Hematuria is presence of RBC in urine. Hemoglobinuria is specifically Hg in urine.
Patient information
What is hematuria?
It's where we find blood in urine. Specifically, red blood cells.
Wait, what different sorts of blood cells are there?
There's red ones, white ones, and platelets. Reds help to carry oxygen, hence it's red color because of the iron that helps bind with oxygen. Whites are cells of the defense system. Platelets help to stop bleeding, by clumping together and making a clot.
Cause
UTI w/ bacteria, usually E coli, followed by Klebsiella pneumonia and Staphylococcus → WBC also present
Stones in the kidney, bladder or ureter (nephrolithiasis)
Tumor in the urinary tract (kidneys, ureters, urinary bladder, prostate, urethra)
Polycystic kidney disease
Trauma
Cancer of the kidney, prostate, or bladder
Benign prostatic hyperplasia → older men (>50yo)
Vigorous exercise (high intensity exercise)
Idiopathic (unknown)
Less commonly:
Glomerular bleeding, e.g. IgA nephropathy, Alport syndrome, thin basement membrane disease
Sickle cell disease
Schistosomniasis, caused by schistosoma h, a major cause of hematuria in African countries
Recent instrumentation of the urinary tract
Prostatitis
Urethritis
Kidney diseases
Rarely:
Loin pain hematuria syndrome, if combined w/ flank pain
Paroxysmal noctural hemoglobinuria, where Hb of hemolyzed cells is passed into the urine, rare
AV malformation of the kidney, rare
Fibrinoid necrosis of the glomeruli, due to malignant HTN
Allergy, can cause episodic gross hematuria, in kids
Left renal vein HTN (aka nutcracker phenomenon), a vascular abnormality, responsible for gross hematuria, rare
Ureteral pelvic junction obstruction, condition beginning from birth, where the ureter is blocked between the kidney and bladder, rare
March hematuria, secondary to repetitive impacts on the body, usually the feet
Athletic nephritis, secondary to strenuous exercise
Alport syndrome
Patient information
What causes oxygen carrying red blood cells, to be found in urine?
So any sort of damage to the kidneys, as they're meant to let certain things go, but not blood cells. Blood cells are supposed to be bigger than the size of the pores in the kidney's glomerulus (8nm), because platelets are 2-3µm, reds are 6-8µm, and whites are 7-30µm, depending on which one we're talking about. So, we find red blood in urine, when there's damage to the kidney. So it's everything from UTI's, stones, cancer, and trauma.
Dx
Medical Hx
Urinalysis (urine testing), which may need to be repeated
Imaging:
CT scanning or U/S, to confirm kidney stones
Cystoscopy of the ureter and bladder, and CT urography, for risk of cancer of the bladder, prostate, ureters, or kidney, including
DDx
Drugs, can cause red discloration of the urine, including:
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