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Tuesday, August 4, 2015
My physician has found blood in my urine for a few months. I had an ultrasound for kidney stones but result was negative. What other problems do you think that I could have with my kidney? I am going to have a catscan next week. I also get bladder infections 2 times a year.
There are abnormalities of the kidney/ureter/bladder system that may predispose a person to bladder infections, and also cause tiny amounts of blood in the urine. These are often diagnosed by an IVP (intravenous pyelogram, a study in which dye is injected into a vein in the arm, circulates through the bloodstream, reaches the kidneys, is excreted in the urine, and gives a series of images that show details of the kidney, ureters, and bladder).
Depending upon your age and ethnic background, you could have some kidney damage due to “glomerulonephritis,” or injury to the tiny filters of your kidney. This is usually accompanied by protein in the urine; if your doctor suspects this type of disorder, blood tests and a kidney biopsy may be needed to make the diagnosis.
If you are older, you could have a tumor of the bladder or the kidneys – this can be diagnosed by an ultrasound, CT scan, or cystoscopy (direct fiberoptic examination of the bladder). If you are a man, your prostate gland could be responsible for the blood. If you are a woman, blood could be coming from the vagina, rather than the bladder or kidneys.
Be aware that, despite much testing, a cause of blood in the urine cannot be found in half or more of patients. In such cases, the patient should be reassured that there is no evidence of cancer or other serious disease. The urine can be rechecked periodically, but it is not considered necessary to repeat all the imaging tests and cystoscopy, for instance, unless something changes for the patient (for instance, the development of hypertension, decreased kidney function, or protein in the urine).
Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University