Hematuria causes

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

For causes of Microscopic Hematuria, click here

Causes

Life Threatening Causes

• Intraperitoneal bladder rupture

• Ureteroarterial fistula

• Hemorrhagic cystitis

• Heart failure

• Malignant hypertension

• Shock

Common Causes

Children	Age <50 years	Age >50 years
Urinary tract infection Benign familial hematuria or Thin basement membrane disease IgA nephropathy Idiopathic hypercalciuria Transient unexplained	Urinary tract infection Transient unexplained Stones Exercise Trauma Polycystic kidney disease	Urinary tract infection Transient unexplained Stones Benign prostatic hyperplasia Bladder cancer Renal carcinoma Prostate cancer

Causes by Organ System

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
Environmental
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
Iatrogenic
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
Opthalmologic
Overdose / Toxicity
Psychiatric
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
Sexual
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

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Differential Diagnosis

CATEGORY	EXAMPLES	COMMON CLINICAL PRESENTATION AND RISK FACTORS
Neoplasm	Any	Male gender, Age older than 35 years, Past or current smoking history, Occupational or other exposure to chemicals or dyes (benzenes or aromatic amines), Analgesic abuse, History of gross hematuria, History of urologic disorder or disease, History of Irritative voiding symptoms, History of pelvic irradiation, History of chronic urinary tract infection, Exposure to known carcinogenic agents or chemotherapy such as alkylating agents, History of chronic indwelling foreign body
	Bladder cancer	Older age, male predominance, tobacco, occupational exposures, Irritative voiding symptoms
	Ureteral or renal pelvis cancer	Family history of early colon cancers or upper tract tumors, flank pain
	Renal cortical tumor	Family history of early kidney tumors, flank pain, flank mass
	Prostate cancer	Older age, family history, African-American
	Urethral cancer	Obstructive symptoms, pain, bloody discharge
Infection/inflammation	Any	History of infection
	Cystitis	Female predominance, dysuria
	Pyelonephritis	Fever, flank pain, diabetes, female predominance
	Urethritis	Exposure to sexually transmitted infections, urethral discharge, dysuria
	Tuberculosis	Travel to endemic areas
	Schistosomiasis	Travel to endemic areas
Calculus	Nephroureterolithiasis	Flank pain, family history, prior stone
	Bladder stones	Bladder outlet obstruction
Prostatic cause	Benign prostatic enlargement	Male, older age, obstructive symptoms
Medical renal disease	Any	Hypertension, azotemia, dysmorphic erythrocytes, cellular casts, proteinuria
	IgA nephropathy	Upper respiratory tract infection, gastroenteritis, synchronous association of pharyngitis, children
Congenital or acquired anatomic abnormality	Polycystic kidney disease	Family history of renal cystic disease
	Uretero-pelvic junction obstruction	History of UTI, stone, flank pain
	Ureteral stricture	History of surgery or radiation, flank pain, hydronephrosis; stranguria, spraying urine
	Urethral diverticulum	Discharge, dribbling, dyspareunia, history of UTI, female predominance
	Fistula	Pneumaturia, Fecaluria, abdominal pain, recurrent UTI, history of diverticulitis or colon cancer
Other	Exercise-induced hematuria	Recent vigorous exercise
	Endometriosis	Cyclic hematuria in a menstruating woman
	Hematologic or thrombotic disease	Family history of personal history of bleeding or thrombosis
	Papillary necrosis	African-American, sickle cell disease, diabetes, analgesic abuse
	Interstitial cystitis	Voiding symptoms