Smoky or tea coloured urine can be a marker of blood in urine, medically known as Hematuria. Frank blood may be present at times. These episodes of hematuria may be painless or associated with pain. Sometimes blood may be incidentally detected on examination of urine for some other reason.

Causes can be non specific like fever, trauma, strenuous exercise, menstruation, foreign body, UTI, stones, tumors etc. Diseases like IgA Nephropathy, Thin BM disease, HUS, MPGN, Lupus Nephritis, Alports syndrome etc. can be associated with hematuria.

Initial investigation includes a detailed analysis of the urine sample which is subsequently followed up with specific investigations including renal function tests, immunological and serological tests and imaging studies like USG, CT etc. A kidney biopsy may be required in selected cases.

Treatment is directed at the underlying disease process. Surgery may be needed in conditions like obstruction, tumours, and stone disease. Other diseases may warrant observation and control of BP or medical therapies like immunosuppressants etc.

Disclaimer: Please consult your doctor in order to optimise treatment.