Differential Diagnosis for Blood in Urine with No UTI

Single Most Likely Diagnosis

• Kidney Stones: This is a common cause of hematuria (blood in urine) without a urinary tract infection (UTI). The stones can cause irritation and bleeding in the urinary tract.

Other Likely Diagnoses

• Benign Prostatic Hyperplasia (BPH): Enlargement of the prostate gland can cause bleeding due to the increased pressure on the urethra and bladder.
• Bladder Cancer: Although less common, bladder cancer can present with painless hematuria and should be considered, especially in older adults or those with a history of smoking.
• Kidney Cancer: Similar to bladder cancer, kidney cancer can cause hematuria without an accompanying UTI.

Do Not Miss Diagnoses

• Trauma: Any form of trauma to the abdomen or back can cause internal injuries leading to hematuria. This is critical to identify as it may require immediate surgical intervention.
• Sickle Cell Disease or Trait: Individuals with sickle cell disease or trait are at an increased risk of developing kidney damage and subsequent hematuria due to the sickling of red blood cells within the kidneys.
• Vasculitis: Conditions like IgA vasculitis can cause kidney inflammation and bleeding, presenting as hematuria.

Rare Diagnoses

• Alport Syndrome: A genetic disorder affecting the type IV collagen in the kidneys, leading to chronic kidney disease and hematuria.
• Goodpasture Syndrome: An autoimmune disease causing inflammation in the kidneys and lungs, which can present with hematuria.
• Nephrocalcinosis: A condition characterized by the deposition of calcium salts within the kidneys, potentially causing hematuria due to the damage to renal tissue.

Each of these diagnoses has a different set of implications for patient management and outcomes, emphasizing the importance of a thorough diagnostic workup for hematuria without UTI.