Idiopathic hematuria

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Idiopathic haematuria is the presence of red blood cells in the urine. The urine may then turn red. The laboratory criterion for haematuria is the detection of more than 5 erythrocytes / µl in the urine. Hematuria can be caused by kidney stones, a kidney tumor, or a urinary tract infection. Treatment includes the use of antibiotics or surgery.

What is idiopathic hematuria?

Hematuria is commonly referred to as hematuria, i.e. the presence of erythrocytes in the urine. Urine in the course of this condition may turn red. We speak of idiopathic haematuria when the urine contains more than 5 items / µl (erythrocytes). Hematuria is one of the alarming symptoms that may indicate a developing urinary tract disease.

The following types of hematuria are distinguished:

• microhematuria (hematuria); the presence of red blood cells can only be revealed through laboratory tests,

• macrohematuria (hematuria) when urine is red – usually 0,2 ml of blood in 500 ml of urine is sufficient for this.

Hematuria always requires consultation with a doctor and thorough diagnosis! If it is not possible to establish its cause, we are talking about idiopathic hematuria.

Idiopathic haematuria – causes of formation

Possible causes of idiopathic hematuria:

  1. urinary tract infection,
  2. kidney stones,
  3. glomerulonephritis,
  4. bladder cancer
  5. injury,
  6. mild familial hematuria,
  7. paroxysmal nocturnal hemoglobinuria – a rare disease caused by the breakdown of red blood cells at night when the blood pH drops,
  8. kidney cancer.

Haematuria may also occur as a result of strenuous physical activity or taking certain medications, such as acetylsalicylic acid. The risk of idiopathic haematuria is greatly increased in:

  1. marathon runners (runner haematuria),
  2. women – many women have had a urinary tract infection, one of the symptoms of which was hematuria,
  3. people with a history of infections, e.g. nephritis after a bacterial or viral infection,
  4. people with a family history of idiopathic haematuria, kidney stones or other kidney ailments,
  5. men after the age of 50 (enlarged prostate),
  6. people who regularly take painkillers or anti-inflammatory drugs,
  7. young men suffering from Alport syndrome (a genetic kidney disorder characterized by haematuria, often associated with neurogenic deafness and eye changes) or kidney stones.

Idiopathic haematuria – diagnosis

In order to diagnose idiopathic haematuria, it is necessary to conduct a medical interview with the patient and perform appropriate tests. The main studies are:

  1. cystoscopy
  2. urine test
  3. computed tomography or magnetic resonance imaging

It may happen that the tests carried out still do not answer the question of where the presence of hematuria came from. Then it is necessary to conduct further tests, especially in people who belong to the group at high risk of bladder cancer, as a result of contact with toxins or smoking.

Treatment of idiopathic hematuria

If the haematuria is accompanied by other symptoms (e.g. fever, renal colic), it may be easier to determine the cause. Treatment consists of administration of antibiotics (in the case of urinary tract infections) or surgery (if the cause of the haematuria is a malignant process).

In addition, people with hematuria should:

  1. drink plenty of water and do not delay urinating; also after sexual intercourse, urinate and wipe the genitals thoroughly;
  2. avoid the use of irritating intimate hygiene products (this prevents urinary tract infections),
  3. quit smoking and avoid contact with chemicals,
  4. Include in your daily schedule – physical activity (moderate).

Text: lek. med. Matylda Mazur

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