What is Microscopic Hematuria?

Urine that contains blood, known as hematuria, generally possesses a reddish or brownish tinge that is easily identifiable. In some cases, blood may be passed in urine without the tell-tale discoloration, a condition known as a microscopic hematuria. Frequently manifesting in the presence a secondary condition, treatment for a microscopic hematuria is centered on remedying the underlying cause of the bleeding. Since individuals with a microscopic hematuria are generally unaware of their condition because they remain asymptomatic, meaning they exhibit no symptoms, the condition is often detected during the administration of a routine urine analysis.

Resulting from the introduction of red blood cells into the urine as it passes through the urinary tract, this generally painless condition often prompts additional testing following its initial discovery. The continued presence of microscopic traces of blood in one's urine during subsequent urinalyses may necessitate the administration of imaging testing, such as magnetic resonance imaging (MRI) and an ultrasound, to evaluate the condition of the urinary tract. Blood tests may also be administered to check for markers indicative of impaired kidney function. Additional testing is often necessary to not only determine the cause of the bleeding, but to rule out other conditions that may induce the passage of urinary blood.

A microscopic hematuria generally presents with an urinary tract infection (UTI), such as one affecting the bladder or kidneys, and may be diagnosed through the administration of a urine analysis. Certain conditions affecting the kidneys, such as vesicoureteral reflux, polycystic kidney disease, and kidney stones, that present with painful urination, pronounced inflammation, or the passage of mineral deposits may also trigger urinary blood. Sometimes, this hematuric presentation may manifest as an idiopathic condition, meaning there is no obvious reason for its occurrence.

Proactive measures may be taken to lessen one’s risk for developing a microscopic hematuria. In most cases, an UTI may be prevented with proper personal hygiene, the daily consumption of plenty of water, and emptying one’s bladder promptly when the urge occurs. Drinking sufficient amounts of water serves to help prevent the formation of kidney stones, as well as to rid the body of unnecessary bacteria that may foster the development of infection. Additionally, adopting dietary changes, such as limiting one’s sodium intake, may also serve to reduce one’s risk for developing a hematuria.

The treatment utilized to remedy this type of hematuria is entirely dependent on the cause of the bleeding. The most common treatment employed for a UTI–induced microscopic hematuria is the administration of an antibiotic and subsequent urinalysis to assess whether the individual is still passing blood. The presence of a microscopic hematuria triggered by the presence of kidney stones generally requires no treatment unless the individual does not pass the stones naturally, in which case surgery may be performed. Depending on the cause, impaired kidney function presenting with a microscopic hematuria often requires extensive treatment to alleviate inflammation and prevent complications.