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Will Proteinuria And Hematuria Develop Into Renal Uremia

2019-04-10 09:32

Proteinuria And Hematuria,Renal Uremia,ProteinuriaHow harmful are occult blood and red blood cells in urine, and will patients progress to uremia?

Urinary occult blood (occult blood, hematuria) is a component of red blood cells (including broken red cells) recognized by the instrument. When the urine of occult blood positive patients is observed under a microscope, it is usually found that the number of red blood cells exceeds the standard. If there are many red blood cells, the urine will be red, which is called naked hematuria.

Is it kidney disease with urinary occult blood or red blood cells?

Occult blood may occur in patients with chronic nephritis, but occult blood may also occur in urethra, ureter, bladder, calculi, renal cancer, etc.

So when occult blood is found, we usually ask patients to check the "erythrocyte morphology analysis" to see if the erythrocyte is deformed or broken. Because red blood cells in the urine of patients with chronic glomerulonephritis are "squeezed" out of the gap in the capillary wall of the glomerulus, the squeezing process will cause red blood cells to deform. If the rate of erythrocyte malformation is high, it is usually renal hematuria.

Does hematuria make kidney disease progress and lead to uremia?

The relationship between hematuria and the progression of nephropathy needs to be seen. We divide hematuria into three types:

1. Transient hematuria

Fever, infection, exercise, trauma, and frozen hematuria are mostly temporary and transient hematuria. Next time, there will be no more hematuria. If the hematuria disappears only once, don't worry.

2. Persistent Simple Hematuria

Hematuria always exists, but there are no other symptoms and abnormal indicators. Renal hematuria often has such manifestations. Simple renal hematuria is usually thin basement membrane nephropathy and mesangial proliferative glomerulonephritis (including IgA nephritis). The pathological changes are mild, the disease rarely progresses, and the incidence of uremia is only 0.7%.

However, the prevalence of uremia in the general population is 0.1%. Simple hematuria significantly increases the risk of uremia, so patients need to check their urine and kidney function every six months. ,

3. Hematuria with proteinuria

If nephropathy patients have both hematuria and proteinuria, the risk of progression of nephropathy is much greater. However, the progression of nephropathy does not depend on hematuria, but proteinuria and blood pressure. Patients with no or partial remission after treatment are at greater risk of renal failure and uremia. Patients with both hematuria and proteinuria need integrated Chinese and Western medicine treatment, which can usually reduce urinary protein, urinary occult blood and blood pressure.

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