Hematuria causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Steven C. Campbell, M.D., Ph.D. Kiran Singh, M.D. [2] Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [3]


Causes of hematuria can range from benign conditions such as urinary tract infection to serious conditions such as bladder cancer.[1] Extrarenal site is responsible for more than 60% of cases of hematuria. Of these, the most important underlying disease is malignancy. In the primary care population, about 5% of patients with microscopic hematuria will have a urinary tract malignancy, mainly of the bladder or prostate. The most common nonmalignant causes of extrarenal hematuria are infections, such as cystitis, prostatitis, and urethritis.Regarding renal causes of microscopic hematuria, the most common cause of isolated glomerular hematuria (without significant proteinuria) is IgA nephropathy, followed by thin basement membrane disease, hereditary nephritis (Alport syndrome), and mild focal glomerulonephritis of other causes.


Life Threatening Causes

Common Causes

Children[2] Age <50 years[3] Age >50 years[3]

Causes by Organ System [4] [5] [6]

Cardiovascular Arteriosclerosis, arteriovenous malformations, endocarditis, cholesterol embolism, heart failure, hypertension, malignant hypertension, shock
Chemical / poisoning
Dermatologic Hereditary hemorrhagic telangiectasis, lupus, Osler's disease, systemic lupus erythematosus, urethral carbuncle
Drug Side Effect Artemether and lumefantrin, beractant, BCG vaccine, bicalutamide, caspofungin acetate, cefpodoxime, cobimetinib, cyclophosphamide,dicoumarol, ethacrynic acid, febuxostat, felbamate, flurbiprofen, gemcitabine, goserelin, hexaminolevulinate, Ibrutinib, Indinavir, Ifosfamide, Ioxilan, leuprolide, methenamine, micafungin, mitotane, olsalazine, Oxcarbazepine, Oxaprozin penicillamine, phenprocoumon, Pramipexole, probenecid, sodium aurothiomalate, sulfasalazine, tiagabine, tolmetin, tiaprofenic acid, warfarin
Ear Nose Throat Hereditary hemorrhagic telangiectasis, mononucleosis, Osler's disease
Endocrine Diabetes mellitus, diabetic glomerulosclerosis, diabetic nephropathy, porphyria
Gastroenterologic Hepatitis B, porphyria
Genetic Alport syndrome, Berger's disease, Fabry disease, Dent's disease, hemoglobinopathy, hemophilia, IgA nephropathy nail-patella syndrome, Nephrolithiasis type 2Osler's disease, paroxysmal nocturnal haemoglobinuria, polycystic kidney disease, thalassemia,renal arteriovenous malformation, thalassemia
Hematologic Cold agglutinins, March haemoglobinuria, hemoglobinopathy, hemophilia, hemolytic uremic syndrome, Henoch schonlein purpura, hereditary hemorrhagic telangiectasis, multiple myeloma, paroxysmal cold haemoglobinuria, paroxysmal nocturnal haemoglobinuria, polycythemia vera, porphyria, sickle cell anemia, thalassemia, thrombocytopeniathrombotic thrombocytopenic purpura
Infectious Disease Acute cystitis, acute interstitial nephritis, acute prostatitis, adenovirus, bilharziosis, bladder tuberculosis, chronic cystitis, cystitis, cytomegalovirus, dengue, Dent's disease, E.coli, ECHO viruses endocarditis, filaria, hepatitis B, Influenza, legionella infection, legionella pneumophila, malaria, micafungin mononucleosis, mycoplasma, nephritis, postinfectious glomerulonephritis, prostate tuberculosis, prostatitis pyelonephritis, radiation cystitis, renal tuberculosis, salmonellaschistosomiasis, toxoplasma, trichinella spiralis, tuberculosis, urethritis, vasculitis, pseudomonas, renal tuberculosis, salmonella, schistosomiasis, torulopsis, toxoplasma, trichinella spiralis, tuberculosis, ureter tuberculosis, urethritis, urinary tract infection. urogential tuberculosis
Musculoskeletal / Ortho Pelvic fracture
Neurologic Arteriosclerosis, arteriovenous malformations, hereditary hemorrhagic telangiectasis, Osler's disease
Nutritional / Metabolic Diabetes mellitus Fabry disease
Obstetric/Gynecologic Endometriosis
Oncologic Angiomyolipoma, bladder cancer, hypernephroma, multiple myeloma, polycythemia vera, prostate adenoma, prostate cancer, renal adenocarcinoma, renal angiomyolipoma, renal arteriovenous malformation, renal pelvis carcinoma, ureter carcinoma, urethra carcinoma, urothelium carcinoma, Wilms' tumor
Overdose / Toxicity
Pulmonary Allergic granulomatosis, sarcoidosis, Wegener's granulomatosis
Renal / Electrolyte Acute cystitis, acute interstitial nephritis Alport syndrome, analgesic nephropathy, Balkan nephropathy, beeturia benign familial hematuria, Berger's disease, calyx diverticulum, cholesterol embolism, chronic cystitis, crescentic glomerulonephritis, cystitis, dense deposit disease, Dent's disease, diabetic glomerulosclerosis, diabetic nephropathy, focal glomerulotnephritis, glomerulonephritis, fibronectin glomerulopathy, hemolytic uremic syndrome, Henoch schonlein purpura, hydronephrosis hypernephroma, IgA nephropathy, Interstitial cystitis, kidney amyloidosis, Loin pain hematuria syndrome,lupus, medullary sponge kidney, membranoproliferative glomerulonephritis, mesangiocapillary glomerulonephritis type iii nephrocalcinosis, nephrolithiasis, nutcracker syndrome, papillary necrosis, polycystic kidney disease, postinfectious glomerulonephritis, post-streptococcal glomerulonephritis, proteinuria, pyelonephritis, radiation nephropathy, renal adenocarcinoma, renal angiomyolipoma, renal artery aneurysm, renal cell carcinoma, renal cyst, renal hyperplasia, renal infarct, renal metastases, renal oncocytoma, renal oncocytoma, renal pelvis carcinoma, renal trauma, renal tuberculosis, renal vein infarct, renal vein thrombosis, shunt nephritis, sponge kidney, systemic lupus erythematosus, thin basement membrane disease, tubulointerstitial nephropathies, urate nephropathy,ureter carcinoma, ureter tuberculosis, urinary tract infection, vesico-ureteral-renal reflux, Wegener's granulomatosis, Wilms' tumor
Rheum / Immune / Allergy Allergic granulomatosis, Cd59 antigen deficiency, Cold agglutinins, dermatosclerosis, Henoch schonlein purpura, microscopic polyangiitis, polyarteritis nodosa, sarcoidosis, systemic lupus erythematosus, Wegener's granulomatosis
Trauma Pelvic fracture
Urologic Acute prostatitis, beeturia, benign prostatic hyperplasia, bladder cancer, bladder tuberculosis Dent's disease, foreign body in urethra, hemorrhage from bladder outlet, hemorrhage from urethra hydronephrosis, interstitial cystitis, Loin pain hematuria syndrome, malignancies of the bladder, meatus stenosis, megaureter, polycystic kidney disease, prostate adenoma, prostate cancer, prostate hyperplasia, prostate tuberculosis, prostatectomy, radiation cystitis, urethra carcinoma, urethral carbuncle, urethritis, urinary stones, urinary tract infection, urogential tuberculosis, urolithiasis, urothelium carcinoma
Miscellaneous Dioctophyma renale, exercise, fistula, foods, Inflammation, infundibulopelvic dysgenesis, Injury, masturbation myoglobinuria, toxins, trauma, tumor, urethral catheterization, urinary catheterization

Causes in Alphabetical Order [7][8][9][10]

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Causes of Microscopic Hematuria

Causes by Anatomic Location

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  1. Rew, Karl (2010). Primary care urology. Philadelphia, Pa. London: Saunders. ISBN 978-1437724899.
  2. Amin, Nimisha; Zaritsky, Joshua J. (2011). "Hematuria": 258–261. doi:10.1016/B978-0-323-05405-8.00069-3.
  3. 3.0 3.1 "www.surgeryjournal.co.uk".
  4. Varma PP, Sengupta P, Nair RK (June 2014). "Post exertional hematuria". Ren Fail. 36 (5): 701–3. doi:10.3109/0886022X.2014.890011. PMID 24865509.
  5. Fiore DC, Fox CL (January 2014). "Urology and nephrology update: proteinuria and hematuria". FP Essent. 416: 11–21. PMID 24432706.
  6. Hotta M (July 2014). "[Diagnosis of hematuria from red blood cells in urinary sediment]". Rinsho Byori (in Japanese). 62 (7): 674–83. PMID 25669037.
  7. Avellino GJ, Bose S, Wang DS (June 2016). "Diagnosis and Management of Hematuria". Surg. Clin. North Am. 96 (3): 503–15. doi:10.1016/j.suc.2016.02.007. PMID 27261791.
  8. Sokolosky MC (August 2001). "Hematuria". Emerg. Med. Clin. North Am. 19 (3): 621–32. PMID 11554278.
  9. Silverman JA, Patel K, Hotston M (July 2016). "Tuberculosis, a rare cause of haematuria". BMJ Case Rep. 2016. doi:10.1136/bcr-2016-216428. PMID 27440856.
  10. Ogunjimi MA, Adetayo FO, Tijani KH, Jeje EA, Ogo CN, Osegbe DN (March 2011). "Gross haematuria among adult Nigerians: current trend". Niger Postgrad Med J. 18 (1): 30–3. PMID 21445110.

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