If you notice blood in your urine, early action can protect your kidneys and give your healthcare team the information they need to manage your care. Here’s what to do during the first 24 hours.
Step 1: Notify Your Nephrology Team Immediately
Don’t ignore it, says Diaz. Call your nephrologist as soon as you notice a change in urine color, especially if this is the first time it’s happened or if the flare feels more severe than previous ones, she says. Reporting this early allows your medical team to determine if you need to be seen in person and if additional testing is needed.
Step 2: Stay Calm
It’s natural to feel distressed, but try to remember that visible blood in the urine during or shortly after an infection is not unusual in IgAN, says Diaz.
Step 3: Hydrate Generously (Unless Your Provider Has Told You Otherwise)
Drinking plenty of fluids helps flush red blood cells through the kidneys’ filtering tubes, which can prevent blockages that might cause further kidney injury, says Dr. Zhdanova. But if you’ve been given fluid limits because of other health issues, follow your provider’s guidance, says Diaz.
Step 4: Avoid Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Avoid NSAIDs, such as ibuprofen (Advil, Motrin) and naproxen (Aleve), for fever or aches, as these can further reduce blood flow to already inflamed kidneys.
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Stick to acetaminophen if needed, Zhdanova says, or ask your nephrologist what medication is safe to use.
Step 5: Monitor Your Blood Pressure
“A flare can cause a sudden spike in blood pressure. If it’s significantly higher than your baseline, it indicates the kidneys are under acute stress and need medical intervention,” says Zhdanova. If you have a home blood pressure monitor, take a reading and write down the number and the time. If you don’t, many pharmacies, clinics, and urgent care centers offer blood pressure checks. Keep a log of these readings to share with your care team.
Step 6: Document Your Symptoms
Diaz recommends noting the color of your urine, when you first noticed the change, and if you see any blood clots. You should also pay attention to how much you’re urinating. If you’re making significantly less urine despite drinking plenty of fluids, it could indicate acute kidney injury (AKI), which is a sudden drop in kidney function, says Zhdanova, and you should notify your care team right away.
Let your nephrologist know about other symptoms, such as fever, discomfort on your side or back, sudden weight gain, fatigue, or swelling in your ankles, hands, or face. This information helps your team determine the best treatment course.
When to Seek Emergency Care
Most IgAN flares can be managed at home with guidance from your nephrology team, but some symptoms need immediate medical attention. Diaz recommends getting emergency care right away if you experience:
- Very little urination or no urination at all
- Severe back or abdominal pain
- Large blood clots in your urine
- Shortness of breath
- Chest pain
- Rapid swelling in your face, legs, or around your eyes
- Blood pressure readings that are higher than your normal range
- Nausea and vomiting
“These symptoms may indicate acute kidney injury, fluid overload, or other serious complications requiring immediate attention and treatment,” says Diaz.
