Hematuria vs. Hemoglobinuria: Key Differences & Treatment
Blood in urine may be an alarming sign of an underlying health problem. Nevertheless, it is important to differentiate hematuria from hemoglobinuria due to their differing etiologies and diagnostic and therapeutic implications. In this guide, you will learn some important differences, symptoms, diagnosis, and treatment for both conditions.
What is Hematuria?
Hematuria is the urinary excretion of red blood cells (RBCs). It is commonly divided into two categories:
- Microscopic Hematuria – No visible blood that can only be detected with a urinalysis.
- Gross Hematuria – Blood is present in the urine and can be red or brownish.
Causes of Hematuria
- Urinary tract infections (UTIs)
- Kidney stones
- Bladder cancer
- Glomerular disease
- Autoimmune disorders
- Trauma or strenuous exercise
Symptoms of Hematuria
- Urine that is pink, red or cola-coloured
- Frequent urination
- Pain or burning when urinating
- Pain in the abdomen or back (depending on the cause)
What is Hemoglobinuria?
Hemoglobinuria occurs when plasma-free haemoglobin is present in the urine due to hemolysis (the breakdown of red blood cells). Unlike hematuria, hemoglobinuria does not contain intact red blood cells.
Hemoglobinuria is the presence of free haemoglobin in the urine, usually occurring as a result of hemolysis (breakdown of red blood cells) in the plasma. Hemoglobinuria does not contain intact red blood cells, unlike hematuria.
Causes of Hemoglobinuria
- Intravascular hemolysis
- Autoimmune disorders
- Liver dysfunction
- Oxidative stress due to infections or toxins
- Severe burns or transfusion reactions
Symptoms of Hemoglobinuria
- Dark, reddish-brown urine
- Fatigue and weakness
- Pale or yellowing of the skin (due to anaemia)
- Shortness of breath
Hematuria vs. Hemoglobinuria Diagnosis
Proper treatment depends on accurate diagnosis. The following differentiating tests is used by doctors to distinguish hematuria from hemoglobinuria:
- Urinalysis – Finding of red blood cells in hematuria, free haemoglobin in hemoglobinuria.
- Centrifuged urine sample – Hematuria will display settled RBCs, whereas the overlying fluid will still be red in hemoglobinuria.
- Blood tests — Help identify signs of hemolysis (decreased RBC count, increased bilirubin and lactate dehydrogenase levels).
- Kidney function tests –Evaluate possible underlying kidney or glomerular diseases.
Treatment for Hematuria and Hemoglobinuria
Treatment varies depending on what is driving each condition:
Hematuria Treatment
- UTIs: Antibiotics to eliminate infection
- Kidney stones: Keep you hydrated, control the pain, or remove it through surgery
- Bladder cancer: Chemotherapy, radiation or surgery
- Glomerular disease: Drugs to suppress inflammation and immune reaction
Hemoglobinuria Treatment
- Hemolysis management: Corticosteroids or immunosuppressive therapy
- Blood transfusions (in case of severe anaemia)
- Avoidance of triggering factors, such as certain drugs or infections
- Plasmapheresis in severe cases of autoimmune hemolysis
Conclusion
Understanding the difference between hematuria and hemoglobinuria is vital for early detection and proper treatment. If you develop symptoms of blood in your urine, see a doctor as early as possible to have it evaluated and appropriately managed.
By being educated about urinary health, you can take constructive steps to safeguard your kidneys and general health. If you find this guide helpful, then please share it with those who might benefit!