After determining the presence of red blood cells in the urine sediment, the true hematuria is established by first taking a medical history, especially after excluding pseudohematuria caused by menstrual contamination and strenuous, high-intensity exercise in women. The possible reasons for this are mechanical damage to the bladder and kidneys during strenuous exercise, distribution of blood to the skeletal muscle during exercise resulting in ischemia and hypoxia in the kidneys, and glomerular hyperfiltration, so the hematuria can be of glomerular or non-glomerular origin.
Hematuria with weight change: weight loss should be considered as urologic tuberculosis or tumor; weight gain with edema is a clinical manifestation of glomerulonephritis and nephrotic syndrome, more so in the latter.
Urologic diseases are the main cause of hematuria. In addition, some systemic diseases involving the kidneys can also lead to hematuria, and urologic lesions account for 95%-98% of the causes of hematuria, commonly due to infection, noninfectious inflammation, stones, and tumors. Urological diseases include: urinary stones, tumors, tuberculosis, trauma, foreign bodies, vascular variants, surgical or catheterization injuries, and interventional device testing.