Urinalysis is included in a mandatory standard examination of patients turning to the doctor. It is prescribed in the preventive purposes during a medical examination even if no complaint is made.
The composition of urine sediment is a “mirror” of metabolism in the body, changes depending on pathological influences, reflects the stage of the disease at the latent for. If the urine detected cells, “sleeps” in normal blood, the mystery will have to solve using various methods of examination.
The study of the States in which the red blood cells in the urine increased identifies this diagnostic symptom, an indicator that indicates bleeding in the urinary pathways or the destruction of the membrane of the glomeruli.
What types of red blood cells found in urine?
The sediment microscopy is the main method, allowing to reveal elevated levels of red blood cells in the urine.
Way possesses each nursing employee of the Department of clinical laboratory medical institutions
Under the microscope the red cells appear rounded formations with herself caught inside the middle. In size, they occupy a middle ground between major leukocyte cells and small platelets. Appearance and shape depend on the saturation of hemoglobin. This substance is the basis of the volume of the erythrocyte.
To distinguish 2 types of cells:
- unchanged – have a typical structure, no different from blood cells, colored red;
- changed is formed in a lengthy leaching process in the urine, as a result, the hemoglobin disappears, the cells shrink or get kind of rings.
The leaching process does not always depend on the pathology. It is possible in the absence of receipt of food substances containing alkali.
If the person, in addition, severely limits the salt, lost alkaline reserve. To maintain acid-alkaline balance of the body “produces” the necessary substances from its own cells.
This is why, to make the right conclusion from the analysis findings, it is necessary to ask the patient about dietary preferences. Some people are trying to heal yourself of trendy diets. The consequence of disturbed metabolism.
What is considered a deviation from the norm?
High red blood cell count in the urine indicates blood, so doctors use the term “hematuria”.
According to the severity of it can be:
- minimal (microscopic hematuria) – urine the usual straw-yellow color, contains impurities only under a microscope specialist counts the number of red cells in field of view in excess of the normal amount (for an adult is 1 in the urine of men, 3 – women, for children up to year 2 to 4 cells), the conclusion is often write the phrase “single in sight”;
- a gross hematuria – red blood cells are so numerous that they cover the entire field of view, usually when the number of cells more than 100 changes urine color, it becomes red-brown.
The color of urine varies not only depending on the number of red blood cells in the urine. The redness is caused by eating dishes from beets, abuse of tablets containing Aspirin and Analginum during the course of treatment injections of vitamin b12.
When microhematuria is considered physiological?
The microhematuria is not always associated with pathological changes. This means that in certain conditions creates an opportunity for erythrocytes to pass restrictive barriers.
Moderately elevated red blood cells in the urine:
- after taking a substantial dose of alcohol;
- when overloaded digestion spicy and salty food;
- due to overheating in the sun, “solar strike”;
- after going to the steam bath;
- on the background of physical exercises and heavy work;
- resulting from stressful situations.
Excess ultraviolet radiation promotes the penetration of erythrocytes into the urine
Doctors always warn about the rules of urine collection for analysis. These include all listed due to space constraints. If the patient did not comply with the conditions, then the conclusion is obtained greatly complicates the interpretation of the violations. There is a reason for re-exploration.
What causes abnormal increase of red blood cells in the urine?
In itself, the increase in red blood cells is not a diagnosis. The patient will be monitored to identify possible pathology.
Origin of hematuria it is possible to allocate three reasons:
- renal or renal – speak about pathological changes in the kidneys;
- prerenal (somatic) indicate a variety of diseases not directly connected with the urinary organs;
- postrenal – mean that a large number of red blood cells enters the urine from the ureters, bladder, urethra.
The reasons for the increase of erythrocytes in the urine can be caused by the gender and age of the person because of the characteristic anatomical and physiological features.
What changes in the kidneys lead to hematuria?
Renal causes are caused by disease and injuries of the kidneys, affecting the glomerular and tubular apparatus, the interstitium.
The most common pathologies, accompanied by hematuria at different stages are:
- injury (rupture of the renal capsule by injury, a penetrating stab wound) – high content of red blood cells in the urine is the localization of internal bleeding;
- inflammatory diseases of the kidneys (glomerulonephritis, pyelonephritis, tuberculosis of kidneys) contribute to the filtration and passage of erythrocytes through the membrane of the glomerular apparatus, increase blood flow to the site of inflammation, stimulate the capillaries in the disease process;
- stone in the pelvis or cups, the growth of the crystal structures leads to injury of the mucosa and feeding vessels;
- malignant tumor of the kidney – with the growth of tumors of the vascular wall are destroyed malignant cells, the hematuria is of mild nature, appear in the urine unchanged erythrocytes;
- hydronephrosis – causes hyperextension of the capsule of the kidney, flow of urine impeded, while there is venous stasis, to create conditions where erythrocytes are under increased pressure to pass through the vascular wall and enter into the urine.
In the diagnosis of renal lesions should pay special attention to the high level of protein, white blood cells, nitrogenous substances in the blood. These indicators suggest the form and stage of inflammation.
What applies to physical reasons?
Somatic (vnepochechny) diseases of the various mechanisms involved in the pathological process of the urinary system.
Similar examples can be:
- diseases of the blood, in violation of coagulation (hemophilia, thrombocytopenia) – an unusual red blood cells have the ability to penetrate through the basal membrane of the glomeruli of the renal system;
- severe intoxication – under the influence of toxins, decay products and toxic substances there is an increased permeability of the membrane, the red blood cells move freely in the urine, occurs in all febrile conditions, hemorrhagic fever, snake bite;
- hypertension – in severe attacks all vessels, including the kidney;
- heart failure leads to venous congestion in the system of the inferior Vena cava extending to renal vein;
- uncontrolled use of some medicines, their negative properties can be compared to toxic effects, these include anticoagulants, sulfonamides, large doses of vitamin C.
The red blood cells out of the cavity of the vessel through a damaged wall
Postrenal pathology with hematuria
Any damage to the ways the urinary tract, lying below the kidney, postrenal considered. Increased content of red blood cells is accompanied by abnormalities of the ureters, bladder, urethra.
In severe forms of cystitis with ulcerative-necrotic, gangrenous, hemorrhagic lesion of the bladder wall, the erythrocytes appear as the destruction of feeding vessels. The movement of stone in the ureter or its location in the bladder dramatically injure the walls and contributes to the appearance in the urine of fresh erythrocytes.
In case of damage to the bladder when carrying out a cystoscopy, catheterization, therapeutic instillation possible mild hematuria for several days after the procedure. A cancerous tumor located in the bladder, causing gross hematuria due to the destruction of large vascular area. The patient draws attention to an increased allocation of blood at the end of urination.
Oxalate stones are the most dangerous in the development of gross hematuria
Features of causes of hematuria in men and women
In men the red blood cells in the urine are increased:
- for prostatitis – inflammation of the prostate contributes to the loosening of the walls of nearby blood vessels, red blood cells of them penetrate into the urine through the urethral canal;
- adenoma and cancer of the prostate, destroying the vessels.
Female gynecological diseases with uterine bleeding accompanied by blood in the urine from the vagina during the act of urination.
Most often bleeding is accompanied by:
- tumors of the uterus;
- erosion of the cervix.
Women are advised not to collect a urine sample during menstruation and several days after. If there is an emergency, urine can take only a catheter.
About hematuria during pregnancy read in this article.
The detection of hematuria in adolescents, but common with older reasons, the possibility must be considered:
- congenital anomalies of blood vessels;
- migrated in childhood diathesis;
- the effects of a virus infection;
- increased sensitivity to drugs.
Child at any age needs to be examined to clarify the causes of hematuria.
Detection of red blood cells in the urine should not be ignored even without the patient’s complaints. You should consider the possibility of latent disease. When the doctor repeated studies must take seriously the preparation and collection analysis. Any violations of the rules lead to unreliable information, difficult to diagnose.