Red Urine: Possible Causes and What They Mean

Red or pink urine looks alarming, and it is normal to be concerned in such a situation. Blood in the urine is called hematuria: sometimes it is visible to the eye, sometimes it is noticeable only in a test under a microscope. In most cases it is not something fatal, but you should definitely get it checked, even if there is very little blood or you are not sure it is blood.

Why urine becomes red or pink

Blood can get into the urine from any part of the urinary tract: from the bladder, the kidneys, or the urethra — the tube through which urine exits the body. Urine can be bright pink, red, or dark brown. The cause cannot be determined by the shade. Red color is not only caused by blood: some foods and medications do this, and in women blood may come from the vagina rather than the bladder.

Blood in the urine: main causes

Possible causes include urinary tract infection, kidney or bladder stones, inflammation (glomerulonephritis), injury to the kidney or bladder, polycystic kidney disease, bladder or kidney cancer, and prostate tumor. There can also be systemic causes: blood clotting disorders such as hemophilia, use of blood-thinning medications, thrombocytopenia, sickle cell disease. In children, blood in the urine often appears after streptococcal tonsillitis. Blood can get into the urine after catheterization, surgery, or a kidney biopsy.

When foods and medications change the color of urine

False hematuria is reddening of the urine without blood. Beets, rhubarb, and large amounts of berries give a pink shade. Some new medications color the urine red or brown. In such a case, a test strip will not distinguish red blood cells from hemoglobin.

• Beets, rhubarb, berries — pink color
• Some medications — red or brown color
• Menstruation or vaginal bleeding in women
• Blood from the rectum rather than the bladder

Red urine in women and men: specific features

In women, blood in the urine is often confused with menstrual or vaginal blood. If blood comes from the vagina between periods, it may not be blood in the urine; pain during intercourse and heavy periods may also be related to the reproductive system. In men over 50, blood in the urine is often accompanied by difficulty urinating, frequent urges, and getting up at night to urinate — this can occur with an enlarged prostate. Sometimes in men blood gets into the urine during ejaculation due to a prostate problem.

Which tests help determine the cause

The doctor will ask when the blood first appeared, what color it is, whether there is pain, odor, frequent urges, and what medications you take. A rectal or vaginal examination may be needed. Next — urinalysis, urine culture, complete blood count with platelets, creatinine, abdominal ultrasound, CT, cystoscopy, sometimes a kidney biopsy and tests for clotting disorders. Treatment depends on the cause found.

When red urine requires urgent medical attention

Red urine by itself is not a reason to call an ambulance. But if you see blood in your urine, you need to see a doctor as soon as possible, even if the amount is small. Do not self-diagnose.

Call 103 or 112 if, with red urine, there is fever, nausea, vomiting, chills, pain in the abdomen, side, or back, if you cannot urinate, or if blood clots are passed in the urine.

Red urine is a symptom, not a diagnosis. This material is for reference and does not replace a doctor's consultation: the color of urine is assessed by a specialist together with test results.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer