Home  |  Rus  |   Ask a question  Contact
Articles  |  Facebook  |  Links

Hematuria (blood in the urine)

 

Hematuria (blood in the urine)

Hematuria (blood in the urine) —is the presence of red blood cells in urine. Hematuria is a symptom of a pathological condition of the body. Hematuria is not always evidence of pathology in the kidney and urinary tract.

In the urine of healthy human red blood cells can be detected with quantitative methods. According to the method Nechiporenko normally in 1 ml of urine detected up to 1000 erythrocytes.

For visual signs of hematuria (blood in the urine) are divided into macro-and microhematuria.
Visible to the eye discoloration of urine (red color of varying intensity) indicate the separation of urine and blood are called gross hematuria (blood in the urine).

Gross hematuria (blood in the urine) occurs when the blood content of about 1 ml in 1 ml of urine.

Microhematuria characterized by the presence of red blood cells in urine, but without changing its color. Microhematuria (blood in the urine) can be detected only through a microscope or test strip. To clarify the causes of hematuria (blood in the urine) other than red blood cell count has a definite value of their morphology. When hematuria (blood in the urine) in urine highlight changes and unmodified red blood cells.

Nature of the change of erythrocytes in hematuria (blood in the urine) (unaltered - save pigment; changed - lost their hemoglobin) is determined by the presence of hemoglobin and indicates the limitations of bleeding and the residence time of erythrocytes in urine. In the process of loss of pigment and red blood cells change their morphology plays a significant role of pH and relative density, urine osmolality.

In weakly acidic and neutral (pH 6,5-7,5), urine red blood cells for a long time remain unchanged. Rapid loss of hemoglobin occurs in gipoizostenurii, with high relative density of urine or acidic and strongly acidic (pH 5,5-6,0) reaction. Erythrocytes in hematuria (blood in the urine) are subject to change when they arrive in the urine with a low relative density of any part of the urinary tract.

Unmodified red blood cells in urine are more common in urological diseases:

Modified red blood cells in urine detected in:

  • glomerulonephritis
  • congestive kidney (with a relative density of urine 1,020-1,027)

Detection of erythrocyte cylinders may be evidence of glomerular origin of hematuria (blood in the urine). In addition, morphologically altered red blood cells pass through the basement membrane in glomerulonephritis deformed to take the form of akantotsitov, whose number may be greater than 10%, the so-called dismorfnye red blood cells, may also be more likely to testify in favor of glomerular hematuria (blood in the urine).

 

Types of hematuria (blood in the urine)

Distinguish between prerenal, renal and postrenalnuyu hematuria (blood in the urine).

Prerenal hematuria (blood in the urine) occurs usually in cases involving hemorrhagic syndrome, due to impairments of the permeability of capillary walls, or hemostatic system. Prerenal hematuria (blood in the urine) is more common in the form of microhematuria.

Renal hematuria (blood in the urine) origin is due to vascular glomerular kidneys. Evidence of glomerular origin of hematuria (blood in the urine) may be the presence of erythrocyte cylinders and morphological changes of erythrocytes.

Diseases for which it may be a significant hematuria (blood in the urine):

  • hematuria (blood in the urine) in some acute nephritis complicating infectious diseases (scarlet fever, influenza, measles, sore throat), usually in the form of microhematuria
  • hematuria (blood in the urine) in glomerulonephritis
  • hematuria (blood in the urine) with nephrosclerosis
  • hematuria (blood in the urine) with nephrolithiasis
  • hematuria (blood in the urine) in renal cancer
  • preembolic hematuria (blood in the urine) and renal infarction
  • hematuria (blood in the urine) in renal tuberculosis

Postrenal hematuria (blood in the urine) due to bleeding from the urinary tract, bursting in the prostate.

The most common cause of hematuria (blood in the urine) is postrenalnoy cystitis or urethritis, urinary tract stones, tumors and prostatic hypertrophy.

For topical diagnosis red blood cell in urological practice used two-and trehstakannaya trial.

Interpretation of urine test results:

  • selection of blood to the urine indicates its origin from the urethra
  • the predominance of red blood cells in the first portion of urine is observed in lesions of the urethra
  • the predominance of red blood cells in the first and third urine sample - the damage of the prostatic urethra
  • the predominance of red blood cells in the third urine sample characteristic lesions of the bladder, and sometimes blood appears only in the last drops of urine
  • uniform distribution of red blood cells in all three portions found in kidney damage, with the presence of erythrocyte cylinders confirms renogenic erythrocytes

 

If you have any questions about the diagnosis or treatment of hematuria (blood in urine), you can specify them with our urologist or a nephrologist on the phone: (499) 130-08-09

 

 
 

 

Neurology, Neurosurgery
(499) 130-08-09
Surgery, Traumatology
+7(903) 167-99-20
Psychotherapy
+7(909) 994-94-66
Mon...Fri 10:00–20:00
Sat 09:00–15:00