Difference Between Hematuria and Hemoglobinuria

Key Difference – Hematuria vs Hemoglobinuria
 

Hematuria and hemoglobinuria are two conditions that cause urine with a reddish tinge. The key difference between hematuria and hemoglobinuria is that hematuria is the passage of red blood cells with urine whereas hemoglobinuria is the passage of hemoglobin with urine.

Most people get frightened when they see a reddish tinge in urine. Red color urine is actually a thing that has to be taken seriously and it needs immediate medical attention because unless you are having your menstruation or on a urinary catheter, it is more likely to be due to a sinister condition. Red color urine can either be due to the passage of red blood cells or due to the passage of hemoglobin.

CONTENTS

1. Overview and Key Difference
2. What is Hematuria 
3. What is Hemoglobinuria
4. Similarities Between Hematuria and Hemoglobinuria
5. Side by Side Comparison – Hematuria vs Hemoglobinuria in Tabular Form
6. Summary

What is Hematuria?

The passage of red blood cells with urine is known as hematuria. Earlier, it was divided into to two main categories as painful and painless hematuria, but since the pain is due to its association with ureteric colic, nowadays hematuria is simply described as hematuria with ureteric colic or hematuria without ureteric colic.

Hematuria can also be classified depending on the stage of the micturition it appears.

• Early hematuria is most often due to a urethral pathology such as urethral strictures and urethral carcinomas.
• If there is a uniform presence of blood throughout the stream, that is more likely to be due to a renal pathology.
• Late or terminal hematuria is due to a problem in the bladder neck or trigone.

Figure 01: Micro Hematuria

Causes

These can be broadly categorized into two categories as local causes and systemic causes.

Local Causes

• Urinary tract infections
• Ureteric stones
• Malignancies in the urinary tract
• Polycystic kidney disease

Systemic Causes

• Drugs such warfarin, heparin, and aspirin
• Bleeding disorders such as hemophilia and von Willebrand’s

Hematuria can be diagnosed using a basic urine full report which will show the increased presence of red blood cells in urine.

What is Hemoglobinuria?

Hemoglobin that is released during the hemolysis of red blood cells binds to haptoglobin before being transported to the spleen where they undergo degradation. But when there is an increase in intravascular hemolysis, all haptoglobin molecules get saturated and hemoglobin starts to pass out with urine. This condition is known as hemoglobinuria.

Causes

• Malaria
• Paroxysmal nocturnal hemoglobinuria
• Burns
• Different forms of vasculitis
• Transfusion reactions due to blood group incompatibility

What is the Similarity Between Hematuria and Hemoglobinuria?

• Urine can get a characteristic reddish discoloration in both these conditions

What is the Difference Between Hematuria and Hemoglobinuria?

Summary – Hematuria vs Hemoglobinuria

Hematuria is the passage of red blood cells with urine whereas hemoglobinuria is the passage of hemoglobin with urine. In hematuria, reddish discoloration of urine is due to red blood cells but in hemoglobinuria, it is the presence of hemoglobin that causes the discoloration of urine. This is the key difference between hematuria and hemoglobinuria.

Reference:

1. Kumar, Parveen J., and Michael L. Clark. Kumar & Clark clinical medicine. Edinburgh: W.B. Saunders, 2009.

Image Courtesy:

1.”Micro Hematuria” By Bobjgalindo – Own work (GFDL) via Commons Wikimedia

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