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About Hematuria

Hematuria is referred to a condition where there is the presence of red blood cells (erythrocytes) in the urine. The bleeding may occur just once or it may be recurrent.

Normally the urine is yellow in color due to the presence of a pigment called urobilirubin. This pigment results from the breakdown of hemoglobin, the oxygen-carrying protein of the red blood cells.

In some cases, a large number of red blood cells may be present but they are visible only when viewed under a microscope (called microscopic hematuria) while in other cases the blood is clearly visible to the naked eye due to the red or a reddish brown color of the urine.

The quantity of blood in the urine is not a correct indication of the gravity of the underlying problem. 

Whatever the type or nature of the condition, hematuria could be an indication of bleeding in the urinary system which includes  the kidneys, ureters (the tubes that transport urine from the kidneys to the bladder), bladder, urethra (the tube that  transports urine out of the bladder) and the prostate gland.  

It must be noted that there may be different reasons for  urine to take on red color. If the red color in the urine is caused by any other factor besides RBCs then the condition is referred to as ‘pseudohematuria.’ The presence of pigments like hemoglobin, porphyrin, myoglobin or betanin (after eating beetroot), eating berries, food coloring or rhubarb or taking  medications such as anti-psychotic - chlorpromazine ,certain laxatives and  certain tranquilizers can impart a red/pink  tinge to urine..

Poisoning due to lead or mercury can cause urine to turn red due to excess amount of porphyrin in the urine.

An infection could be suspected if white blood cells (WBCs)  are found along with the RBCs.

Hematuria often indicates different problems in men and women and occurs at a frequency of 10% in the general population.

Remember drugs can not only cause urine to look red but sometimes even orange, green or black. These are some of the common drugs that can alter the color of urine –

Drugs making Urine Orange –

• Pyridium or  phenazopyridine use in urine infections

• Rifampin – used to treat tubeculsis

• Vitamin B supplementns.

Drugs making urine Black -

• Methyldopa or Aldomet  - used to treat blood pressure.

Drugs making urine Blue or Green -

• Methylene blue dye.

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