Causes of red urine: from dark pink to bright brown colors

Massive release of erythrocytes (haemolys) provokes a sharp change in urine parameters.

Urine is dark red

Dark red urine is an alarming signal indicating nephron blockage, the risk of hemolytic anemia and ARF (acute renal failure). Dark red urine is provoked by the following factors:

1. Renal etiology of causes:

• kidney disease;
• pathologies of the urinary tract;
• general intoxication of the body;
• pathology, damage to tubuli renales/ tubulus renalis (renal tubules);

2. Somatic etiology of factors:

• pathologies of internal organs, chronic form or exacerbation of the process.

3. Postrenal etiology of causes:

• anuria;
• acute renal postrenal failure;
• oliguria;
• chronic renal failure.

Reasons that provoke such a symptom as red urine:

1. Nephrosclerosis.
2. Amyloid dystrophy.
3. Glomerulonephritis
4. Inflammation of the renal pelvis, pyelonephritis.
5. Urolithiasis.

Typical differential signs by which dark red urine is distinguished from the physiological transient condition causing red urine are as follows:

• Associated symptoms include increased body temperature and chills.
• Persistent nausea, periodic urge to vomit.
• Yellowish discoloration of the fibrous tissue of the eye (jaundice of the sclera of the eye).
• Weakness, fatigue.
• A nagging pain in the right side (hypochondrium).
• Anuria.
• Bleeding in the urinary tract.
• Crush syndrome (Bywaters, crush syndrome).

Other reasons:

• Bright, dark crimson urine color occurs in patients taking drugs containing phenolphthalein. Such cases are not pathological, the urine color is restored fairly quickly after the end of taking the drugs.
• Brownish, dark red urine may occur after taking medications based on Rubiceae (madder).

In combination with dark red urine, these signs indicate anxiety:

1. Haemoglobinaemia (hemoglobinemia).
2. Bilirubinemia.
3. Haemoglobinuria (hemoglobinuria).

Massive hemolysis is manifested by an indicative symptom - urine that is the color of water used to wash meat ("meat slops"). This indicator indicates the total breakdown of red blood cells, the release of hemoglobin and its excretion through urine. If you do not seek medical help in this condition, there is a risk of rapid development of ARF (acute renal failure).

Urine is reddish brown in color

An unusual shade of urine, red-brown urine is one of the signs of the pathological process of red blood cell hemolysis, which is called methaemoglobinuria. Methemoglobinemia can be congenital or develop as a result of intoxication. The blood condition, when about 50% of hemoglobin takes the form of ferrihemoglobin (3-valent iron), can develop due to the influence of the following substances and factors:

• Aromatic chemical dyes (benzenes – aniline, nitroaniline, methylaniline).
• Reaction to chlorobenzene, silver nitrate, naphthalene, products with nitrates, chlorates.
• Complications after a long course of ABT (antibacterial therapy) or long-term use of nitroglycerin, chloroquine, metronidazole, rifampicin.
• Taking drugs from the sulfonamide series, phenacetin.
• Treatment with drugs containing resorcinol.
• Reaction to the administration of lidocaine, novocaine.
• Intoxication with saltpeter, copper sulfate.

In addition, red-brown urine may be a consequence of pathological dysfunction of internal organs - liver, gall bladder. Hepatopathologies (hepatitis) color urine in a brownish tint, acute forms of the disease provoke capillary bleeding, which is clinically manifested as the release of erythrocytes into urine already colored brown. Such a mixture of shades has an important diagnostic value, of course, not being an independent accurate marker of the disease.

Also, red-brown urine is one of the symptoms of an advanced oncological process (melanoma), hemolytic anemia, liver cirrhosis, acute glomerulonephritis or one of the forms of hepatitis in the terminal stage.

Less often, urine changes to a red-brown hue after a severe case of tonsillitis, extensive burns, after bites from poisonous snakes, insects, or mushroom poisoning.

Urine is bright red

Red blood cells in urine give it a bright shade. Bright red urine is primarily evidence of a neutral or alkaline reaction. The higher the acidity of urine, the brighter its color index. Other reasons that provoke bright red urine may be:

1. Somatic factors:

• Thrombocytopenia.
• Anemia.
• Hemophilia.
• Systemic vasculitis.
• Chemical intoxication.
• Intoxication from bites of poisonous insects and snakes.
• Somatic diseases of viral or bacterial etiology.

2. Renal causes:

• Autoimmune pathology - glomerulonephritis.
• Pyelonephritis.
• Trauma, rupture of kidney tissue.
• Amyloidosis.
• Renal infarction.
• Hydronephrosis.
• Nephrolithiasis.

3. Postrenal factors:

• Trauma, ruptured bladder.
• Cystitis.
• Terminal stage bladder cancer with bleeding.
• Urolithiasis.

In addition, red blood cells (erythrocytes) in the urine, bright red urine may indicate bleeding of uterine origin, an erosive process in the cervix in women.

Pink red urine

The onset of microhematuria can only be detected in a laboratory, using urine tests. Pink urine is already a transition from the final stage of invisible release of red blood cells to another type - macrohematuria or a transient phenomenon associated with diet.

Reasons why urine may be pink:

• Adding rhubarb root to food, various rhubarb dishes (jelly, salad, pies, side dishes).
• Consumption of pink beets, cranberries, black currants, blackberries (plant pigments).
• Taking medications based on aminophenazone, a course of treatment with anthraquinone, propofol.
• The use of salicylates and ibuprofen can also cause a change in the color of urine to a pink tint.
• Initial stage of bladder inflammation.
• Benign tumor process (urethral polyps).
• Bruises of the back in the kidney area.
• Alcohol intoxication.

If the urine is pink due to a food factor, the intensity of its color depends on the pH. The acidic environment of urine enhances the brightness of the shade, pale pink color is a clear indication that the urine shows an alkaline reaction.

For other reasons for the appearance of red urine, read this article.