Differential Diagnosis for Urinating Straight Blood
- Single most likely diagnosis
- Kidney stones: This condition is a common cause of gross hematuria (visible blood in the urine), especially if the stones are large enough to cause significant irritation or blockage in the urinary tract.
- Other Likely diagnoses
- Urinary Tract Infection (UTI): While more commonly associated with dysuria (painful urination) and frequent urination, severe UTIs, especially those involving the kidneys (pyelonephritis), can cause hematuria.
- Bladder cancer: Although more common in older adults, bladder cancer can present with painless gross hematuria, making it a consideration in the differential diagnosis.
- Prostate issues (in men): Conditions like benign prostatic hyperplasia (BPH) or prostate cancer can cause urinary retention, difficulty starting urination, and hematuria.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Sepsis from a urinary source: While less common, if a urinary tract infection progresses to sepsis, it can be life-threatening and requires immediate attention.
- Trauma to the urinary tract: Accidental injury to the kidneys, ureters, bladder, or urethra can cause hematuria and may require urgent surgical intervention.
- Vasculitis affecting the kidneys: Conditions like IgA vasculitis (formerly known as Henoch-Schönlein purpura) or granulomatosis with polyangiitis can cause renal involvement leading to hematuria.
- Rare diagnoses
- Sickle cell disease or trait: These conditions can lead to sickling in the low-oxygen environment of the kidney medulla, causing damage and potentially hematuria.
- Arteriovenous malformations (AVMs) or fistulas in the urinary tract: These are abnormal connections between arteries and veins that can cause bleeding into the urinary system.
- Goodpasture syndrome: A rare autoimmune disease that can cause glomerulonephritis and pulmonary hemorrhage, presenting with hematuria among other symptoms.
- Nutcracker phenomenon: Compression of the left renal vein between the aorta and the superior mesenteric artery, which can cause left-sided hematuria.