Elevated red blood cells in the urine: causes and treatment

Urine tests are performed in the diagnosis and treatment of many types of diseases, as well as during routine medical examinations. Changes in the composition of urine indicates the presence of any pathology. These indicators include an increased number of red blood cells in the urine of an adult.

The first rule is to treat the cause, not the effect, that is, the disease itself, and not just the increased content of red blood cells. To make an accurate diagnosis, you need to pass several additional tests and make an ultrasound of the kidneys, bladder and urinary tract.

In this material, we will consider all the possible reasons because of which red blood cells appeared above the norm in the urine, as well as find out what this means and what consequences it may pose.


The process of establishing the fact that red blood cell counts are elevated in a urine test consists of two steps:

  1. Color study. If the urine is reddish or brown in color, then this is a sign of gross hematuria, that is, the number of blood cells exceeds the norm several times;
  2. Microscopic examination. If there is more than 3 red blood cells in a certain area of ​​the material being analyzed (field of view), then a microhematuria is diagnosed.

To determine the diagnosis is very important to determine the type of red blood cells:

  1. Unchanged red blood cells - they have hemoglobin, in the form of such little bodies resemble double-concave discs and are painted red.
  2. Modified red blood cells in the urine - the so-called. alkaline, there is no hemoglobin in their composition, microscopic examination shows that such little bodies are colorless, resemble the shape of a ring. Hemoglobin is derived from such red bodies due to increased osmolarity.

The appearance of blood in the urine is a reason for immediate visits to the doctor, since most of the causes of hematuria are very dangerous. The process of urine formation begins in the glomeruli of the kidneys, where the primary filtration of the blood takes place, while normally the red blood cells, leukocytes and plasma proteins do not pass through the glomerular membrane. Therefore, their appearance in the urine is a sign of disease.

Erythrocyte norm in urine in women and men

According to reviews of medical specialists, red blood cells in the general analysis of urine are detected in isolated cases. The causes of this condition can be various factors, for example: intense physical exertion, alcohol abuse, a long period of time spent on the legs, as well as various diseases.

The norm of red cells in the general analysis of urine in women and men is 1-3 erythrocytes in the field of view. According to the doctors, the excess of the red blood cells in the general analysis of urine indicates the presence of a pathological process.

If red blood cells are elevated in the urine, what does this mean?

Why is the analysis showing a high content of red blood cells in the urine, and what does this mean? If red blood cells are detected in the urine of an adult above the norm, this suggests that it is necessary to identify the source of bleeding.

Depending on the location, there are 3 groups of reasons:

  • Somatic or prerenal - not directly related to the urinary system;
  • Renal - arising from kidney disease;
  • Postrenal - caused by pathology of the urinary tract.

The same symptom in men and women can have various causes, including due to anatomical and physiological features.

Causes of elevated red blood cells in the urine

The causes of somatic origin are related to the fact that the kidneys are not involved in the pathological process, but respond to the disease in other organs and systems. These include:

  1. Thrombocytopenia - reducing the number of platelets in the blood, entails the problem of clotting in blood vessels, and, consequently, the ingress of blood into the urine.
  2. Hemophilia. Here, a decrease in blood clotting also occurs, however, the reason is different. However, liquefied and not able to coagulate normally, the blood penetrates through the glomeruli into the urine.
  3. Intoxication of the body - the entry of toxins (poisons) in various viral and bacterial infections causes an increase in the permeability of the glomerular membrane to the erythrocytes, due to which they enter the urine.

Root causes cause an increase in red blood cells in kidney disease:

  1. Acute and chronic glomerulonephritis - the disease leads to a breakdown of the filtering function of the kidneys, so that red blood cells leak into the urine.
  2. Kidney cancer is a growing tumor that affects the walls of blood vessels, forming small bleeding into the urine. When analyzing observed red blood cells of the usual form.
  3. Urolithiasis disease. Here we are talking about the violation of the integrity of the mucous membrane, as a result of which bleeding appears, and part of the blood enters the urine.
  4. Pyelonephritis - due to the inflammatory process, the permeability of the blood vessels of the kidney increases, and red blood cells penetrate into the organ.
  5. Hydronephrosis - difficulty in outflow of urine leads to stretching of the organ and microdamage of the vessels.
  6. When a serious injury, rupture of the kidney, knife wound, severe injury, gross hematuria is diagnosed, there is an extensive release of blood in the urine.

In the case of causes of postrenal origin, a high content of red blood cells in the urine develops due to diseases of the bladder or urethra:

  1. Cystitis is an inflammatory disease of the bladder, during which red blood cells can enter the urine through weakened vascular walls.
  2. Presence in the urethra or in the bladder of the stone. Here you can instantly expect trauma to the mucous membranes.
  3. Injuries to the bladder and urethra with vascular damage and bleeding are accompanied by gross hematuria.
  4. Bladder cancer leads to rupture of blood vessels through which erythrocytes leak. Depending on the size of the hole depends on the volume of blood entering the urine, the larger it is, the richer the color.

Causes in men

Certain diseases of the reproductive organs can also provoke an increased number of red blood cells in the urine. So some diseases of the prostate gland in men lead to hematuria:

  1. Prostatitis is an inflammation that affects the prostate gland. Filling urine with erythrocytes is identical to all other inflammatory processes in the urogenital system.
  2. Prostate cancer. In this case, the damage to the blood vessels occurs due to the destruction of their walls by a growing tumor.

Causes in women

In women, the appearance of erythrocytes in the urine is caused by such diseases of the organs of the reproductive system:

  1. Cervical erosion is a wound on the mucous membrane of the cervix, resulting from mechanical injury, hormonal failure, or genital infection. Naturally accompanying blood excretion.
  2. Uterine bleeding - blood from the vagina can then enter the urine during urination.

Physiological causes

At the end we will show the moments that may also lead to an increase in the number of red blood cells in the urine in adults, but at the same time not related to diseases of the internal organs:

  1. Air temperature too high. This can usually be a hazardous job in hot shops or after being in a sauna.
  2. Strong stresses that make the walls of blood vessels more permeable.
  3. Alcohol - it also makes the walls permeable, and, besides that, it narrows the kidney vessels.
  4. Great physical exertion.
  5. Excessive passion for spices.

When in the urine red blood cells, white blood cells and protein

When the results of urine analysis show abnormality, the content of not only red blood cells, but also leukocytes or protein is a serious reason to consult a doctor for a detailed diagnosis.

Such changes may occur in inflammatory diseases of the kidneys, tuberculosis, urolithiasis, hemorrhagic cystitis, urinary tract tumors and other conditions.

It is necessary to accurately identify the cause of changes in blood and urine tests. If you do not attach any importance to this, chronic kidney disease and renal failure may develop in the future.

What to do if red blood cells are elevated in the urine?

First of all, you need to identify a disease that provokes an increase in red blood cells in the urine, and then to treat it. As a rule, the following methods are used in the treatment:

  • antibiotic therapy;
  • diet therapy;
  • anti-inflammatory therapy;
  • the use of diuretic drugs, if there are stagnant urine;
  • limiting the amount of fluid consumed to reduce the renal load;
  • surgery if cancers, urolithiasis or trauma were found.

In addition to erythrocytes with gross hematuria, hemoglobin can directly impart red staining to the urine.

Watch the video: Urinary Tract Infection. How To Prevent UTI 2018 (January 2020).


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