RBC in Urine

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Hematuria is the presence of abnormal numbers of red cells in urine due to: glomerular damage, tumors which erode the urinary tract anywhere along its length, kidney trauma, urinary tract stones, renal infarcts, acute tubular necrosis, upper and lower uri urinary tract infections, nephrotoxins, and physical stress. Red cells may also contaminate the urine from the vagina in menstruating women or from trauma produced by bladder catherization. Theoretically, no red cells should be found, but some find their way into the urine even in very healthy individuals. However, if one or more red cells can be found in every high power field, and if contamination can be ruled out, the specimen is probably abnormal.

RBC's may appear normally shaped, swollen by dilute urine (in fact, only cell ghosts and free hemoglobin may remain), or crenated by concentrated urine. Both swollen, partly hemolyzed RBC's and crenated RBC's are sometimes difficult to distinguish from WBC's in the urine. In addition, red cell ghosts may simulate yeast. The presence of dysmorphic RBC's in urine suggests a glomerular disorder such as a glomerulonephritis. Dysmorphic RBC's have odd shapes as a consequence of being distorted via passage through the abnormal glomerular structure.

Red blood cells can enter the urine from the vagina in menstruation or from the trauma of bladder catheterization.
A high count of red blood cells in the urine can indicate infection, trauma, tumors, or kidney stones. If red blood cells seen under microscopy look distorted, they suggest kidney as the possible source and may arise due to kidney inflammation (glomerulonephritis). Small amounts of red blood cells in the urine are sometimes seen young healthy people and usually are not indicative of any disorder.

Test results
Greater than normal numbers of red blood cells in the urine may indicate:
·Acute tubular necrosis  
·Cystitis (bladder infection)  
·Interstitial nephritis  
·Pyelonephritis (kidney infection)  
·Kidney trauma  
·Kidney tumor  
·Kidney stones  
·Menstrual bleeding  
Additional conditions under which the test may be performed:
·Alport syndrome  
·Complicated UTI (pyelonephritis)  
·Membranoproliferative GN II  
·Kidney vein thrombosis  
Hematuria has many different causes:
·Blood in the urine can come from any condition that results in infection, inflammation, or injury to the urinary system.  
·Typically, microscopic hematuria indicates damage to the upper urinary tract (kidneys), while visible blood indicates damage to the lower tract (ureters, bladder, or urethra). But this is not always the case.  
·The most common causes in people younger than 40 years of age are kidney stones or urinary tract infections.  
·These may also cause hematuria in older people, but cancers of the kidney, bladder, and prostate become a more common concern in people older than 40 years of age.  
·Several conditions causing hematuria may exist at the same time.  
·Some causes of hematuria are serious, others are not. Your health-care provider will perform tests to help tell the difference.  
The well-known causes of blood in the urine include the following:
·Kidney stones  
·Infections of the urinary tract (UTIs) or genitals  
·Blockage of the urinary tract, usually the urethra: by a stone, a tumor, a narrowing of the opening (stricture), or a compression from surrounding structures  
·Cancer of the kidney, bladder, or prostate  
·Kidney disorder  
·Blood clotting diseases  
·Injury to the upper or lower urinary tract, as in a car accident or a bad fall (especially falls onto your back)  
·Medications: antibiotics (for example, rifampin [Rifadin]), analgesics such as aspirin, anticoagulants (blood thinners such as warfarin, [Coumadin]), phenytoin (Dilantin), quinine (Quinerva, Quinite, QM-260)  
·Benign (noncancerous) enlargement of the prostate known as benign prostatic hypertrophy (BPH), a common condition in older men  
·Chronic disorders such as diabetes, hypertension, and sickle cell anemia  
·Viral infections  
·Inflammation of the kidney, usually of unknown cause  
·Strenuous exercise, especially running, results from repeated jarring of the bladder  
·Sometimes no cause is found for blood in the urine.  
If serious conditions such as cancer, kidney disorder, and other chronic disorders that cause kidney damage or bleeding are ruled out, the cause is usually not serious.
The hematuria will probably go away by itself or continue as a chronic condition without doing harm. Any changes should immediately trigger a return visit and evaluation by your health-care provider.
Urine can be colored pink, red, or brown for reasons that have nothing to do with bleeding in the urinary tract:
·Foods: beets, berries, and rhubarb in large amounts  
·Food colorings  
·Medications: Different medications can change your urine color.  
·Menstrual blood  
·Liver disorders: These may also be very serious causes of discolored urine.  

Also you should know
Blood in the urine is not always visible. If the amount of blood is small, the urine can look normal. This is called microscopic hematuria because the blood cells are visible only under a microscope. Typically, this is discovered when the patient has a urine test for some other reason.

When there is enough blood to be visible, the urine may look pinkish, red, or smoky brown (like tea or cola). This is called gross or frank hematuria. It takes very little blood in urine to be visible - about 1/5 of a teaspoon in one half of a quart of urine.

Older adults, especially men, have hematuria more often than younger people because they are more likely to take medications that can irritate the urinary tract, or have enlargement of the prostate, or cancer.

If you have a urinary tract infection, you will take antibiotics for three to 14 days, depending on what part of the urinary tract is infected.

If you have kidney stones, be sure to drink plenty of liquids to help pass the stones and prevent other stones from forming. You may need to take pain-reliever medications.

The prognosis for most people is good, because the most common causes of blood in the urine can be cured. People who are otherwise healthy can usually be treated on an outpatient basis.

All information on this page is intended for your general knowledge only and does not provide medical advice, diagnosis or treatment.