Erythrocytes in urine, what does it mean?

These last few days have been very busy, so I've had to be absent for a couple of days, but it can happen, it's part of the daily routine. But here I am, reading, learning and sharing information that I hope will be relevant and interesting for everyone.

Recently I have seen a particular case that I would like to share, not the case itself, but part of the studies performed to the patient, that for protection of her information I omit the name and other personal data that do not contribute anything to the post that I will share below.

Laboratory tests are always a fundamental piece to define some diseases, however, an inadequate reading of these can cause more problems in the treatment. This time I will share my impressions of a urine test, in which you can observe not only the presence of dysmorphic and eutrophic RBCs (red blood cells or erythrocytes), but also a cloudy characteristic, among other aspects that I will discuss shortly. .

If you want to know why erythrocytes can sometimes be found in urine, read on, this post will interest you.

Let's start by having an overview of renal function in terms of urine filtration, because remember that in other posts I have explained that the kidneys perform various functions, such as blood pressure control, control in the production of blood cells among others.

As for the function of blood filtration and urine production this is highly controlled by hormonal substances, in addition to electrolytes such as sodium, chlorine and potassium, but also by the size of the renal filter itself. Actually at the ultrastructural and molecular level it is very complex, but I will explain it as follows.

Let us visualize a filter, which has slots, against which the blood "hits" but only small molecules which are metabolic wastes can pass through these small slots, they do not allow for example cells to pass (erythrocytes, platelets, white blood cells) as well as macromolecules, such as globulins or proteins such as albumin.

When any of these elements are found in the urine we have to imagine that something is going on, but this "something" is not necessarily a kidney problem.

Keeping in mind what was explained above (the filter), we must know that the kidneys are organs that do an excellent job but are highly sensitive to multiple things, such as temperature changes, changes in the concentrations of some blood elements, state of dehydration, among others.

For the case in question I would like to emphasize the case of increased body temperature or fever. This particularly affects the kidneys. In the case in question, which can be seen in the following image, Dysmorphic hematocytes are observed in the urine.

When we speak of dysmorphic red blood cells or erythrocytes we refer to those that do not have a normal shape, and therefore, can be eliminated via the urinary tract. Usually you may think that the problem is renal, and this is not always the case. If they do what most patients do, which is to Google before going to the doctor, they will surely go into a kind of chaos, because they may think that they have a serious glomerular problem. The renal glomeruli being the elementary part of the filtering at the level of the kidneys.

Urinalysis result photo

I know that the result is in Spanish, it is my native language, but I have highlighted the place where it says Dysmorphic Erythrocytes, which is what I want to emphasize the most in this opportunity.

Here I also want to emphasize the importance of talking to patients, of asking them about the evolution of the disease, because that is what helps guide us even more. This patient, as expected, looked up "Dysmorphic erythrocytes " on Google, and came in very worried, because she feared a renal lesion.

The detail is that she had had a high fever due to a strong respiratory infection of viral origin, which has caused her to eliminate this particular type of erythrocytes in her urine. This is basically due to the fact that she is dehydrated, which can affect the shape of the erythrocytes to a small extent. So, she should hydrate adequately, so that she can then, in a few days, do a new urine test and most likely verify that indeed, her erythrocytes are fine and she has nothing to worry about.

The high temperatures have made the renal filter permeable to what it should not be and here is the result. But obviously, this is not the only cause of getting blood or red cells in the urine, and not necessarily all causes are pathological.

Pixabay/ Author: mohamed_hassan

For example, if a woman has menstruation and a urine test is done, erythrocytes or blood will surely be found in the urine. Obviously, kidney stones can injure the kidney or the urinary tract and also produce this result, severe kidney infections as well, some accident involving a blow or concussion in the lumbar area, blood clotting disorders, but all this must be accompanied by other tests and above all to talk to patients to find out what has happened to them, what they have felt.

I hope that with this publication you can understand a little more about the possible causes, diverse, of what can provoke the presence of these findings in the urine. There is nothing definitive and absolute in medicine, everything is subject to interpretation that must go hand in hand with a good analysis of the signs and symptoms, a very well worked clinical history, and gaining the trust of patients so that they can talk calmly about their state of health.

Thank you very much for reading this publication, I hope you have enjoyed it and that it serves as a form of guidance and education, any questions or suggestions, as always, I remain at your disposal.

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• Links consulted

• The Abnormal Urinalysis

• URINALYSIS