Some of them are obliged to reside in the urine, because they are associated with the need to get rid of unwanted slag through the kidneys. Other – need not be present in a healthy renal and urinary tract or allowed in small quantities.
A survey of children always involves a urine test. And in it a compulsory part of the study is the sediment microscopy. This includes all of the elements with their mass.
The second group in the child’s body are red blood cells in the urine. Clinical symptom called hematuria.
When the red blood cells in the urine are the norm?
Rules of red blood cells in the urine of the child vary depend on age and sex. Immediately after birth the baby’s blood begins to move with the parent at their own level. Accumulated during intrauterine life, the RBCs are destroyed, so for several days, children may experience physiological jaundice and urine acid diathesis. In the urine found old red blood cells up to 7 on one field of view.
The length of the period depends on the individual adaptive reactions of an infant. In under one year of age the presence of erythrocytes in the urine due to a gradual activation of the filtration activities of the glomeruli. Functional ability of the kidneys fully disclosed to two years. Therefore, a one year old baby normal rate is allowed up to 5 cells in field of view.
The child after two years in the absence of disease and good development is set constant norm from zero up to 2-4 cells. They are assessed in prison as “single”. Girls tend to 0-3, boys – 1. Detection of a greater number requires an explanation, the purpose of treatment.
In childhood and adolescence may be a temporary increase.
- with overheating in the sun or in the bath;
- sports physical activity;
- inclusion in the diet of “adult” foods containing hot spices, lots of salt, preservatives;
- the use of significant amounts of citrus fruits, chocolate;
- a long walk in tourist travel;
- stressful situation;
In adolescent girls during the beginning of menstruation in the collected urine find unmodified red blood cells. Often this is due to inexperience and ignorance of the rules of urine collection for analysis.
As the red blood cells get into urine?
Red blood cells are blood cells responsible for oxygen transport in tissue and withdrawal of carbon dioxide. The blood through the finest capillaries enters the glomerular apparatus of the kidneys. Here is a sophisticated filtering process: all the necessary substances and cells linger, and waste toxins, decay products of old tissue pass through the membrane into the primary urine.
The condition of nephrons depends on the appearance of hematuria
To change this process only the pathology of the membrane. Erythrocytes are large cells and the healthy glomeruli are not skipped.
The filtration in the direction of increasing bandwidth occurs when:
- inflammation of the tissues of the kidney, infectious and autoimmune origin (glomerulonephritis, pyelitis, pyelonephritis);
- the destruction of the membrane toxic poisonous substances poisoning, severe intoxication during infectious diseases (influenza, diphtheria, scarlet fever, typhus);
- the compression of the glomeruli large volume of urine when hampered outflow of the ureters (hydronephrosis, cystic kidney, urolithiasis);
- obstructed venous outflow and by extension to the renal vein in severe heart failure, congenital defects in the stage of decompensation.
Another option is the disease of the vascular wall. The normal vessels are sufficiently strong and elastic. When injected arteries and veins in the area of inflammation in the urinary organs (cystitis, urethritis, pyelitis), they become loose and passable for shaped elements.
Especially hard occur systemic diseases affecting all blood vessels:
- lupus erythematosus.
Elevated red blood cells in the urine of the child can be detected at the mucosal injury of the kidney and ureter salts, stones. Discovered cells are called “fresh”. They did not stay long term in the urine.
The structure is completely preserved, in contrast to the modified erythrocytes in the urine of the child can be detected at the leaching and loss of hemoglobin. They have a wrinkled look that can resemble a ring.
What disorders of a child can be assumed by red blood cells in the urine?
Diseases in which increased red blood cells in the urine of the child can be divided into diseases of the urinary organs (the kidneys, ureters, bladder, urethra):
- inflammatory (glomerulonephritis, pyelonephritis, cystitis, urethritis);
- non-inflammatory lesions (kidney stones, tumors, hereditary pathology);
- specific inflammation of the kidneys caused by Mycobacterium tuberculosis;
- the trauma.
Diseases that cause kidney damage in severe or terminal stage:
- infectious diseases (influenza, hemorrhagic fever, meningitis, intestinal infection, typhoid);
- extensive suppurative processes (cellulitis, osteomyelitis, abscess forming pneumonia, sepsis);
- diseases of the blood (kapilliarotoxicos, hemophilia, hemolytic anemia, hereditary pathology).
In the urine of the child is detected the contents of erythrocytes after contact with secretions from the intestines or vagina in cases of rectal bleeding during enterocolitis, inflammatory diseases of the appendages and endocrine changes in girls.
The table shows the division of the causes of hematuria in 3 types
|Prerenal (somatic)||Renal (kidney)||Postrenal|
|severe intoxication infectious diseases||injury||cystitis|
|diseases of the blood||glomerulonephritis, pyelonephritis, tuberculosis||the stone located in the bladder or ureter|
|cardiac decompensation defects||stone, located in the cups or pelvis||bladder cancer|
|toxicity, including adverse effects of drugs||tumors||urethritis|
|septic condition||hydronephrosis||congenital malformation of the ureters and blood vessels|
It should be noted that the diagnosis given considerable attention to other changes of urine sediment which accompany hematuria:
- identification of protein cylinders in high concentrations, renal epithelium proves the disturbed filtration in the kidneys;
- severe pyuria and bacteria means inflammation;
- the crystalline salt explain why it is necessary to look for a stone in the urinary ways.
The cylinders in the urine are the casts of substances that clog the renal tubules
In children, laboratory signs of increased red blood cells in the urine are often the first symptoms of a latent or lingering course of the disease. It is therefore necessary to conduct a survey to understand the reasons why.
What a comprehensive survey is recommended for the baby?
If the red blood cells in the urine exceed the normal number when you re-analyze and troubleshoot power supply problems, there is a need for additional examination to clarify the nature of the pathology.
- General blood analysis with determination of coagulation factors;
- conducting biochemical tests for detection of blood disorders of the metabolism of nitrogenous substances;
- Ultrasound of the kidneys and the abdominal cavity;
- urine samples in Hamburge and Nechiporenko;
- older children have the option of carrying out computed tomography, excretory urography;
- if necessary – consultation of the urologist, children’s gynecologist, cardiologist.
Ultrasound shows abnormal size of kidney structures in the disturbed location, dense stones and tumors
The clinical course of diseases of the urinary organs with hematuria
Most often red blood cells in the urine occur in inflammatory diseases of the urinary organs, injuries of, at least – in connection with tumors, urolithiasis, hereditary and congenital disorders.
Glomerulonephritis is an infectious allergic the beginning, resulting in autoimmune inflammation of the glomerular apparatus. In urine detected leached erythrocytes, renal epithelial cylinders, a protein, a moderate amount of leukocytes.
The child observed:
- swollen face;
- complaints of headaches.
Parents should notice a decrease in the allocation of the total volume of urine per day. Pyelonephritis – occurs in connection with infection of the Cup-pelvis-plating system, bacteria, viruses, fungi accession genus Candida. In the investigation of urine revealed moderate hematuria, but a significant number of white blood cells, bacteria, cylinders.
In pyelonephritis the child should be in bed
Symptoms consist of:
- lower back pain (in babies – in the navel);
- a significant increase in temperature with chills;
- complaints about cramps when urinating, more frequent tenesmus;
Cystitis and urethritis occurs more often in girls or boys with phimosis.
- pain in the abdomen;
- cramps when urinating;
- urinary incontinence;
- General malaise, weakness.
Inflammatory diseases of the child are rarely taken from chronic. Treatment should be in hospital, then – long adherence and diet. Stones in the urinary organs of children are rare. For their education the child needs a long time to suffer from altered metabolism. However, the salt crystals in the analysis indicate the beginning formation of the stone structures.
The most dangerous in respect of injury of the wall of the ureter salts of oxalic acid. Their crystals have sharp needle-like education. Therefore, the detection of salts in the urine of the child parents need to take action dietary.
Injury to urinary organs occurs in the fall, the injury. The most dangerous consequences – a tear in the renal capsule, avulsion of the ureter. The urine flows into the abdominal cavity and causes signs of peritonitis. Treatment only operative.
When should I contact the pediatrician?
First, you need to take responsibility for the clinical examination of young children and students. The purpose of the studies of blood and urine tests aimed at early detection of the pathology until the symptoms are absent.
An urgent need to bring the child to the pediatrician if:
- complaints about cramps when urinating;
- urinary incontinence in children after five years;
- crying and straining during the act of urination of the baby;
- frequent urination, especially at night;
- pain in the lower back or abdomen;
- changed urine color (redness, turbidity, sediment).
Unusual excitement of the baby can not be taken at the whims of
In acute transient attack I advise you to collect your urine for diagnosis immediately after decrease in pain or an hour, following the rules of sterility. To study a container of urine should be delivered within a half hour.
What to remember when collecting a urine sample from a baby?
According to the rules, you need to collect urine in the morning after cleaning the baby. Utensils it’s better to buy at the pharmacy, it’s sterile and has a convenient cover. Research is needed for the average portion, so you’ll have to adapt to the child began to urinate in the pot, and then to expose the tank.
Infants it is recommended to purchase special containers. To store the collected analysis of the house. It would be faster to deliver it to the lab.
Parents and close adults should be attentive to the complaints of children. Kids do not know how to talk about their health, so anxiety is manifested. Unusual stimulation of the child should cause the vigilance of the parents. It is always better to timely check tests than long-term to treat a chronic pathology.