Causes and treatment of hematuria in adults and children: nonspecific, idiopathic, essential, initial, relapsing

Sometimes to understand that something is wrong with the body, only the results of the tests will help. The analysis of blood will give an assessment of the general condition of the body, and urine tests can be used to assess the state of the urinary system. Particular attention should be paid to the presence of erythrocytes in the urine - red blood cells.

Hematuria - what is it?

The appearance of blood in the urine is called hematuria. It is not necessary that the patient will notice with the naked eye the presence of blood cells in the analysis, hematuria can go unnoticed and appear exclusively at the doctor's reception.

By itself, hematuria is not considered a disease, it is only a symptom of the pathology of the urinary tract.

Despite this, in the international classification of diseases, hematuria has its own codes for ICD-10:

  • N02 - recurrent and persistent hematuria;
  • R31 - nonspecific hematuria.

If there is a significant amount of blood in the urine that is visible to the naked eye, one speaks of a macrogemuria, and this is evidence of a serious urological disease.

Sometimes it happens that the appearance of erythrocytes in the urine of women can be associated with a careless collection of analysis on critical days. In this case, hematuria is not discussed.

In any case, the appearance of urine in blood tests in both adults and children or newborns is considered a threatening symptom and requires additional examination.

What is hematuria

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Specialists classify hematuria by several features:

  • the number of erythrocytes in the urine;
  • source of bleeding;
  • development mechanism;
  • place of occurrence;
  • clinical manifestations;
  • duration.

By the number of red blood cells, microhematuria is isolated, in which the number of red blood cells in the urine is not so numerous that it was possible to visually assess the presence of blood in the urine, and the macrohematuria in which the blood in the secretions is so large that the color of urine can change to brown or black.
On the video of what a microhematuria is:

Depending on the source, hematuria is divided into:

  • initial( initial).With this type of blood, the initial portion of urine is colored, which may be associated with bleeding from the urethra;
  • terminal( final).With this type of hematuria, blood is not observed in the first portions of the urine, and only the last part of the urine contains blood. Often terminal hematuria accompanies various lesions of the neck of the bladder or prostate;
  • total - all urine is completely colored with blood. Total hematuria is observed in lesions of the parenchyma of the kidneys, its pelvis, bladder or ureter.

This division will help the doctor in the study to suggest in which department of the urinary system a pathology has occurred.

The development mechanism is distinguished by:

  • extrarenal type. About this form is said in the case when the hematuria does not arise due to damage to the kidney;
  • Idiopathic - originated for the first time. It is often found in pregnant women, due to hormonal changes or mechanical damage due to the effects of the fetus on the kidneys and urinary tract.
  • Renal type - associated exclusively with renal pathology;
  • postrenal hematuria - bleeding originates from pathological processes in the bladder.

Depending on the place of origin, hematuria is divided into:

  • glomerular, when blood enters urine through the glomerulus of the kidney. Lasts for a long time, almost always has a total form, accompanied, as a rule, by the presence of protein in the urine;
  • postglomerular - the source of bleeding is located near the glomerular filter.

In terms of duration, hematuria is divided into three types:

  • short-term - observed with passage of concrements;
  • persistent - hematuria persists for a long time, sometimes even for several years;
  • asymptomatic( painless) - observed with some congenital diseases of the kidneys;
  • intermittent - hematuria is intermittent, intermittent. It is observed with trauma, immunoglobulin nephropathy, Berger's disease.

According to the clinical features of the disease, specialists distinguish:

  • isolated hematuria - the emergence of only bleeding, not combined with other signs of the disease;
  • combined with proteinuria;
  • recurrent hematuria;
  • essential - this is called the form of hematuria, in which it is impossible to reliably determine the cause of the pathological condition. At the present time, if the diagnostician has modern equipment, the term is considered obsolete and is practically not used.

Reasons for

In a healthy person, hematuria is practically not observed. It is extremely rare for people who make long hiking trips, or for sprinters after a long distance race. As a rule, after the end of the load, the condition improves independently. In such cases, specialists mark microhematuria.

As for macrogematuria, it is always evidence of severe damage to the kidney or urinary system.

Conditionally, there are several reasons that can cause the appearance of red blood in the urine:

  • trauma of the lower abdomen or back in the kidney area;
  • taking medications( drug hematuria);
  • kidney disease - both hereditary and acquired;
  • oncological diseases of internal organs.

If you take into account hematuria of non-parental origin, then most often hematuria is the result of the formation and movement of concrements along the urinary tract.

The cause of hematuria in men can be prostatic diseases:

  • prostatitis;
  • is a cancerous tumor;
  • prostate adenoma.

In terms of renal hematuria, its causes may be:

  1. Injuries and injuries of the kidneys.
  2. Stone formation and passage of stones.
  3. Tumor processes. The appearance in the urine of blood clots should alert the patient and serves as a signal for urgent medical treatment.
  4. Inflammatory and infectious diseases of the kidneys.
  5. Hereditary and congenital malformations of the kidneys in newborns. Sometimes the causes of blood in the urine are inflammatory and infectious diseases of the body, not associated with the urinary system: sepsis, measles, scarlet fever, rheumatism, etc.
    In the chart, possible causes of hematuria

    Symptoms of

    Speaking of symptoms, it should be noted that hematuria is not a separate disease, but in itself serves as a symptom of any disease. Therefore, it is necessary to talk only about the accompanying complaints of patients, indicating a particular cause, causing an increase in red blood cells in the analysis of urine.

    Most often, patients complain of such feelings:

    • pain in the lumbar region or in the side, which pops about the defeat of the kidneys, which indicates the defeat of the kidneys;
    • pain when urinating, before or immediately after bladder emptying;
    • thirst;
    • severe weakness and dizziness;
    • pain in the lower abdomen;
    • the appearance of blood clots in the urine, which may indicate the presence of renal bleeding;
    • inability to completely empty the bladder, frequent urge to urinate;
    • appearance in the urine along with the blood of small stones or sand, which speaks of urolithiasis.


    To diagnose a disease that causes hematuria, you should immediately contact a urologist. First of all, if a doctor suspects hematuria, the doctor will prescribe a urine test that will show whether the patient actually suffers from hematuria or if the urine is colored red due to other causes.

    A urine test given by a patient will show if there is an increased number of red blood cells in the urine, whether proteinuria is observed, whether there are salt in the test sample that can cause stone formation, or bacteria that can cause inflammatory diseases of the kidneys.

    In addition to urinalysis, the doctor will most likely prescribe the following:

    • blood test for creatinine;
    • radiography of the abdominal cavity;
    • ultrasound of the kidneys and bladder;
    • intravenous pyelography, which gives a complete picture of the pathologies of the urinary system;
    • cystoscopy - endoscopic examination of the bladder;
    • MRI or CT of the abdominal cavity;
    • three-cup urine sample to determine which of the portions of urine is present in the blood. In this case, the doctor will determine if the hematuria is initial, terminal or total, which will suggest which part of the urinary system has a pathological process.

    Treatment of

    To get rid of such a symptom as hematuria, it is necessary to identify a disease that causes the appearance of red blood cells in the urine.

    In the case of infection of the urinary tract or bladder, the patient will be prescribed antibacterial therapy.

    In case of kidney trauma, the patient is shown urgent surgical intervention.

    To stop bleeding in the hematoma, the doctor can prescribe hemostatic drugs, and if blood loss is more than 500 ml, infusion therapy will be needed.

    In any case, the patient, who has hematuria, should immediately go through all the examinations, appointed by the doctor and urgently begin treatment. This terrible symptom in any case can not be ignored!

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