There are “three elders” living in the laboratory of the hospital: blood routine, urine routine and fecal routine. You know, those who can be honored as “elders” and also named “several elders” are by no means ordinary people.
Among them, urine routine is such a real expert.
The most uncertain thing about kidney disease is its concealment.
At first, the patient may not have any symptoms-legs and feet are strong, food is delicious, what is satisfactory, and the appearance of urine is no different from that of normal people. It was not until one day when I felt slightly unwell that I went to check it out that I found myself with nephritis, renal insufficiency and even uremia like a bolt from the blue!
Urine routine this elder, holding a [demon mirror], can see the big from the small. In front of it, many kidney diseases can be exposed at an early stage.
There are nearly 20 items, large and small, in urine routine. For chronic kidney disease, there are two most important indicators: urine protein and urine red blood cells.
There is protein in the urine
Kidneys are not only hardworking, but also very clever in their work.
When it helps the human body filter blood and eliminate waste, it will carefully select useful substances, such as protein and other components, to leave behind.
The protein excreted from normal people’s 24-hour urine will not exceed 100 mg, and the urine routine check list shows [-]. If the protein in 24-hour urine exceeds 150 mg, it is called proteinuria, and the urine routine list will be marked with [trace] or [+]. The more the amount of +, the more the protein content in urine.
However, protein appears in urine, especially when there is more than one +, or there is + in many examinations, which indicates that the urinary system is likely to have problems. At this time, it is time to go to the hospital to find a nephrologist to have a look and find out the reason.
It should be noted that some normal people in strenuous exercise, fever, dehydration, nervousness, eating a large amount of protein, etc., may also appear transient urine protein, which is called physiological proteinuria. When life returns to normal, this + will soon return to normal, don’t worry. And in this case, urine protein usually does not exceed a +.
Erythrocytes appear in urine
When the kidney filters blood, red blood cells cannot be easily discarded.
Red blood cells rarely appear in the urine of normal people.
In routine urine examination, there are three indexes reflecting red blood cells: urine occult blood, flow cytometry urine red blood cells and red blood cell microscopy.
Of the three, the most confusing one is occult blood in urine.
Positive occult blood in urine does not necessarily mean bleeding in urine. Its detection method depends on whether the test paper changes color to obtain the result. However, in addition to red blood cells, if there are myoglobin and hemoglobin in urine, and even a large amount of vitamin C before urine test, it may be misjudged as [hematuria].
Flow cytometric urine erythrocytes, The test method is to count red blood cells by machine, which is more reliable than urine occult blood. It is not that there will be no errors (if some components in urine are similar in shape and size to red blood cells, they may be mistaken for red blood cells to be included in the count), but clinically, if it indicates red blood cell proliferation, it can basically be considered true.
Generally speaking, the normal detection value of flow cytometry urine red blood cells is 0 ~ 25/microliter.
Red blood cell microscopy is based on the count of red blood cells counted by human eyes. Seeing is believing. If doctors see a certain number of red blood cells under a high-power microscope, they can definitely think of hematuria!
Urinary erythrocytosis indicates that there may be renal or urinary system diseases, such as nephritis, urinary calculi or space occupying lesions, urinary tract infection, etc. It is also necessary to further clarify the causes in nephrology or urology.
When urine protein and urine red blood cells are positive at the same time, it indicates that the possibility of kidney diseases, especially nephritis, is greater.