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Blood Clots in Urine

Blood Clots in Urine

Most of the time, blood clots in urine signifies infection of the urinary tract and kidney stones. Find out more information on what causes blood in urine, and the associated symptoms and treatment for this condition.
Chandramita Bora
Last Updated: Apr 23, 2018
The presence of blood clots in urine can be an indicator of several health conditions, some of which can be quite serious. The medical term used for the presence of blood in the urine is hematuria or haematuria. Hematuria can be of two types, microscopic and macroscopic hematuria, depending on whether blood in the urine can be seen with the naked eye.
So, If you can see blood in urine and the color of the urine also changes from pale yellow to pink, red or brown, then it is macroscopic hematuria, which is also known as gross hematuria. On the other hand, in case of microscopic hematuria, only a small amount of blood can be found in the urine, for which it does not cause any change in urine coloration. As a result, the presence of blood cells in urine can be detected only through a microscope.
What Causes Blood Clots in Urine?
There can be numerous factors that can cause hematuria. But sometimes, the urine may turn red or brown not because of the presence of blood cells, but due to the consumption of certain dark-colored foods, like beets, rhubarb, and berries, which of course is not a cause of concern. Similarly, intake of some medications, such as phenazopyridine can also change the color of the urine.
Some women may mistake vaginal bleeding for blood in urine. Similarly, men may also mistake bloody ejaculation, which is associated with prostate problems, for blood in urine. So, all these factors need to be taken into account, before coming to the conclusion that changes in urine coloration is caused by the presence of blood clots. However, there are several health conditions, in which blood cells can leak into the urine to change its color, some of which are explained below.
Infection of the Urinary Tract
Infections, most commonly infection of the urinary tract can cause the presence of blood in urine. Infection of the urinary tract is one of the most common causes of hematuria, and is more prevalent among women. It is usually caused by bacterial growth in the urethra and the urinary bladder. Sometimes, infection present in the urethra or bladder can travel up and spread to the kidneys as well. Along with the presence of blood in the urine, urinary tract infection can produce the following symptoms
  • A burning sensation while urinating
  • Frequent urge to urinate
  • Cloudy or murky urine
  • Pain in the flank and upper back region
  • Fever
  • Pain or discomfort in the lower abdomen
  • Bad-smelling urine
Kidney Stones
Stone-like deposits can form in the kidneys, due to the crystallization of calcium and other compounds, like oxalates and uric acid, present in the urine. This usually happens when the urine becomes highly concentrated with these compounds. Kidney stones produce symptoms only when the stones move around or pass into the ureter. The most common symptoms of kidney stones are
  • Pain below the ribs, towards the side and back
  • Pain in the lower abdomen and groin
  • Painful urination
  • Cloudy urine with a foul smell
  • Frequent urge to urinate
  • Red, brown, or pink urine
  • Nausea and vomiting
  • Fever (if infection is present)
Kidney Disease
Kidney diseases can impair the filtering capacity of the kidneys by attacking the nephrons, which in turn can allow blood cells to leak into the urine. Chronic kidney disease can be a complication of systemic diseases, like diabetes and hypertension. Apart from causing hematuria, kidney diseases can produce the following symptoms
  • Swelling of the ankles, feet, and hands
  • Nausea and vomiting
  • Increased fatigue and tiredness
  • Changes in urine output
  • Chest pain and shortness of breath (when fluid accumulates in the lungs)
  • Loss of appetite
Prostate Enlargement
Passing blood clots in the urine can be associated with the enlargement of prostate gland. What causes enlargement of this gland is not known with certainty, though it has been observed that the risk for developing this condition increases with age. Enlargement of the gland compresses the urethra, which can block the flow of urine. Prostate enlargement can cause hematuria, along with the following symptoms
  • Incomplete emptying of the bladder
  • Difficulty in urinating
  • Persistent urge to urinate frequently
  • Incontinence
Cancer
Sometimes, blood in urine can be a sign of cancer of the bladder, kidneys or the prostate gland. Tumors of the urinary bladder and kidneys can also cause hematuria. However, there may not be any other symptom in the early stages of these cancers. Sometimes, frequent and painful urination, and persistent back and pelvic pain, and weight loss, may be present in cancer of the bladder and kidneys.
Sickle Cell Anemia
It is an inherited condition, characterized by the production of abnormal red blood cells, that cannot carry oxygen to the cells effectively. The condition can cause both microscopic and macroscopic hematuria. In addition to these, this inherited condition can cause
  • Anemia
  • Periodic episodes of pain
  • Frequent infections
  • Swollen hands and feet
  • Fever
  • Delayed growth in children
Strenuous Exercise
Macroscopic hematuria can be caused by intense workouts, though the exact reason behind it is not clearly understood. It has been observed that it is more prevalent among the runners. Factors like, dehydration, trauma to the bladder, and the breakdown of red blood cells during aerobic exercises, are believed to be associated with hematuria, experienced after doing strenuous exercise.
Other Possible Causes
Sometimes, injury to the urinary tract and the kidneys can cause blood to appear in the urine. Benign familial hematuria or basement membrane disease, is another condition that can cause hematuria. This condition is characterized by thin basement membrane of the glomeruli in the kidney, though the kidneys can function normally. It is a rare disease, that usually runs in families. Apart from these, certain medications, especially aspirin, penicillin, heparin, and the anti-cancer drug cyclophosphamide, may cause the presence of blood in the urine.

Diagnosis and Treatment
A number of diagnostic tests can be required for determining the exact cause of hematuria. Physicians usually start diagnosis with a detailed analysis of the symptoms and the medical history of the patient. So, an elaborate study is carried out regarding whether the patient is experiencing pain while urinating, the shape and the size of the blood clots, and time pattern or at what time during urination the clots appear, i.e. whether they appear at the beginning, at the end or throughout the entire stream. The diagnostic tests that are carried out include, blood test, urinalysis, urine culture, ultrasound of the abdomen and renal tract, CT scan, cystoscopy and X-ray. Biopsy is also performed to look for bladder cancer.
Treatment for hematuria, depends on the underlying causes. If it is found to be caused by urinary tract infection, then antibiotics are recommended to cure the problem. However, factors other than infection would require different treatment options. As for example, if it is caused by kidney stones, then depending on their size and location, medical or surgical treatment can be required. Similarly, enlargement of the prostate gland can also require medical or surgical treatment.
So, if you observe red or pink urine, first consider what foods and medications you have taken recently, or whether you are doing any strenuous exercise. If you are sure that the change in urine coloration is not associated with these factors, then consider consulting your health care provider, in order to find out the actual causes. This can ensure early diagnosis and prompt treatment, if this condition is associated with any medical condition.
Disclaimer: This article is for informative purposes only, and should not be treated as a substitute for professional medical advice.