What does it mean if erythrocytes are found in urine, their norms and treatment

Erythrocytes are red blood cells, which contain iron-containing protein hemoglobin, responsible for the exchange of oxygen and carbon dioxide in the tissues of the whole body. The condition in which these cells are in the urine is called erythrocyturia or hematuria. What this means and whether there is a threat to human health, the doctor will tell after conducting an additional survey.

• Urinalysis
• General
• Clinical
• Using indicator test strips
• By Nechiporenko
• Two- and three-glass sample
• Norms
• For manual microscopy of sediment for general urine analysis
• For concealed blood test using test strips:
• By Nechiporenko:
• What is the significance of
• Elevated
• Unchanged( fresh)
• Modified( dysmorphic)
• Leached
• Single
• Reasons for
• For women
• For men
• For a child
• When pregnant
• Treatment

Urinalysis

The number of erythrocytes in urine can be determined using laboratory tests. Accuracy of the result will ensure the preparation and proper collection of material:

• exception at least 2 days before the analysis of physical, psycho-emotional loads, intimacy;
• the end of the medication intake a few days before the urine test;
• adherence to a diet that excludes fatty, spicy foods and foods that can color the urine in a different color;
• hygienic procedures( warm water washout) immediately before urination;
  

  
  

• collection of material for study in the morning, after sleep;
• preparation of clean dry containers and rapid delivery of urine to the laboratory.

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General

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Clinical

It is carried out in laboratories and allows to evaluate the state of the body according to the set of sample parameters:

• organoleptic study - involves research of color, odor, transparency, daytime diuresis;
• physicochemical - study of the density, acidity of urine;
• biochemical - detection in the liquid of glucose, proteins, ketone bodies, hemoglobin, bilirubin, nitrites and other constituents.

A manual microscopy of the urine sediment is also carried out - the material in the tube is run in a centrifuge, after which the remaining layer is examined:

• an organized sediment - may include erythrocytes, leukocytes, cylinders, bacteria, yeast fungi, mucus, flat and cylindrical epithelium cells;
• is an unorganized precipitate - it consists of salt crystals.

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Using indicator test strips

In this case, the analysis decoding table consists of 2 sectors:

• without hemolysis( natural decomposition of red blood cells with release of hemoglobin) - with small points in the fields to compare the result;
• with hemolysis - uniformly colored fields.

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According to Nechiporenko

Allows more accurate calculation of the number of leukocytes, red blood cells and cylinders per unit volume of liquid - 1 milliliter or 1 liter. Appointed in case of deviation from the norm of the results of the general analysis. For the study, the average portion of the morning urine is taken.

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Two- and three-glassed sample

Is a laboratory study of 2( for women) or 3( for men) portions of urine obtained during one urination and collected in different containers. It is carried out to clarify the localization of the inflammatory process. Indications are changes in color of urine, discomfort during urination, aching pain in the kidneys.

In a triplicate trial in men, hematuria, found only in the first portion of urine, indicates urethral diseases, in the middle portion - on problems with the bladder, in the third portion - on prostate cancer. With traces of blood in the first and third containers, the diagnosis is urethritis and prostatitis. In hematuria, found in all containers, they speak of stones in the kidney or bladder, kidney tuberculosis, trauma or cancer.

If in the case of a two-glassed sample in women, impurities are found in the first container, this indicates urethritis, in the second - about cystitis, in both - about pyelonephritis.

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Standards

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For manual microscopy of sediment in general urine analysis

The rates may vary depending on the sex and age of the patient:

• in men - 0-2 erythrocyte in the field of vision;
• in women - 0-3 cells in the field of vision;
• in children - 2-4 units( in newborns - up to 7) in sight.
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For concealed blood test using test strips:

• Negative value of - 0 of erythrocytes in 1 microliter of liquid or 0 milligram of hemoglobin in 100 milliliters of urine.
• Weakly positive reaction of - 5-10 cells in 1 microliter of urine or 0.015 milligrams of hemoglobin in 100 milliliters.
• Positive - 50 units in 1 microliter of material or 0.15 milligrams of hemoglobin per 100 milliliters of material.
• A sharply positive - 250 erythrocytes in 1 microliter of urine or 0.75 milligrams of hemoglobin in 100 milliliters of the sample.

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According to Nechiporenko:

The norm is the number of red blood cells not exceeding 1 thousand units per 1 milliliter of urine( or from 0 to 1 * 10⁶ cells per 1 liter of material).

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What does the

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Elevated

The excess of the norm of red blood cells in urine is calledhematuria and is divided into the following types:

• Microhematuria. Visually, the color of urine is normal, however, microscopy reveals intact erythrocytes( not hemolyzed).
• Macrohemuria. Characterized by the acquisition of urine reddish hue due to the presence in it of free hemoglobin.

This condition indicates bleeding in the genitourinary system.

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Unchanged( fresh)

Represents red blood cells containing hemoglobin. They have the form of discs of a yellowish-green color. Detect in an alkaline, neutral or slightly acidic environment. Their presence in the urine indicates the defeat of the urinary tract - urethritis, cystitis, movement of the stone.

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Modified( dysmorphic)

Corrected erythrocytes are considered to be changed, which occurs at high urine density, but at the same low density, they increase in diameter. The state of cell changes is also characteristic of urine stagnation.

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Leached

Erythrocytes devoid of hemoglobin, resembling colorless rings in shape. Also refer to the changed. Leaching of blood cells is characteristic of an acidic environment. Finding them in the urine testifies to the permeability of the renal filter, that is, the filtration disorders caused by kidney diseases.

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Single

Detection of single in the preparation of red blood cells is considered the norm, their number should be 0-2 in the field of view.

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Reasons for

The main causes of a large number of erythrocytes in the urine are lesions of the kidneys, bladder and urinary canals:

• Urolithiasis - in the formation of stones and their movement injured mucous membranes of the kidneys, bladder and urinary canals, while unchanged erythrocytes enter urine.
• The increased content of salts in the kidney and bladder can also lead to damage to the mucous membranes of these organs.
• Glomerulonephritis is an inflammation of the glomerulus of the kidneys, in which haematuria often occurs.
• Hydronephrosis is a violation of the outflow of urine, in which it accumulates, causing enlargement and trauma to the kidneys.
• Malignant tumors - during their growth destroy the blood vessels, causing small bleeding and the entry of red blood cells into the urine.
• Injury of the kidney or bladder from the outside of the , resulting in damage and bleeding.

Among other diseases that cause hematuria, are:

• Hemophilia - with poor blood coagulation, the synthesis of blood plasma is disrupted and the erythrocytes enter urine.
• Thrombocytopenia - a low platelet count in the blood also worsens its coagulability, as a result of which, by filtering through the kidneys, blood cells enter the urine.
• Intoxication of the body - ingestion of poisons, toxins, as well as viral and bacterial infections increases the permeability of the glomerulus of the kidneys.
• Postponed diseases - fever, malaria, smallpox cause an increase in the level of erythrocytes in the urine.

Also the appearance of hematuria can provoke non-pathological factors:

• Physiological - the permeability of the walls of blood vessels arises after excessive physical exertion, bath or sauna visits, prolonged sun exposure, abuse of spicy food or alcohol.
• Some medications - urotropine, sulfonamides, various anticoagulants, ascorbic acid.

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In women

In connection with the physiological characteristics, there are diseases characteristic of women:

• Cystitis is an inflammation of the bladder, in which blood can penetrate into the urine through the weakened walls of the vessels.
• Pyelonephritis is a bacterial kidney damage that causes inflammation and penetration of erythrocytes through the kidney canals into the urine.
• Uterine bleeding - blood gets into the urine during urination.
• Cervical erosion - this process is characterized by a violation of the integrity of blood vessels.

When taking the test during menstruation or with insufficient hygiene of the genitals, an unreliable result is possible.

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In men

Hematuria often occurs against the background of diseases of the male genitourinary sphere:

• Urethritis - inflammation of the urethra( urethra), accompanied by painful urination.
• Prostate adenoma is an inflammatory process in the tissues of the prostate.

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For a child

When an increased erythrocyte is found in the urine of a child, a check should be performed as soon as possible in order to diagnose and cure possible diseases:

• Kidney and organ damage of the genitourinary system.
• Bladder ureter reflux is a condition in which the urine flow from the kidney to the ureter is disturbed by the weakening of the valve and it can move in the opposite direction. The disease can lead to kidney loss.
• Inflammatory diseases of other internal organs and systems.

Also the causes of hematuria in children can be:

• Incorrect food, which includes products with preservatives and dyes, a large amount of protein foods, citrus fruits, chocolate.
• Non-compliance with the regime of day and rest, excessive physical activity, stress.

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During pregnancy

During the period of bearing a child, the whole organism experiences an increased burden, and in particular - the urinary system. Fetal health largely depends on the functioning of the kidneys of the mother, so the slightest deviation of the urine from the norm is a serious cause for concern.

During pregnancy, all chronic diseases worsen, and uterine growth can lead to squeezing of internal organs. During this period, a general urine test is the most common study that allows you to monitor a pregnant woman's condition and quickly recognize a pathology.

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Treatment of

Increase in the level of erythrocytes in urine is not an independent disease, for the normalization of indicators it is necessary to identify the cause of the pathology and eliminate it. If hematuria is detected, reanalyses should be performed. When confirming the results, the doctor( nephrologist or urologist) appoints additional tests:

• ultrasound examination of the kidneys and organs of the abdominal cavity;
• contrast X-ray of the urinary system;
• analysis for bacterial inoculation;
• detailed analysis and biochemical blood test;
• consultation of narrow specialists.