The human excretory system responds to every disease in the body, as biological and chemical toxins are usually excreted by the kidneys. A pathological process localized directly in the kidneys can contribute to an increase in the permeability of the membrane of the renal glomeruli, as a result of which blood cells leak out. The condition, which is manifested by the presence of red blood cells in the urine, is called hematuria. What it is? What are the reasons for this phenomenon? What treatment is required? These and other questions will be considered in the article.
Types of hematuria
Based on the cause of occurrence, hematuria (symptoms of the pathology will be described below) is divided into:
- extrarenal, not related to trauma or kidney disease;
- 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 becomes reddish, then macrohematuria occurs.
If red blood cells are present in the urine in a small amount and the color of the urine remains unchanged, they speak of microhematuria.
Based on which of the portions of urine contains blood, initial hematuria (in the 1st portion), total (in all 3 portions), final (in the last portion) can be diagnosed. This division makes it possible to determine at what level of the urinary system the pathological process develops: the higher the lesion, the later red blood cells appear in the urine.
With an 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
This pathology may be accompanied by pain in the urethra and bladder during urination or precede it. Sometimes the pain is constant and unrelenting.
Pain in the lumbar region, in the side, under the scapula may indicate inflammation of the kidney, trauma, nephroptosis (prolapse of the kidney).
Common signs of blood loss is total hematuria, the symptoms in this case are pallor, weakness, thirst, dizziness.
Sand, calculi may be released, which indicates urolithiasis. In the case of allocation of cylinders (oblong clots) of yellow or brown color, one can speak of a lesion (inflammatory or traumatic) of the kidney parenchyma.
Integuments of yellow, greenish shades indicate insufficient function of the gallbladder, liver, hemolysis, destruction of red blood cells.
Spicy orprolonged chronic bleeding in the urinary system, in which a large blood clot is formed in a short time, blocking the entrance to the urethra, leading to the impossibility of emptying the bladder. Also, the urine outlet may 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, kidney tuberculosis, and bleeding disorders.
Hematuria is extremely rare in normal conditions. 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 have cases of this disease. Microhematuria has an isolated character, and the development of renal failure does not occur.
Microhematuria can occur after running or walking for a long time. After the cessation of physical activity, red blood cells disappear. What is the reason for the development of such a phenomenon, today it has not been precisely established.
Macrohematuria is never found in he althy people. This condition usually indicates severe damage to the urinary tract or kidney tissue.
Why can non-renal hematuria occur? The reasons for this phenomenon are associated with a violation of the integrity of the urinary tract mucosa. This injury is preceded by tumor, inflammatorylesions or injuries, which are often accompanied by ulceration. 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 urinary tract mucosa.
Renal hematuria develops as a result of destructive processes in the tissues of the kidneys, impaired venous outflow, and necrotizing vasculitis. Glomerular hematuria is associated with immunoinflammatory 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 why does it develop? This condition may occur due to the pathology of various parts of the urinary system.
Prostate:
- Prostate cancer.
- Inflammation of the prostate gland (prostatitis).
- Benign prostatic hyperplasia.
Urethra:
- Foreign body in urethra.
- Injury to the urethra.
- Tumor of the urethra. Cancer of the urethra is quite rare and is often accompanied by urethrorrhagia - the appearance of blood from the urethra between urination.
- Inflammation of the urethra (urethritis).
Upper urinary tractpaths:
- Penetrating wound, blunt trauma.
- Kidney stones. Often the cause of hematuria is urolithiasis. S alt deposits form in the renal papillae, resulting in the formation of stones in the drainage system of the kidneys. Kidney stones may not manifest themselves in any way, but if the mucous membrane of the urinary tract becomes irritated or inflamed, blood appears in the urine.
- Kidney tumor. An alarming sign of kidney cancer is worm-like blood clots in the urine. Blood can also appear due to benign tumors.
- Infections.
- Birth defects (kidney cyst).
- Blood clotting disorders (hemophilia, sickle cell anemia, leukemia).
- Renal vein thrombosis, renal embolism.
- Kidney diseases: glomerulonephritis (in this case, blood in the urine can only be detected 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, back pain, possible blood poisoning).
Ureter:
- Injury.
- Rising infection.
- Ureteral stone formation.
- Tumor disease of the ureter.
Lower urinary tract:
- Infections: hemorrhagic cystitis (a serious illness characterized by bleeding from the bladder), schistosomiasis (the bladder is affected by a parasitic worm), tuberculosis of the bladder.
- Injury to the bladder.
- Urolithiasis.
- 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 carry out successful treatment).
- Irradiation of the bladder.
- A drug like Cyclophosphamide used to treat cancer can cause blood in the urine.
Diagnosis
Above, we examined the symptoms and causes of such a phenomenon as hematuria, what we know about it. Now let's discuss the methods of diagnosing this pathology. In order to detect hematuria, it is required to conduct a urine test in the laboratory. It should be borne in mind that the color of urine does not always indicate the presence of blood. Urine may turn dirty pink or light red due to certain foods.
Research by the Nechiporenko method
Collect the first morning urine (about 150 ml). Before the collection procedure, the morning toilet of the genital organs is mandatory. The collection container must be sterile. Material for research must be delivered to the laboratory within 2 hours.
Research on daily urine volume
Urine for analysis begins with the second morning urination and ends the next day with the first morning urination. During the day, urine is collected in one container, then the resulting volume is fixed, mixed well and part (150 ml) is poured into a separate container. In the process of collecting urine, hygiene should be observed. In order to better preserve the material, a specialpreservative.
Additional research methods
Also carry out microscopy of the sediment to determine the number of erythrocytes in the field of view. To determine whether the tubules and glomeruli are affected, you can use phase-contrast microscopy of the urine sediment.
Differential diagnosis involves ultrasound of the pelvic organs and kidneys, cystoscopy with biopsy, excretory urography, retrograde renography, kidney biopsy, testicular and prostate examination, urine culture on a nutrient medium (definition of a bacterial infection), computed tomography and X-ray (foreign body detection).
Hematuria: treatment of pathology
Hematuria is a symptom, so the therapy of this phenomenon should be carried out in combination with the treatment of the underlying disease.
For the relief of bleeding, the drugs "Vikasol", "Ditsinon", aminocaproic acid, a solution of calcium chloride 10% are used. If the 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, the use of antispasmodics and thermal procedures are prescribed to facilitate its discharge. If the stone cannot come out on its own, an operative or cystoscopic extraction is performed.
In case of kidney injuries with tissue rupture and hematoma formation, emergency surgical intervention is necessary.
Hematuria and proteinuria combined with corticosteroids.
If chronic hematuria is diagnosed,treatment involves the use of iron supplements and B vitamins.
If the child has a pathology
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, a spongy kidney, etc. A urinalysis must be included in a preventive examination of a child.
Chronic kidney bleeding in a child can be triggered by tuberculosis infection, which proceeds aggressively in early childhood. Due to hereditary diseases of the blood coagulation system, multiple hemorrhages and hematuria occur, in this case, hematomas and telangiectasias are accompanied. The child may be injured in a fall. If blood relatives have hematuria without damage to he alth, benign familial hematuria is not excluded in the baby, such a phenomenon is associated with the peculiarity of the structure 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 be caused by a streptococcal infection that affects the renal parenchyma. A viral disease of the upper respiratory tract provokes IgA nephropathy. Most often, the pathology is benign in nature, and the development of chronic renal failure does not occur. The malignant course of the disease is manifested by high blood pressure, proteinuria,gross hematuria.
Hematuria during pregnancy
Most often, hematuria in women during childbearing occurs in the 2-3rd trimester. The fetus is constantly growing, the ureters are clamped 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 dramatically if, before pregnancy, a woman suffered from inflammation of the kidneys or she has chronic renal failure. It is very important not to confuse uterine bleeding with urinary tract bleeding. 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 may be enough to stop them.
Conclusion
Urological diseases in the absence of adequate treatment can provoke cancer, various inflammatory diseases, 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 leave this phenomenon unattended and, if it is detected, immediately consult a doctor. This is the only way to save your he alth, and in some cases, your life. Take care!
