What is blood in urine (hematuria)?
Hematuria, or blood in the urine, can be either gross (visible) or
microscopic (blood cells only visible through a microscope). Gross hematuria can
vary widely in appearance, from light pink to deep red with clots. Although the
amount of blood in the urine may be different, the types of conditions that can
cause the problem are the same, and require the same kind of workup or
evaluation.
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. Any degree of blood
in the urine should be fully evaluated by a physician, even if it resolves
spontaneously.
Infection of the urine, (often called a urinary tract infection or UTI)
stemming either from the kidneys or bladder, is a common cause of microscopic
hematuria. Urine is naturally sterile and should not contain bacteria. Kidney
and bladder stones can cause irritation and abrasion of the urinary tract,
leading to microscopic or gross hematuria. Trauma affecting any of the
components of the urinary tract or the prostate can lead to bloody urine.
Hematuria can also be associated with renal (kidney) disease, as well as
hematologic disorders involving the body's clotting system. Medications that
increase the risk of bleeding, such as aspirin, warfarin (Coumadin),
orclopidogrel (Plavix), may also lead to bloody urine. Lastly, cancer anywhere
along the urinary tract can present with hematuria.
Treatment
Most teens don't need any kind of treatment for hematuria. When it's due to
an infection, doctors might treat it with antibiotics. If hematuria is a sign of
something more serious — like sickle cell disease — doctors will treat that
condition.
If you've been treated for hematuria, your doctor will probably want you to
get follow-up tests after treatment to make sure your urine is free of red blood
cells. People who get blood in their urine more than once but have no other
signs of illness may need urine tests and physical exams every few months for a
year and yearly after that as a precautionary measure. If the hematuria goes
away, your doctor may still want to check your urine once a year.
2013年12月16日星期一
Blood urea nitrogen (BUN) test
BUN is an indication of renal health. Normal ranges 8-20 mmol/L. If
Glomerular Filtration Rate (GFR) and blood volume decrease (hypovolemia) then
BUN will increase. Other factors responsible for its increment are fever,
increasedcatabolism, high-protein diet and gastrointestinal bleeding.
BUN (urea-N) is mg/dL in the United States, Mexico, Italy, Austria, Germany. Elsewhere, the concentration of urea is reported as mmol/L, generally depending on the lab.
To convert from mg/dL of blood urea nitrogen to mmol/L of urea, multiply by 0.357 (each molecule of urea having 2 nitrogens, each of molar mass 14g/mol)
Urea [mmol/L] = BUN [mg/dL of nitrogen] x 10 [dL/L] / 14x2 [mg N/mmol urea]
convert BUN to urea in mg/dL by using following formula:
Urea [mg/dL]= BUN [mg/dL] * 2.14
(conversion factor derived by: MW of urea = 60, MW of urea nitrogen = 14x2 => 60/28 = 2.14)
factor = 1 for conversions in mmol (1 mole N2 = 2 moles N per mole of urea):
BUN [mmol/L]= urea [mmol/L]
Urea nitrogen levels tend to increase with age. Infants have lower levels than other people do, and the range in children varies.
Generally, a high blood urea nitrogen level means your kidneys aren't working well. But elevated urea nitrogen can also be due to:
· Urinary tract obstruction
· Congestive heart failure or recent heart attack
· Gastrointestinal bleeding
· Dehydration, resulting from not drinking enough fluids or for other reasons
· Shock
· Severe burns
· Certain medications, such as corticosteroids and some antibiotics
· A high protein diet
If kidney damage is a concern, ask your doctor what factors may be contributing to the damage and what steps you can take to try to control them.
BUN (urea-N) is mg/dL in the United States, Mexico, Italy, Austria, Germany. Elsewhere, the concentration of urea is reported as mmol/L, generally depending on the lab.
To convert from mg/dL of blood urea nitrogen to mmol/L of urea, multiply by 0.357 (each molecule of urea having 2 nitrogens, each of molar mass 14g/mol)
Urea [mmol/L] = BUN [mg/dL of nitrogen] x 10 [dL/L] / 14x2 [mg N/mmol urea]
convert BUN to urea in mg/dL by using following formula:
Urea [mg/dL]= BUN [mg/dL] * 2.14
(conversion factor derived by: MW of urea = 60, MW of urea nitrogen = 14x2 => 60/28 = 2.14)
factor = 1 for conversions in mmol (1 mole N2 = 2 moles N per mole of urea):
BUN [mmol/L]= urea [mmol/L]
Urea nitrogen levels tend to increase with age. Infants have lower levels than other people do, and the range in children varies.
Generally, a high blood urea nitrogen level means your kidneys aren't working well. But elevated urea nitrogen can also be due to:
· Urinary tract obstruction
· Congestive heart failure or recent heart attack
· Gastrointestinal bleeding
· Dehydration, resulting from not drinking enough fluids or for other reasons
· Shock
· Severe burns
· Certain medications, such as corticosteroids and some antibiotics
· A high protein diet
If kidney damage is a concern, ask your doctor what factors may be contributing to the damage and what steps you can take to try to control them.
2013年12月15日星期日
Proteinuria
What is proteinuria?
Proteinuria also called albuminuria or urine albumin-is a condition in which urine contains an abnormal amount of protein. Albumin is the main protein in the blood. Proteins are the building blocks for all body parts, including muscles, bones, hair, and nails. Proteins in the blood also perform a number of important functions. They protect the body from infection, help blood clot, and keep the right amount of fluid circulating throughout the body.
As blood passes through healthy kidneys, they filter out the waste products and leave in the things the body needs, like albumin and other proteins. Most proteins are too big to pass through the kidneys' filters into the urine. However, proteins from the blood can leak into the urine when the filters of the kidney, called glomeruli, are damaged.
Proteinuria is a sign of chronic kidney disease (CKD), which can result from diabetes, high blood pressure, and diseases that cause inflammation in the kidneys. For this reason, testing for albumin in the urine is part of a routine medical assessment for everyone. Kidney disease is sometimes called renal disease. If CKD progresses, it can lead to end-stage renal disease (ESRD), when the kidneys fail completely. A person with ESRD must receive a kidney transplant or regular blood-cleansing treatments called dialysis.
Who is at risk for proteinuria?
People with diabetes, hypertension, or certain family backgrounds are at risk for proteinuria.
Another risk factor for developing proteinuria is hypertension, or high blood pressure. Proteinuria in a person with high blood pressure is an indicator of declining kidney function. If the hypertension is not controlled, the person can progress to full kidney failure.
African Americans are more likely than Caucasians to have high blood pressure and to develop kidney problems from it, even when their blood pressure is only mildly elevated. In fact, African Americans are six times more likely than Caucasians to develop hypertension-related kidney failure
What are the signs and symptoms of proteinuria?
Proteinuria has no signs or symptoms in the early stages. Large amounts of protein in the urine may cause it to look foamy in the toilet. Also, because protein has left the body, the blood can no longer soak up enough fluid, so swelling in the hands, feet, abdomen, or face may occur. This swelling is called edema. These are signs of large protein loss and indicate that kidney disease has progressed. Laboratory testing is the only way to find out whether protein is in a person’s urine before extensive kidney damage occurs.
Proteinuria also called albuminuria or urine albumin-is a condition in which urine contains an abnormal amount of protein. Albumin is the main protein in the blood. Proteins are the building blocks for all body parts, including muscles, bones, hair, and nails. Proteins in the blood also perform a number of important functions. They protect the body from infection, help blood clot, and keep the right amount of fluid circulating throughout the body.
As blood passes through healthy kidneys, they filter out the waste products and leave in the things the body needs, like albumin and other proteins. Most proteins are too big to pass through the kidneys' filters into the urine. However, proteins from the blood can leak into the urine when the filters of the kidney, called glomeruli, are damaged.
Proteinuria is a sign of chronic kidney disease (CKD), which can result from diabetes, high blood pressure, and diseases that cause inflammation in the kidneys. For this reason, testing for albumin in the urine is part of a routine medical assessment for everyone. Kidney disease is sometimes called renal disease. If CKD progresses, it can lead to end-stage renal disease (ESRD), when the kidneys fail completely. A person with ESRD must receive a kidney transplant or regular blood-cleansing treatments called dialysis.
Who is at risk for proteinuria?
People with diabetes, hypertension, or certain family backgrounds are at risk for proteinuria.
Another risk factor for developing proteinuria is hypertension, or high blood pressure. Proteinuria in a person with high blood pressure is an indicator of declining kidney function. If the hypertension is not controlled, the person can progress to full kidney failure.
African Americans are more likely than Caucasians to have high blood pressure and to develop kidney problems from it, even when their blood pressure is only mildly elevated. In fact, African Americans are six times more likely than Caucasians to develop hypertension-related kidney failure
What are the signs and symptoms of proteinuria?
Proteinuria has no signs or symptoms in the early stages. Large amounts of protein in the urine may cause it to look foamy in the toilet. Also, because protein has left the body, the blood can no longer soak up enough fluid, so swelling in the hands, feet, abdomen, or face may occur. This swelling is called edema. These are signs of large protein loss and indicate that kidney disease has progressed. Laboratory testing is the only way to find out whether protein is in a person’s urine before extensive kidney damage occurs.
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