Hemoglobin in urine: what does it mean? Causes and signs of violation, the norm
The presence of hemoglobin in the urine is called hemoglobinuria. Normally, this protein is only inside the erythrocytes. In a healthy person, hemoglobin cannot penetrate through the filtration apparatus of the kidneys and is excreted in the urine. The rate of this protein in the analysis is zero. Therefore, the detection of hemoglobin in urine should always be alarming. This may indicate a serious illness.
How does hemoglobin appear in urine
If a person has hemoglobin in the urine - what does this mean? This result indicates the penetration of blood into the urine. The etiology of deviation may be different. The following causes of hemoglobin in the urine can be distinguished:
- This protein enters the urine when bleeding in the organs of the urinary system. This can be noted in glomerulonephritis, inflammatory processes and tumors in the organs of excretion.In such cases, the urine is colored pinkish or reddish. The analysis reveals a large number of red blood cells. This phenomenon is called hematuria.
- Hemoglobin can enter the urine during the destruction of red blood cells in the vessels. This condition is called hemolytic anemia. This is observed in case of intoxication, pathologies of the spleen, allergic reactions, infections, injuries, burns. When these diseases in the blood plasma contains a large amount of hemoglobin. Then this protein penetrates through the filtration glomeruli of the kidneys and ends up in urine. This is an extremely dangerous condition that can lead to kidney failure.
- Hemoglobin in urine may occur after blood transfusion. This suggests that the donor material did not fit the patient. In the body, there is a massive destruction of red blood cells.
- Positive hemoglobin in the urine can be determined by increasing the level of myoglobin - a protein contained in muscles. These two compounds are very similar in structure. Therefore, myoglobin in the results of the analysis is often defined as hemoglobin.An increase in muscle protein content is a sign of serious muscular disease.
- Athletes, athletes sometimes marked marching form of hemoglobinuria. This is the result of increased load on the legs. Such a deviation is not considered a pathology. Hemoglobinuria usually disappears after eliminating excessive physical activity.
- With prolonged exposure to low temperatures, cold paroxysmal hemoglobinuria occurs. This is a rather rare occurrence. It is completely reversible. After warming the body hemoglobinuria passes. A course of treatment is required only in case of chronization of the process.
- The presence of hemoglobin in the urine can be a sign of an extremely rare disease - paroxysmal nocturnal hemoglobinuria. This life-threatening pathology is accompanied by massive destruction of red blood cells, pain in the lumbar region and the release of black urine. Such conditions in patients usually occur after sleep. Immediate blood transfusion and iron medication are needed.
Normally, blood protein in the urine should not be determined. Its quantity should be zero.Only the presence of 1 - 2 erythrocytes in the field of view of the microscope is allowed. These blood cells also secrete hemoglobin. However, its amount is so insignificant that it is not found in the results of the study.
Traces of hemoglobin in the urine usually indicate pathology. The reasons for this deviation may be different. The doctor may suggest a diagnosis in terms of blood protein. In some cases, hemoglobin may appear in urine in very small quantities during emotional experiences or after physical exertion.
If the hemoglobin index in the urine is from 10 to 25, then this indicates bleeding in the urinary organs. Such a result of the analysis can also be associated with diseases accompanied by the destruction of red blood cells. Blood enters the urine when filtered in the kidneys.
If the concentration of hemoglobin in the urine is between 25 and 50, then this is a sign of blood diseases. It can also be a sign of increased myoglobin in muscle disorders. Such indicators should seriously alarm the patient and the attending physician. To clarify the causes of pathology, it is necessary to undergo a series of additional studies.
If the hemoglobin values in urine exceed 50, then in most cases this is due to an increase in myoglobin protein. It appears in the urine in severe muscle diseases. This can be a sign of severe injuries, extensive hematomas, and infectious processes in muscle tissue. In such diseases, leukocytes in the urine are usually enlarged.
For pregnant women, the norm of blood protein in urine is not more than 0.1. If elevated hemoglobin is detected in the urine, this may be a sign of kidney stones. In the period of gestation, the hormones change. This often increases the risk of oxalate stones. They have sharp edges that hurt the mucous membrane of the urinary tract. These causes blood to enter the urine.
Hemoglobin in urine in pregnant women can occur in infectious diseases of the urinary tract. These pathologies in the period of gestation are harder, as the woman cannot take antibiotics and other medicines. Hemoglobin can also appear on the background of sore throat or scarlet fever.
In children, the detection of hemoglobin in urine without treatment can lead to chronic diseases of the genitourinary system.The following diseases can provoke hemoglobinuria in a child:
- urolithiasis disease;
- tumors of the kidneys and bladder;
- infectious diseases of the kidneys and urinary tract;
- increased levels of calcium in urine;
- narrowing of the ureters;
- phimosis in boys;
- trauma organs allocation.
If a child has a change in the color of urine, it is urgent to contact a pediatrician or pediatric nephrologist. It is necessary to conduct an ultrasound of the kidneys and bladder to identify the cause of the pathology.
Signs of hemoglobinuria
Sometimes in hemoglobinuria, the presence of blood in the urine can be detected with the naked eye. Urine can have a different shade: from slightly pink to the color of meat slop. However, urine staining does not always speak of pathology. Urine can change its color after eating vegetables or red berries.
Symptoms of hemoglobinuria can be different depending on the cause of the appearance of blood in the urine. A person may experience lower back pain, aching joints, fever, and indisposition. There is an increase in the liver and spleen. The patient's skin becomes pale or yellowish.
What to do with a positive analysis
Hemoglobin is usually determined in a general clinical study of urine. There is also a rapid diagnosis of the presence of blood protein in the urine. In pharmacy chains you can find special kits for determining hemoglobin in urine. If a positive test result requires additional tests.
Assign more detailed studies of urine and blood:
- urine electrophoresis;
- a study on hemosiderin and detritus in the urinary sediment;
- blood coagulation test (coagulogram);
- urine and blood tests for biochemical parameters;
- bacteriological examination of urine sediment;
- ammonium sulphate test (for myoglobin determination);
- Coombs test for antibodies to erythrocytes.
In addition to laboratory research methods, conduct ultrasound diagnostics of the kidneys and urinary tract. If trauma is suspected, radiography of the excretory organs is indicated. In severe cases, a bone marrow biopsy is done.
Hemoglobinuria therapy depends on the etiology of the disorder. It is necessary to eliminate the cause that caused the appearance of blood in the urine.During the treatment of the underlying disease, corticosteroid hormones and iron supplements are prescribed. This prevents the development of severe anemia. Vitamin therapy is also recommended. With a tendency to thrombosis prescribed anticoagulants. If hemoglobinuria occurs due to poisoning with various poisons, then detoxification is required. In severe cases, the patient receives a blood transfusion and red blood cell mass.
Hypothermia is contraindicated in patients with hemoglobinuria. Also, patients are encouraged to use less fluid, so as not to create an excessive burden on the kidneys.
If hemoglobin is detected in the urine, you must immediately visit a doctor. A dangerous sign is also a change in the color of urine. This can be a sign of serious kidney disease or blood formation that requires immediate treatment.