Normally, there are no red blood cells in urine. If there are more than 3 red blood cells in each high magnification field, it is called hematuria. If the urine is only found under the microscope, but the eye cannot see blood, it is called microscopic hematuria; if the eye can see that the urine is “flesh-washing” or blood-colored, or even has blood or blood clots in the urine, it is called sarcoid hematuria. Therefore, not all hematuria can be detected by the eyes. If you can see blood in your urine with your eyes, and at least 1 ml of blood is mixed in about 1,000 ml of urine, this means that hematuria is more serious, and you should hurry to find out the cause and treat it actively.
(I) Etiology of hematuria
Hematuria is often caused by diseases of the urinary organs. Human urine is produced in the kidneys and discharged through the renal pelvis, ureter, bladder and urethra. Any disease in these organs that causes bleeding can cause hematuria.
Diseases that commonly cause hematuria include various types of nephritis, urinary tract infections, hemorrhagic cystitis, urinary stones, renal tuberculosis, renal tumors, kidney and urethral injuries, etc. Hematuria is one of the main symptoms of these diseases.
(B) Differential diagnosis of hematuria
When urination starts with hematuria and the latter part of the urine is normal, it is usually due to urethral disease; if urination starts normally and ends with hematuria, it is mostly due to cystitis and prostate disease; if it is “full-blown hematuria” with dark red blood, it is usually due to kidney disease. Blood in urine is rarely a sign of shock.
Hematuria is commonly seen in the following diseases.
1, acute glomerulonephritis hematuria with scanty urine, proteinuria, swelling, hypertension, tonsillitis a week before the onset.
2, pyelonephritis, hematuria with urinary pain, urinary urgency, urinary frequency, back pain, fever.
3, urinary stones characterized by hematuria with renal colic, or symptoms such as interrupted urination, difficult urination and painful urination.
4.Nephritic tuberculosis with hematuria accounts for more than 90% of cases, characterized by urinary urgency, urinary frequency and urinary pain gradually aggravated.
5, kidney and urinary tract injuries mostly have a history of lumbar or abdominal trauma, such as contusions, bruises, falls, etc.
6, allergic purpura this disease has bleeding spots on the skin, gastrointestinal bleeding, joint pain. Hematuria appears after 2 or 4 weeks with bleeding spots on the skin.
7, systemic diseases vitamin C, vitamin K deficiency, blood diseases such as leukemia, hemophilia can cause hematuria.
8.Medicinal hematuria Some drugs have damage to the kidneys and can cause hematuria after taking them. Such as gentamicin, tetracycline, sulfonamides, kanamycin, etc.
9, temporary hematuria caused by drinking too little water, increase drinking water, dilute the urine will disappear soon.
(C) Rescue measures
1, bed rest, minimize strenuous activities. Phenobarbital, Valium and other sedative and sleeping drugs can be taken if necessary.
2, drink a lot of water to reduce salt crystals in the urine and speed up the excretion of drugs and stones. Those with nephritis who have swelling should drink less water.
3, the application of hemostatic drugs, such as anilox blood, hemostatic min, vitamin K, but also can be combined with vitamin C.
4.Caution in the use of drugs that cause hematuria, especially for those who already have kidney disease.
5.Hematuria is caused by urinary tract infection, oral and injectable antibiotics and urinary tract cleansers, such as flupirtate, furazim, ampicillin, penicillin, methotrexate and other drugs.
Urinary stones are often associated with severe abdominal pain, and oral belladonna tablets, 654-2, and atropine may be given to relieve spasm and pain. Not all red urine is hematuria. Some foods and drugs can make the urine red, yellow-red or brown, such as rhubarb, phenolphthalein, rifampin, tetracyclines, phenol red, purine drugs, etc.
Some drugs can cause hematuria, such as cyclophosphamide, allopurinol, heparin and bicoumarin.
Hemoglobin or myoglobinuria caused by massive red blood cell or tissue destruction due to wrong blood transfusion, severe trauma, etc., is not hematuria.
Blood dripping from the urethra due to bleeding from a lesion in the anterior urethra is also not hematuria.
Hemorrhage from neighboring organs mixed with urine to stain the urine is also not hematuria.