The human excretory system responds to every disease in the body, since biological and chemical toxins are usually excreted by the kidneys. A pathological process localized directly in the kidneys can increase the permeability of the membrane of the renal glomeruli, as a result of which blood cells leak out. A condition that is manifested by the presence of red blood cells in the urine is called hematuria. What it is? What are the reasons for this? What treatment is required? We will consider these and other questions in the article.
Types of hematuria
Based on the cause of the occurrence, hematuria (symptoms of pathology will be described below) is divided into:
- extrarenal, not associated with an injury or illness of the kidney;
- renal, developing due to renal pathology;
- postrenal, which occurs if the urinary tract and bladder are affected.
If a sufficiently large amount of blood is found in the urine and the urine itself acquires a reddish hue, then macrohematuria takes place.
If red blood cells are present in the urine in a small amount and the color of the urine remains unchanged, they speak about microhematuria.
Based on which portion of urine contains blood, initial hematuria (in the 1st portion), total (in all 3 portions), final (in the last portion) can be diagnosed. Such a division makes it possible to determine at what level the urinary system develops a pathological process: the higher the lesion, the later the red blood cells appear in the urine.
With isolated urinary syndrome, proteinuria and hematuria are often combined. Proteinuria is a condition characterized by the appearance of protein in the urine. An increased amount of protein in the urine is the most common sign of urological diseases.
Hematuria syndrome
Such a pathology may be accompanied by pain in the urethra and bladder during urination or precede it. Sometimes the pain is constant unremitting.
Pain in the lumbar region, on the side, under the shoulder blade may indicate inflammation of the kidney, trauma, nephroptosis (drooping kidney).
Common signs of blood loss are total hematuria, the symptoms in this case are pallor, weakness, thirst, dizziness.
Sand, stones can be released, which indicates urolithiasis. In the case of the allocation of cylinders (oblong clots) of yellow or brown color, we can talk about the defeat (inflammatory or traumatic) of the renal parenchyma.
The skin of a yellow, greenish hue indicates insufficient function of the gallbladder, liver, hemolysis, and destruction of red blood cells.
Acute or prolonged chronic bleeding in the urinary system, in which a large blood clot is formed in a short time, blocking the entrance to the urethra, making it impossible to empty the bladder. Also, the output of urine can be blocked by a large stone.
Why does this condition develop?
If hematuria is detected, the causes of this phenomenon may be different. Most often, pathology develops with tumors, inflammatory diseases, urinary tract injuries, urolithiasis, glomerulonephritis, renal tuberculosis, and blood clotting.
Normally, hematuria is extremely rare. A relatively benign condition in which microhematuria is diagnosed is a disease of the thin glomerular basement membranes. Most often, relatives of such patients also identify cases of this ailment. Microhematuria is isolated and renal failure does not occur.
Microhematuria may occur after running or long walking. After the cessation of physical activity, red blood cells disappear. What is the reason for the development of such a phenomenon has not been precisely established to date.
Macrohematuria is never found in healthy people. This condition, as a rule, indicates a severe lesion of the urinary tract or renal tissue.
Why can non-renal hematuria occur? The causes of this phenomenon are associated with a violation of the integrity of the urinary tract mucosa. Tumor, inflammatory lesions or injuries, which are often accompanied by ulceration, precede this damage. Bladder hematuria is the result of stone formation or passage of a stone through the ureters, urethra, bladder. An overdose of anticoagulants can cause bleeding from the mucous membrane of the urinary tract.
Renal hematuria develops as a result of destructive processes in the tissues of the kidneys, impaired venous outflow, as well as necrotizing vasculitis. Glomerular hematuria is associated with immuno-inflammatory damage to the glomerular basement membrane or its congenital anomalies. In addition, kidney hematuria occurs with inflammatory and toxic lesions of the tubules. Also, pathology can develop due to increased renal intravascular coagulation.
So, hematuria - what is it and as a result of what develops? This condition can occur due to the pathology of various departments of the urinary system.
The prostate gland :
- Prostate cancer
- Inflammation of the prostate gland (prostatitis).
- Benign prostatic hyperplasia.
Urethra
- Foreign body in the urethra.
- Urethral trauma.
- Tumor of the urethra. Urethral cancer is rare and often accompanied by urethrorrhagia - the appearance of blood from the urethra between urination.
- Inflammation of the urethra (urethritis).
Upper urinary tract :
- Penetrating wound, blunt trauma.
- Stones in the kidneys. Often the cause of hematuria is urolithiasis. Salts are formed in the renal papillae, resulting in stones forming in the drainage system of the kidneys. Kidney stones may not manifest themselves in any way, but with irritation or inflammation of the urinary tract, blood appears in the urine.
- Renal tumor. An alarming sign of kidney cancer is vermiform blood clots in the urine. Blood may also appear due to benign tumors.
- Infections
- Congenital disorders (cyst in the kidneys).
- Blood coagulation disorders (hemophilia, sickle cell anemia, leukemia).
- Renal vein thrombosis, renal embolism.
- Kidney diseases: glomerulonephritis (in this case, blood in the urine can be detected only with a microscope), pyelonephritis (with such an ailment, blood in the urine may not be accompanied by a pain attack, but more often this disease is characterized by fever, lower back pain, possibly blood poisoning).
Ureter :
- Injury.
- Ascending infection.
- The formation of stone in the ureter.
- Tumor disease of the ureter.
Lower urinary tract :
- Infections: hemorrhagic cystitis (a serious ailment characterized by bleeding from the bladder), schistosomiasis (the bladder is affected by a parasite worm), and bladder tuberculosis.
- Bladder injury
- Urolithiasis disease.
- Bladder tumor (it is very important to identify the painless appearance of hematuria, this will make it possible to diagnose the early stage of the disease and conduct successful treatment).
- Bladder irradiation.
- A drug like Cyclophosphamide, used to treat cancer, can trigger blood in the urine.
Diagnostics
Above, we examined the symptoms and causes of such a phenomenon as hematuria, that we know this. Now let's discuss diagnostic methods for this pathology. In order to detect hematuria, a urine test is required in the laboratory. It should be borne in mind that the color of urine does not always indicate the presence of blood. Urine may become a dirty pink or light red due to the consumption of certain foods.
Nechiporenko research
The first morning urine (about 150 ml) is collected. Before the collection procedure, a morning toilet of the genitals is mandatory. The collection container must be sterile. Research material must be delivered to the laboratory within 2 hours.
The study of the daily volume of urine
Urine for analysis begins to be collected from the second morning urination and ends the next day with the first morning urination. During the day, urine is collected in one container, after which the resulting volume is fixed, mix well and part (150 ml) is cast into a separate container. In the process of collecting urine, hygiene should be observed. In order for the material to be better preserved, a special preservative is used.
Additional research methods
Sediment microscopy is also performed to determine the number of red blood cells in the field of view. Determine whether the tubules and glomeruli are affected by phase-contrast microscopy of urine sediment.
Differential diagnosis involves ultrasound of the pelvic organs and kidneys, cystoscopy with a biopsy, extretory urography, retrograde renography, kidney biopsy, examination of the testes and prostate, urine culture (culture of bacteria), computed tomography and x-ray (detection of a foreign body).
Hematuria: treatment of pathology
Hematuria is a symptom, therefore, the treatment of this phenomenon should be carried out in combination with the treatment of the underlying ailment.
For the relief of bleeding used drugs "Vikasol", "Dicinon", aminocaproic acid, a solution of calcium chloride 10%. If blood loss is more than 500 ml, infusion therapy is required to replenish the blood volume.
If a calculus is found in the ureter or urethra, prescribe the use of antispasmodics and thermal procedures that will facilitate its discharge. If the stone cannot come out on its own, prompt or cystoscopic extraction is performed.
In case of kidney injuries with rupture of tissues and the formation of hematomas, emergency surgical intervention is necessary.
In the case of a combination of hematuria and proteinuria, corticosteroids are prescribed.
If chronic hematuria is diagnosed, treatment involves the use of iron and B vitamins.
If the pathology in a child
Hematuria in children is most often associated with damage to the kidney parenchyma. In infancy, a short time after birth, congenital malformations manifest themselves: the presence of a cyst, spongy kidney, etc. A routine examination of the baby must include a urinalysis.
Chronic kidney bleeding in a child can be triggered by a tuberculosis infection, which proceeds aggressively in early childhood. Due to hereditary diseases of the blood coagulation system, multiple hemorrhages and hematuria occur, in which case hematomas and telangiectasias accompany. A child may be injured if dropped. If hematuria is present in blood relatives without prejudice to health, the baby does not exclude benign family hematuria, this phenomenon is associated with a structural feature of the kidney.
Parents should be extremely careful. The anxiety of the child should alert them, so pain can manifest itself. You should also pay attention to high body temperature and urinary retention.
Hematuria in children can occur due to streptococcal infection, which affects the renal parenchyma. Viral disease of the upper respiratory tract provokes IgA nephropathy. Most often, the pathology is benign, and the development of chronic renal failure does not occur. The malignant course of the disease is manifested by high blood pressure, proteinuria, macrohematuria.
Hematuria during pregnancy
Most often, hematuria in women during the period of bearing a child occurs in the 2-3rd trimester. The fetus is constantly growing, the ureters are pinched by the uterus - this negatively affects the function of the kidneys. The result of stagnation of urine in the pelvis can be the formation of stones that damage the epithelium and cause bleeding. The likelihood of developing hematuria increases sharply if a woman suffered from kidney inflammation or has chronic renal failure before pregnancy . It is very important not to confuse uterine bleeding and bleeding from the urinary tract. Since in the first case there is a serious danger to both the mother and the fetus. During the bearing of the baby, the blood coagulation system is activated and special preparations are prescribed for its correction. Hematuria in women during pregnancy can be caused by taking anticoagulants, and in order to stop bleeding, it is enough to cancel them.
Conclusion
Urological diseases in the absence of adequate treatment can provoke cancer, various inflammatory diseases, and numerous complications. In some cases, the only symptom of the pathology of the urinary system is hematuria. What is it, you learned from this article. Do not disregard this phenomenon and immediately seek medical attention if it is detected. Only in this way will you maintain your health, and in some cases your life. Take care of yourself!