Blood in the urine is called hematuria and should be evaluated by a doctor. Since trace blood in the urine can be invisible to the eye, a microscope is required to quantify the amount. Some blood loss in microscopic amounts is observed transiently during menstruation or exercise but should not be visible. Persistent visible and excess microscopic hematuria is abnormal. In addition to blood, particulates can be found in the urine and have many causes.
Normal Urine
Urine is a product of blood flow filtered and concentrated by the kidney. The concentrated filtrate -- urine -- is collected from both kidneys and stored in the bladder until a person chooses to void. The urine varies in color depending on concentration, clear to dark yellow with increasing concentration. Exercise usually does not alter normal function of the kidney. The normal ingredients of urine are urea -- waste product, electrolytes and traces of protein. Occasionally, crystals of various salts may be found giving the urine a turbid or particulate appearance. Hematuria presents as a tea color to frankly bloody appearance. Food, medications or body pigments may turn urine red or orange, simulating hematuria.
Hematuria
Visible blood in the urine is always abnormal and can suggest a bleeding disorder or a structural abnormality in the urinary system. Exercise-induced hematuria is a subset of hematuria and requires the same thorough medical evaluation. Bleeding disorders can include medications like aspirin, coumadin and heparin or medical conditions affecting blood and coagulation systems. Structural problems in the urinary system include infections, kidney stones, cancer or kidney disorders. In some cases, a cause for exercise-induced hematuria is not found and is assumed to be benign.
Particles in the Urine
Particles in the urine are not a specific symptom. As mentioned earlier, crystals from normal salts can precipitate out under different circumstances. Crystals in the urine can form stones over time and appear as sand or gravel upon voiding. Usually, diet and urine acidity are responsible for crystals. Other causes of particles in the urine include clumps of blood, urinary system cells or debris from infection.
Exercise, Hematuria and Particles in the Urine
The combination of blood and particles in the urine after exercise could be explained by exercise-induced hematuria with clumps of blood cells mixed in the urine. Exercise could agitate a structural abnormality in the urinary system such as kidney stones or bladder cancer resulting in the appearance of blood and particles. Finally, an untreated urinary tract infection could show more blood and debris after exercise. In summary, medical followup is imperative given the nature and complexity of this symptom.
References
- "Brenner & Rector's The Kidney: Hematuria"; Barry M. Brenner, M.D.; 2008
- "Campbell-Walsh Urology, 9th ed.: Hematuria"; Alan J. Wein, M.D., et al.; 2007
