Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).
- Alport syndrome (also called progressive hereditary nephritis) – genetic disorder with both autosomal dominant and autosomal recessive inheritance with malformed collagen fibers that can lead to nephritis (inflammation of the kidneys) with progressive renal failure (kidney weakness), sensorineural hearing loss, and various eye diseases such as a cataract (cataract)
- Malformations of the urinary tract
Blood, blood-forming organs – immune system (D50-D90).
- Disseminated intravascular coagulation – acquired blood clotting disorders due to excessive consumption of clotting factors and platelets (thrombocytes).
- Hemophilia (bleeding disorder)
- Paroxysmal nocturnal hemoglobinuria (PNH) – acquired disease of the hematopoietic stem cell caused by a mutation of the phosphatidyl inositol glycan (PIG) A gene; characterized by hemolytic anemia (anemia due to disintegration of red blood cells), thrombophilia (tendency to thrombosis) and pancytopenia, ie. i.e. a deficiency in all three cell series (tricytopenia) of hematopoiesis, i.e. a leukocytopenia (reduction of white blood cells), anemia and thrombocytopenia (reduction of platelets), is characterized.
- Sickle cell anemia (med: drepanocytosis; also sickle cell anemia, English : sickle cell anemia) – genetic disease with autosomal recessive inheritance affecting erythrocytes (red blood cells); it belongs to the group of hemoglobinopathies (disorders of hemoglobin; formation of an irregular hemoglobin called sickle cell hemoglobin, HbS).
- Thrombocytopenia – too few platelets in the blood.
Endocrine, nutritional and metabolic disorders (E00-E90).
Cardiovascular system (I00-I99)
- Hypertension (high blood pressure)
- Renal artery embolism – occlusion of a vessel supplying the kidney due to a detached blood clot.
- Renal artery thrombosis – occlusion of a vessel supplying the kidney.
- Subacute bacterial endocarditis (endocarditis of the heart).
- Vasculitis(vascular inflammation)
Infectious and parasitic diseases (A00-B99).
- Schistosomiasis – worm disease (tropical infectious disease) caused by trematodes (sucking worms) of the genus Schistosoma (couple flukes).
- Helminthiasis (worm diseases)
- Tuberculosis (consumption) (→ renal tuberculosis).
- Viral infections, unspecified
Musculoskeletal system and connective tissue (M00-M99).
- Systemic lupus erythematosus (SLE) – autoimmune disease that can occur in any organ and always affects the skin and blood vessels.
Neoplasms – tumor diseases (C00-D48).
- Urinary bladder carcinoma (bladder cancer); in more than 90% of cases, histologically there is urothelial carcinoma (transitional cell carcinoma), but in some cases it may be adenocarcinoma or squamous cell carcinoma (5%) – microhematuria (presence of blood in the urine (hematuria), which can be detected microscopically or by Sangur test using test strips) is indicative of this in 0.8% of GP patients aged 40-59 years and in 1.6% of patients aged 60 years and over; in the case of macrohematuria (visible blood in the urine), the risk of bladder cancer is 1.2% in younger patients and 2.8% in older patients
- Renal cell carcinoma (kidney cancer)
- Prostate carcinoma (prostate cancer)
- Urethra carcinoma (carcinoma of the urethra, urethral cancer) (extremely rare).
- Urothelial carcinoma of the upper urinary tract (upper tract urothelial carcinoma, UTUC).
Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).
- Benign prostatic hyperplasia – benign proliferation of the tissue of the prostate gland.
- Chronic interstitial cystitis (IC) – chronic, abacterial cystitis; pain syndrome associated with pollakiuria (urge to urinate frequently without increased urination) and urinary urgency.
- Endometriosis – occurrence of endometrium (lining of the uterus) outside the uterus, for example, in or on the ovaries (ovaries), tubes (fallopian tubes), urinary bladder or intestines.
- Glomerulonephritis – kidney disease with inflammation of the kidney filterlets (glomeruli).
- IgA nephropathy – disease of the kidney mediated by the immune system.
- Nephritis (inflammation of the kidney)
- Nephrolithiasis (kidney stones) – approximately 69.5% of asymptomatic microhematuria is due to urinary stone disease
- Nephrotic syndrome – collective term for symptoms that occur in various diseases of the glomerulus (renal corpuscles); proteinuria (increased excretion of protein with urine) with a protein loss of more than 1 g/m² KOF/d; hypoproteinemia, peripheral edema due to hypalbuminemia of < 2.5 g/dl in serum; hyperlipoproteinemia (lipid metabolism disorder).
- Papillary necrosis – inflammatory changes in the renal papillae with tissue death.
- Prostate varices – varicose veins on the prostate gland.
- Prostatitis – inflammation of the prostate gland.
- Pyelonephritis (inflammation of the renal pelvis).
- Thin basement membrane syndrome – affects the boundary layer between connective tissue and epithelium at the kidneys.
- Ureteral stone (ureteral stone)
- Urethritis (inflammation of the urethra)
- Urolithiasis (urinary stone disease) – approximately 69.5% of asymptomatic microhematuria is due to urinary stone disease
- Injuries to the urinary tract
- Cystic kidney disease (cystic kidney) – kidney changes with the formation of water-filled cavities.
- Cystitis (inflammation of the bladder)
Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).
- Parainfectious hematuria (short-term slight red coloration of the urine) – is harmless and does not reflect glomerulonephritis (kidney disease with inflammation of the kidney filterlets (glomeruli)).
Other differential diagnoses
- Menstruation (menstrual period)
- After physical exertion (intense jogging or intense marches → march hematuria); often occurs combined with marschalbuminuria; (protein excretion in urine as regulatory albuminuria after physical exertion) resolves after 24 to 72 hours
- Sitting cycling (immediate – acute) → macrohematuria (visible blood in the urine).
- Trauma (injuries)
Medication
- Antibiotics
- Penicillins
- Sulfonamides
- Anticoagulants – medications used to thin the blood such as heparin, phenprocoumon, warfarin (Coumadin) (approximately 46% of people over 60 are anticoagulated) → increased likelihood of developing macrohematuria (red coloration of urine to the naked eye)
- Macrohematuria at
- Vitamin K antagonists (VKA; warfarin): 26.7% probability.
- All other antithrombotics: <5% probability.
- Odds ratio (odds ratio; risk ratio) of hematuria:
- Warfarin to rivoraxaban was 33
- Warfarin to dabigatran was 16
- Antiplatelet agents cause 76 times less hematuria compared with anticoagulants. The odds of hematuria with acetylsalicylic acid (ASA) were 6.7 times with clopidogrel and 3.5 times with ticagrelor.
- Dabigatran was 198 times more likely to cause severe hematuria compared with warfarin, while clopidogrel was 1.2 times more likely to cause severe hematuria compared with ASA.
- Macrohematuria at
- Aspirin type drugs
- Cyclophosphamide (Cytoxan)
X-rays
- State after radiotherapy (Radiatio).
Diseases that can lead to hemoglobinuria
Hemolytic anemia – anemia caused by destruction of erythrocytes (red blood cells) – may be due to the following diseases/conditions.
- Blood transfusion incidents
- Gravidity (pregnancy)
- March hemoglobinuria – hemoglobinuria caused by heavy walking, (excretion of hemoglobin (red blood pigment) through the kidneys) without disease value.
- Malaria – tropical infectious disease transmitted by the Anopheles mosquito.
- Typhoid fever – infectious disease characterized by pea porridge-like diarrhea.
- Poisoning with carbolic acid or various fungi.
Other discolorations of the urine
- Discoloration of urine due to various foods such as blueberries or beet, taking various medications such as especially rifampicin (antibiotic) or in chronic lead poisoning.
