Hematuria

　　Hematuria is common in life. Finding hematuria does not need to be anxious. First, we need to find the cause of the disease in order to effectively treat the disease. So, how does hematuria occur? Experts introduce in detail:

　　The causes of hematuria:

　　1. Urinary system diseases such as various nephritis (acute glomerulonephritis, viral nephritis, hereditary nephritis, purpura nephritis), stones (kidney, bladder, urethra), heart and kidney tuberculosis, various congenital malformations, trauma, tumors, etc.

　　2. Systemic diseases such as hemolytic diseases, leukemia, heart failure, sepsis, vitamin C and K deficiency, hypercalciuria, neonatal hemorrhage, etc.

　　3. Physical and chemical factors such as food allergy, radiation exposure, drugs, toxins, and post-exercise. To clarify the cause, it is very important to determine the site of hematuria, and the three-cup test can understand the source of hematuria, which is very simple.

　　Take three cups, take the first segment of urine in the first cup, the middle segment of urine in the second cup, and the last segment of urine in the third cup. If the first cup is hematuria, it indicates that the blood comes from the urethra; if the third cup is hematuria, it is terminal hematuria, and the lesion is mostly in the bladder or posterior urethra; if the first, second, and third cups are all red, it indicates total hematuria, suggesting that the lesion is in the kidneys or above the urinary tract. To determine the cause of hematuria, it is important to identify the site of hematuria, and various experiences, X-ray and CT examinations, and even kidney biopsy can be used for diagnosis.

　　Hematuria usually does not occur alone and often occurs with other diseases. Attention should be paid to it in the process of clinical diagnosis and treatment. The main complications of hematuria include the following:

　　1. Urinary tract stones: including kidney, ureter, bladder, or urethra stones.

　　2. Urinary and reproductive system infections: such as pyelonephritis, renal tuberculosis, cystitis, prostatitis, etc.

　　3. Primary nephritis: including acute and chronic nephritis, focal nephritis, benign acute hemorrhagic nephritis, etc.

　　4. Secondary nephritis: purpura nephritis, lupus nephritis, IgA nephropathy.

　　5. Urinary and reproductive system tumors: including kidney tumors, ureteral tumors, bladder tumors, prostate tumors, etc.

　　6. Other urinary tract diseases: such as kidney下垂, wandering kidney, congenital polycystic kidney, etc.

　　7. Urinary tract injury: damage to the kidneys from various chemicals or drugs, hematuria caused by sulfonamide drugs, etc.

　　Everyone is prone to hematuria, as it is often caused by urinary tract infections, and hematuria can affect people's daily lives. So, what are the manifestations of hematuria patients? Below, the editor introduces what the manifestations of hematuria are.

　　Manifestations of hematuria

　　1. Changes in urine color: The main manifestation of hematuria is the change in urine color. In addition to microscopic hematuria, whose color is normal, gross hematuria can present different colors depending on the amount of bleeding. Urine may appear pale red, resembling the color of washing meat, indicating that the blood content per liter of urine exceeds 1 mL. When bleeding is severe, urine may appear like blood. When the kidney bleeds, the urine and blood mix evenly, and the urine appears dark red; when the bladder or prostate bleeds, the urine is bright red, and sometimes there are blood clots. However, red urine is not necessarily hematuria and requires careful distinction. If the urine appears dark red or soy sauce color, it is not turbid and has no sediment, and microscopic examination shows no or only a small amount of red blood cells, it is hemoglobinuria; brown or wine-red, not turbid, and microscopic examination shows no red blood cells, it is porphyria. Taking certain drugs such as rhubarb, rifampicin, or eating certain red vegetables can also cause red urine, but microscopic examination shows no red blood cells.

　　2. Abnormal segmental urine: Observe the color of the urine by segmenting the entire urine, such as the three-cup test. Use three clean glass cups to collect the initial segment, middle segment, and terminal segment urine for observation. If the initial segment shows hematuria, it indicates that the lesion is in the urethra; if the terminal segment shows hematuria, it indicates that the bleeding site is at the bladder neck, trigone, or anterior urethra of the prostate and seminal vesicle; if all three segments are red, it indicates total hematuria, suggesting that the hematuria originates from the kidney or ureter.

　　3. Microscopic hematuria: The urine color is normal, but microscopic examination can determine hematuria and judge whether it is renal or post-renal hematuria. The size and shape of red blood cells are different, indicating glomerular hematuria, which is seen in glomerulonephritis. Because red blood cells leak from the glomerular basement membrane, when passing through the renal tubules with different osmotic gradients, chemical and physical actions damage the red blood cell membrane, causing hemoglobin to leak out and deform. If the red blood cells in the microscopic examination have a single shape, similar to peripheral blood, it indicates homogeneous hematuria, suggesting that the hematuria originates from the post-renal, seen in renal pelvis, calyces, ureters, bladder, and prostate lesions.

　　4. Symptomatic hematuria: When hematuria occurs, patients may have systemic or local symptoms, mainly urinary system symptoms. For example, if accompanied by dull pain or colic in the renal area, it indicates that the lesion is in the kidney. Bladder and urethral lesions often have symptoms such as frequent urination, urgency, and difficulty in urination.

　　5. Asymptomatic hematuria: Some patients with hematuria have neither urinary tract symptoms nor systemic symptoms, and it is seen in the early stage of certain diseases, such as renal tuberculosis, renal cancer, or early bladder cancer.

　　Normal urine contains a very small amount of red blood cells. The urine that has not been centrifuged can have 0-2 red blood cells per high-power field under a microscope. If the number exceeds this, it is considered hematuria. How to prevent hematuria? Next, we will invite an expert to give a detailed introduction to everyone:

　　1. Avoid strenuous exercise and pay attention to the combination of work and rest.

　　2. Patients with hematuria should develop the habit of drinking plenty of water in their daily life. It is best to drink magnetized water.

　　3. Actively treat urinary system diseases such as calculi and inflammation.

　　4. Pay attention to health care and protective measures in the production of rubber, plastic, dyes, and other tools.

　　5. In daily life and work, do not often keep the bladder highly filled. It is necessary to urinate in a timely manner to reduce the prolonged retention of urine in the bladder.

　　6. Abstain from smoking and drinking alcohol, and avoid consuming刺激性 foods such as chili, dog meat, donkey meat, horse meat, coriander, scallion, raw garlic, and spicy foods.

　　7. Because hematuria is not a serious symptom, patients should not be overly frightened. They should communicate with patients, comfort and explain to them, and 1-3 milliliters of blood in 1000 milliliters of urine is gross hematuria, which is not serious, and it should be treated in a timely and regular manner.

　　Hematuria is not a serious disease, but it is necessary to do a good job of related control and prevention work. Otherwise, it is not easy to control other complications. It is still hoped that patients can pay attention.

　　It is very important to determine the location of hematuria. Urine three-cup test can understand the source of hematuria, and the method is very simple. Such as: Take 3 cups, in one urination, take 3 cups, the first cup takes the initial urine, the second cup takes the middle urine, and the third cup takes the final urine. If the first cup is hematuria, it indicates that the blood comes from the urethra; if the third cup is hematuria, it is terminal hematuria, and the lesion is mostly in the bladder or posterior urethra; if the first, second, and third cups are all red, it indicates that the hematuria is throughout, suggesting that the lesion is in the kidneys or above the urinary tract.

　　In addition, for further clarification of the diagnosis, the following examinations can be performed:

　　1. Repeatedly search for cancer cells in the urine. If cancer cells are found in fresh urine, it will help in the diagnosis of bladder cancer.

　　2. Radiographic examination, including abdominal plain film, intravenous pyelography, and renal angiography, etc.

　　3. Type B ultrasonic examination: helpful in diagnosing polycystic kidney and renal tumor.

　　4. Radioisotope examination, commonly used renal scan, is beneficial for the diagnosis of renal tumors.

　　5. Cystoscopy can directly find the location and nature of the bleeding.

　　6. Other examinations: For cases where the source of hematuria cannot be determined or suspected to come from the kidneys, CT scan or renal biopsy can be performed.

　　Therapeutic diet for hematuria: (for reference only, please consult a doctor for details):

　　1) 1500 grams of celery. Wash the celery, crush it to extract the juice, heat and boil it, take 60 milliliters each time, and take 3 times a day.

　　Effect: Cool blood and stop bleeding.

　　2) 1500 grams of radish, appropriate amount of honey and salt. Wash the radish, peel and slice it, soak in honey for 10 minutes, dry it on a tile, and then soak and dry it again (BF) (do not burn) for 3 times in total. Chew and eat several slices each time, with salt water as a drink, 4 to 5 times a day.

　　Effect: Clear heat and dissipate blood stasis.

　　3) Appropriate amount of peanut kernel. Roast the peanut kernel, take half a cup of the red skin, grind it into fine powder, and take it with boiling water. Effect: Clear heat and stop bleeding.

　　4) 2 grams of black locust seed powder, 2 grams of rhubarb powder, and 1 egg. Make a hole in the egg, put black locust seed powder and rhubarb powder inside, mix well, seal with white flour, steam, and eat 2 eggs each time, once a day, for 4 days, then stop for 2 days, and drink plenty of water after taking it.

　　Effect: Cool blood and stop bleeding.

　　5) 3 grams of rhubarb and 1 egg. Make a hole in the egg, fill it with powdered rhubarb, seal with wet paper, and then steam and eat. Take once a day.

　　Effect: Clear heat and stop bleeding.

　　6) 60 grams of June Snow root, 15 grams of reed root, and 2 eggs. Boil together until the eggs are cooked, remove the residue and eggshell, and eat the eggs and drink the soup on an empty stomach in the morning and evening.

　　Effect: Clear heat and cool blood, suitable for children's hematuria.

　　7) Take 100-200 grams of mountain chive flowers, cook and drink, take twice a day, it is effective for general hematuria and chyle hematuria.

　　8) Use 50 grams of lotus seed and half a cup of lotus juice. After the lotus seed is cooked, take with lotus juice. Take twice a day, it is effective for hematuria.

　　9) Take a moderate amount of fresh celery, crush and squeeze juice, take 1 small bowl each time, take on an empty stomach, for 5-7 days, it can treat hematuria.

　　10) Use 3-5 grams of roasted soybean skin, grind into powder, take with warm water or use cowpea roasted and ground into powder, take 3 grams each time, twice a day, with water or yellow wine, for several days, it is effective for treating hematuria.

　　11) Take 200 grams of green bean sprouts, mix with sugar and eat, which can treat hematuria.

　　12) Use 200 grams of bitter melon head, decoct in water; a handful of clean soybean dregs, decoct in water; grape root, 100 grams of sugar, decoct in boiling water; 15 grams of black plum, decoct in water. All these remedies have the effect of treating hematuria, and can be selected according to circumstances.

　　Differentiation and Treatment:

　　1. Bladder湿热证: Burning and painful urination, fresh red urine, fever worse at night, bitter and dry mouth, red tongue, yellow greasy coating, rapid pulse. Clear the bladder and cool blood to stop bleeding. Modified Xiao Jie Drink.

　　2. Exuberant Heart Fire: Fresh red urine, short and yellow urine, burning and painful, restlessness and insomnia, red face and mouth sores, thirst for drinks, constipation, red and red tip of the tongue, yellow coating, rapid pulse. Clear the heart and relieve fire, cool blood and stop bleeding. Modified Da Chi Powder and Xiao Jie Drink.

　　3. Blood Heat Activating Blood: Fresh red urine, high fever and irritability, thirst for cold drinks, spots on the body, or epistaxis, dry and hard stool or hematochezia, red and dark tongue, yellow and dry coating, rapid pulse. Clear heat and detoxify, cool blood and stop bleeding. Modified Shizi and Dihuang Decoction with Xijie and lotus node.

　　4. Deficiency of Yin and Exuberant Fire: Short and red urine with blood, dizziness and tinnitus, red cheeks and feverish sensation, restlessness and dry mouth, soreness and weakness in the lower back and knees, red tongue, thin coating, rapid pulse. Nourish Yin and reduce fire, cool blood and stop bleeding. Modified Zhizi and Dihuang Decoction.

　　5. Deficiency of Spleen and Kidney Qi: Long-standing illness with pale red urine, frequent urination, dizziness and tinnitus, pale complexion, fatigue and weakness, shortness of breath and low voice, decreased appetite and abdominal distension, soreness and pain in the lower back or accompanied by epistaxis and purple spots, pale tongue, thin pulse. Tonify the spleen and kidney, nourish blood and stop bleeding.