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Hematuria and proteinuria are parts of the reason why male patients come to the nephrology department for consultation. As people have more chances to receive regular medical examinations, they pay more attention to their health and more and more patients come to the nephrology department for consultation.

Hematuria

Hematuria means the presence of blood (red blood cells) in the urine. When you look at the report, there are two kinds of cases called hematuria: one is positive occult blood, which is tested with test paper; the other is that there are several red blood cells in the urine, which is the result of microscopy. Both represent problems with the kidney and urinary systems. However, occult blood reactions can sometimes be affected by food or drugs, so it is important that both tests are done.

Hematuria can be divided into gross hematuria and microscopic hematuria according to different degrees. The urine appearing red does not necessarily mean that it is gross hematuria as some foods and drugs affect the color of urine, such as beets and anti-tuberculosis drugs, which must be distinguished first.

In addition, female friends in menstruation will also cause urine mixed with blood, so there is no need to be alarmed when hematuria is detected immediately before and after menstruation. Re-examination can be performed 5 or 6 days later.

Microscopic hematuria means that the blood is invisible to the naked eye but more than three red blood cells can be detected under a high power microscope. Either gross or microscopic hematuria represents any area of the urinary tract system (kidney, ureter, bladder, urethra) that may be diseased and requires further examination.

Further examinations include urinary X-ray and renal ultrasonography to exclude bleeding from stones or renal tumors. In addition, further microscopic examination of the red blood cells in the urine (Wright's stain) is also necessary to see whether the red blood cells in the urine are complete, so that "glomerular hematuria" can be distinguished from "non-glomerular hematuria."

"Glomerular hematuria" refers to the glomerular diseases of the kidney, while "non-glomerular hematuria" means any bleeding in the urinary tract caused by infection, inflammation, calculi, trauma, or tumor.

Proteinuria

Bubbles in the urine are not always proteinuria, especially in men who urinate standing up. It is better to do urine analysis to determine whether there is proteinuria. People normally discharge 40 to 80 mg of urine protein every day, up to 150 mg, so once the urine protein exceeds 150 mg per day, it is not normal.

Some proteinuria does not persist, such as "functional proteinuria," which occurs only during intense exercise, fever, high temperature work or labor. The patient does not have proteinuria while lying in bed, but proteinuria occurs after they wake up and are moving around, which is especially prevalent among adolescents. Orthostatic proteinuria, also known as postural proteinuria, is usually less than 1 gram (1,000 mg) per day. Both of them are benign and have a good prognosis. Patients do not need to take medication and only need to be followed up regularly.

Persistent proteinuria usually indicates that the structure of the kidney itself (including the glomerulus and renal tubule) has problems, and is usually associated with systemic diseases such as diabetes, hypertension, lupus erythematosus, glomerulonephritis, drug-induced tubulointerstitial nephritis, and so on.

Nephrotic syndrome is defined as the loss of more than 3.5 grams of urine protein per day. In cases where the cause cannot be determined, a "kidney biopsy" should be performed, during which a nephrologist needs to treat proteinuria according to the definite etiology to improve the condition, without developing symptoms of malnutrition and edema.