2014年4月13日星期日

Hematuria (Blood in Urine) in CKD Stage 3

In CKD stage 3, there will appear many symptoms such as high blood pressure, proteinuria, pain in the lower back, etc. Besides these, hematuria or blood urine is also concerned by many patients, which can be divided into gross hematuria and microscopic hematuria. We can see gross hematuria with our naked eyes. The urine looks reddish, which is like water where flesh is washed. We can only see microscopic hematuria with the help of microscopy. There are more than 3 red blood cells per high power field.

Gross hematuria can vary widely in appearance, from light pink to deep red with clots. Despite the quantity of blood in the urine being different, the types of conditions that can cause the problem are the same, and the workup or evaluation that is needed is identical.
What are the causes of blood in urine?
The causes of gross and microscopic hematuria are similar and may result from bleeding anywhere along the urinary tract. One cannot readily distinguish between blood originating in the kidneys, ureters (the tubes that transport urine from the kidneys to the bladder), bladder, or urethra.
Here, we mainly research renal hematuria, which means that blood urine is caused by the damage of kidney. In kidney, there is renal glomerular filtration membrane, through which, only small molecules such as creatinine, urea nitrogen and urea acid, etc can leak out. When kidney is damaged, there is also damage in this filtration membrane, thus causing the leaking out of red blood cell, the urine of which is caused hematuria or blood urine.

In stage 3 of chronic kidney disease, hematuria or blood urine comes into being like this. If not treated well, the leaking out of red blood cells will worsen blood urine in turn, which forms a vicious circle for the pore of basilar membrane will become bigger.

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