I often have patients who consult me at work for blood in urine, so I will talk to the guys about hematuria in the form of science.
1.First of all, you don’t have to be overly nervous when you find hematuria: some of them are not true hematuria, such as certain foods (beets, food pigments, etc.) and drugs (rifampin, phenol red, phenytoin sodium, etc.) that cause red urine, endogenous hemoglobinuria, myoglobinuria and porphyria when there are no red blood cells on microscopic examination despite abnormal urine color.
2, followed by the classification and etiology of hematuria.
Surgical hematuria Commonly found in stones, tumors, trauma, foreign bodies, malformations or vascular abnormalities of the urinary system, surgical injuries parasitic diseases, etc.
Renal hematuria is seen in various glomerulonephritis, tubulointerstitial nephritis, urinary tract infection, polycystic kidney, spongy kidney, renal artery embolism and thrombosis, renal vein thrombosis, renal infarction, renal tuberculosis, motility hematuria, renal papillary necrosis, renal cortical necrosis, hereditary nephritis, thin basement membrane nephropathy.
3. Systemic diseases with hematuria.
(1) Infections: seen in infective endocarditis, sepsis, epidemic hemorrhagic fever, scarlet fever, leptospirosis, epidemic cerebrospinal meningitis, etc.
(2) Hematologic diseases: seen in thrombocytopenic purpura (idiopathic, secondary), thrombotic thrombocytopenic purpura, hemolytic-uremic syndrome, allergic purpura, hemophilia, etc.
(3) Immune diseases: seen in systemic lupus erythematosus, polyarteritis nodosa, systemic sclerosis, dermatomyositis and vasculitis renal damage, etc.
(4) Drugs: analgesics can cause renal papillary necrosis, birth control pills can cause lumbago-hematuria syndrome, cyclophosphamide can cause hemorrhagic cystitis, certain antibiotics can cause interstitial nephritis, certain toxic substances, radiation, etc. can cause renal lesions.
5, physiological hematuria: seen in high fever, strenuous activity, heavy physical labor and after long standing (Nutcracker phenomenon).
6.Urinary tract adjacent organ diseases: such as prostatitis, acute appendicitis, acute pelvic inflammatory disease, rectal colorectal cancer, etc.
If patients are found to have symptoms of carnal hematuria please pay attention to the following points.
(1) Whether the hematuria is persistent or intermittent and recurrent.
(2) The relationship between hematuria and cold, tonsillitis, intestinal infection, systemic infection, etc.
(3) Whether the hematuria is accompanied by symptoms of urinary tract irritation (frequency, urgency, painful urination), pain or fever.
(4) Whether there is any previous association with abdominal and pelvic tumors, and whether there is a history of other chronic diseases.
The most basic tests for hematuria
1.Urinary routine examination.
2.Urine triple cup test.
3.Urinary phase contrast microscopy.
If you find hematuria, please go to the hospital in time and do not delay your condition.