Hematuria - what is it? Causes of hematuria

The excretory system of a person reacts to every disease in the body, as biological and chemical toxins are usually excreted by the kidneys. The pathological process, localized directly in the kidneys, can promote an increase in the permeability of the membrane of the renal glomeruli, as a result of which the blood cells are seeping. The condition, which is manifested by the presence of erythrocytes in the urine, is called hematuria. What it is? What are the reasons for this phenomenon? What treatment is required? These and other issues will be considered in the article.

Types of hematuria

Based on the cause, hematuria (the symptoms of the pathology will be described below) is divided into:

• Extrarenal, not associated with trauma or infirm kidney;
• Renal, developing due to renal pathology;
• Postrenal, which occurs if the urinary tract and bladder are affected.

If a large amount of blood is found in the urine and the urine itself acquires a reddish hue, then there is a macrogathermia.

If the red blood cells are present in the urine in small amounts and the color of the urine remains unchanged, they speak of a microhematuria.

Based on the fact, in which of the portions of urine is present blood, the initial hematuria (in the first portion), total (in all 3 portions), the final (in the last portion) can be diagnosed. This division makes it possible to determine in which level of the urinary system the pathological process develops: the higher the damage, the later the erythrocytes 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. The increased amount of protein in the urine is the most frequent sign of urological diseases.

Hematuria syndrome

Such pathology can be accompanied by painful sensations in the urethra and bladder during urination or precede it. Sometimes the pain is permanent.

Pain in the lumbar region, in the side, under the scapula may indicate inflammation of the kidney, trauma, nephroptosis (omission of the kidney).

Common signs of hemorrhage are total hematuria, the symptoms in this case are pallor, weakness, thirst, dizziness.

Sand, concrements can be allocated, which indicates a stone disease. In the case of the allocation of cylinders (oblong bunches) of yellow or brown color, one can speak of a lesion (inflammatory or traumatic) of the kidney parenchyma.

Skin covers of yellow, greenish hues indicate insufficient function of the gallbladder, liver, hemolysis, destruction of erythrocytes.

Acute or prolonged chronic bleeding in the urinary system, in which a large blood clot that overlaps the entrance to the urethra is formed in a short time, leads to the impossibility of emptying the bladder. Also, the urine output can be blocked by a large stone.

Why does this state develop?

If hematuria is detected, the reasons for this phenomenon can be different. Most often, pathology develops in tumors, inflammatory diseases, urinary tract trauma, urolithiasis, glomerulonephritis, kidney tuberculosis, and clotting disorders.

In normal hematuria is extremely rare. A relatively benign condition, in which microhematuria is diagnosed, is a disease of the thin basal membranes of the glomerulus. Most often, relatives of such patients also reveal cases of this ailment. Microhematuria is of an isolated nature, and there is no development of renal failure.

Microhematuria can occur after running or long walking. After stopping physical activity, red blood cells disappear. What is the reason for the development of such a phenomenon, for today is not exactly established.

Macrogematuria is never found in healthy people. This condition, as a rule, indicates a severe damage to the urinary tract or kidney tissue.

Why can there be non-hematuria? The causes of this phenomenon are associated with a violation of the integrity of the urinary tract mucosa. Preceding this damage are tumor, inflammatory lesions or trauma, which are often accompanied by ulceration. Hematuria of the bladder is the result of the stone formation or passage of the stone along the ureters, the urethra, the 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, the violation of venous outflow, as well as necrotizing vasculitis. Glomerular hematuria is associated with the immune-inflammatory damage of the basal membrane of the glomerulus or its congenital anomalies. In addition, hematuria of the kidney 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 how does it develop? This condition can arise 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 the urethra.
• Injury of the urethra.
• Swelling of the urethra. Cancer of the urethra is rare and often accompanied by urethrorrhagia - the appearance of blood from the urethra between urination.
• Inflammation of the urethra (urethritis).

Upper section of the urinary tract :

• Penetrating wound, blunt trauma.
• Stones in the kidneys. Often the cause of hematuria is urolithiasis. In the papillary papillae, deposition of salts is formed, as a result of which stones form in the drainage system of the kidneys. Kidney stones can not behave themselves, but with irritation or inflammation of the urinary tract mucosa appears blood in the urine.
• Tumor of the kidneys. An alarming sign of kidney cancer are vermicular clots of blood in the urine. Blood can also appear as a result of benign tumors.
• Infections.
• Congenital disorders (cyst in the kidneys).
• Blood clotting disorders (hemophilia, sickle-cell anemia, leukemia).
• Thrombosis of the renal vein, renal embolism.
• Kidney diseases: glomerulonephritis (in this case, the blood in the urine can be detected only with the help of a microscope), pyelonephritis (with such a disease the blood in the urine may not be accompanied by a pain attack, but more often for such a disease fever, low back pain, possible blood infection).

Ureter :

• Injury.
• Ascending infection.
• Formation of a stone in the ureter.
• Tumor disease of the ureter.

Lower urinary tract :

• Infections: cystitis hemorrhagic (a serious ailment characterized by bleeding from the bladder), schistosomiasis (the bladder is affected by a parasitic worm), tuberculosis of the bladder.
• Injury of the bladder.
• Urolithiasis disease.
• Tumor bladder (it is very important to detect a painless appearance of hematuria, this will enable to diagnose the early stage of the disease and to conduct successful treatment).
• Irradiation of the bladder.
• A medication such as "Cyclophosphamide" used to treat cancer can provoke the appearance of blood in the urine.

Diagnostics

Above we disassembled the symptoms and causes of a phenomenon such as hematuria, what it is we know. Now let's discuss the methods of diagnosing this pathology. In order to identify hematuria, it is required to conduct urine tests in the laboratory. It should be borne in mind that the color of urine does not always indicate the presence of blood. Urine can acquire a dirty pink or light red color due to the use of certain products.

Investigation by the Nechyporenko method

Collect the first morning urine (about 150 ml). Before the collection procedure, the morning toilet of the genitalia is mandatory. The packaging container must be sterile. Delivery to the laboratory material for the study is necessary within 2 hours.

A study of the daily volume of urine

The urine is collected for analysis from the second morning urination and ends the next day with the first morning urination. Within a day, the urine is collected in one container, after the volume is fixed, mixed well and a part (150 ml) is poured into a separate container. During the collection of urine, hygiene should be observed. In order to better preserve the material, use a special preservative.

Additional research methods

Also, microscopy of the sediment is performed to determine the number of red blood cells in the field of vision. Determine if the tubules and glomeruli are affected, using a phase-contrast microscopy of urine sediment.

Differential diagnosis involves ultrasound of the pelvic organs and kidneys, cystoscopy with biopsy, extreme urography, retrograde renography, kidney biopsy, testicle and prostate research, urine culture on nutrient media (detection of bacterial infection), computed tomography and x-ray (foreign body detection).

Hematuria: treatment of pathology

Hematuria is a symptom, therefore therapy of the given phenomenon should be carried out in a complex with treatment of the basic illness.

To stop bleeding, use drugs "Vikasol", "Dicinon", aminocaproic acid, a solution of calcium chloride 10%. If blood loss is more than 500 ml, an 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 that facilitate its departure are prescribed. If the stone itself can not exit, carry out an operative or cystoscopic extraction.

With injuries of the kidney with tissue rupture and the formation of hematomas, urgent surgical intervention is necessary.

In the case of a combination of hematuria and proteinuria, corticosteroids are prescribed.

If chronic hematuria is diagnosed, the treatment involves the use of iron preparations and B vitamins.

If the pathology of the child

Hematuria in children is most often associated with a lesion of the kidney parenchyma. In infancy, shortly after birth, congenital defects show up: the presence of a cyst, a spongy kidney, etc. A preventive examination of a child must include a urine test.

Chronic kidney bleeding in a child can be triggered by a tuberculosis infection that occurs aggressively in early childhood. Due to hereditary diseases of the blood coagulation system, multiple hemorrhages and hematuria occur, in this case hematomas and telangiectasias accompany. The child may be injured in the fall. 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 peculiarity of the kidney structure.

Parents should be extremely careful. Anxiety of the child should alert them, so the pain syndrome can manifest. Also, attention should be paid to high body temperature and urinary retention.

Hematuria in children may occur due to streptococcal infection, which affects the renal parenchyma. Viral disease of the upper respiratory tract provokes IgA-nephropathy. More often the pathology is benign, and the development of chronic renal failure does not occur. Malignant course of the disease is manifested by high blood pressure, proteinuria, macrogmaturia.

Hematuria in pregnancy

Most often, hematuria in women during childbearing occurs in the 2-3 rd trimester. The fetus is constantly growing, the ureters are pinched by the uterus - this negatively affects the function of the kidneys. A consequence of stagnation of urine in the pelvis may 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 kidney inflammation or she has chronic renal failure. It is very important not to confuse the 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 carrying out 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 the use of anticoagulants, and in order to stop bleeding, it is enough to cancel them.

Conclusion

Urologic 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 you find it immediately contact your doctor. Only in this way will you preserve your health, and in some cases your life. Take care of yourself!