Hemoglobinuria

Excretion of free hemoglobin in the urine, typically resulting from intravascular hemolysis, causing renal filtration of excess plasma hemoglobin and producing dark-red, brown, or cola-colored urine.

Causes

• Sickle cell anemia

• Paroxysmal nocturnal hemoglobinuria

• Infectious causes

  • Urinary tract infection

  • Pyelonephritis

  • Tuberculosis

  • Malaria

  • Other infections causing hemolysis

• Autoimmune and toxic hemolysis:

  • Autoimmune hemolytic anemia

  • Complement-mediated hemolytic disorders

  • Hemolytic transfusion reactions

  • Drug-induced hemolysis

  • Lead poisoning

  • Toxin-induced hemolysis

• Physical and mechanical causes

  • March hemoglobinuria

  • Severe burns

  • Mechanical hemolysis from prosthetic heart valves or ECMO

• Renal and microvascular causes

  • Hemolytic-uremic syndrome

  • Thrombotic thrombocytopenic purpura

  • Acute glomerulonephritis

  • Renal malignancy