce cups). Women 19 years old and older should drink about 2.2 Liters of liquid each day (close to 9 eight-ounce cups). Ask your caregivers to tell you how much fluid you need to drink, and what fluids are best for you.

If you use pain medicine too much and too often, tell your caregiver. Abusing pain medicine can lead to urinary tract cancer, or make the cancer come back. Get help controlling your use of pain medicine.

Stop smoking. Smoking increases your risk of cancer of the urinary tract. It also harms your heart and lungs.

Will I need appointments with other caregivers?

Children who have family members with kidney failure, glomerulonephritis, or other diseases need to see a nephrologist. If you can often see blood in your urine, and you have other signs and symptoms, you need to see a nephrologist. He may collect a biopsy (sample) from your kidney. Older adults (50 years of age and over) with blood that can be seen in their urine may need to see a urologist and have a cystoscopy done. During a cystoscopy, a scope is inserted into the urethra and bladder to look at it. Children may need an appointment with a urologist if they have problems with how their urinary system is formed. This is also true if they have stones or tumors. You may need to see a caregiver that is trained in genetic diseases. This caregiver may ask you for information about your family's medical history.

What should I expect with time or treatment?

If you have hematuria without other signs and symptoms you may not need to stay in the hospital. Antibiotic medicine may be needed to treat urinary tract infections and prevent hematuria. You will need to stay in the hospital if your condition worsens, you have a large amount of bleeding, or your kidneys stop working well or at all. You may need surgery or medicine given through an intravenous (IV) tube placed in your vein. You may need to use medicine for a long time if you have certain types of kidney stones. Certain kidney diseases may get worse over time. Children with kidney disease and high blood pressure may need treatment for a long time.

Call your caregiver if you have any of the following:

Small amounts of blood in your urine, skin rashes, and pain or swelling in your joints.

Pain and difficulty passing urine.

Passing blood clots, stones, or tissue while urinating.

Questions or concerns about your acute hematuria, treatment, or care.

Seek immediate help by calling 911 if you have any of the following:

Passing large amounts of fresh blood out with your urine.

Edema (swelling) in your arms or legs, pain and tenderness in the abdomen, and weight loss or gain.

Coughing up fresh blood or blood in your sputum (spit).

Blood in your urine after an injury, such as a fall.