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If your urine is reddish or bloody in the urine, you should consider the possibility of kidney stones, bladder cancer, and kidney cancer as well as damage to the glomeruli of the kidneys. Hankook Ilbo file photo |
Normal urine color is a clear tan with a light beer color. The color of urine is determined by the concentration and composition of the urine. Bilirubin, a metabolite of red blood cells, is excreted in the urine through the liver, giving it a weak yellow color.
However, some people have reddish urine or blood mixed with it. Such hematuria may be just a symptom, but it is a signal that it can lead to glomerular damage, urolithiasis, and, in severe cases, bladder and kidney cancer.
Hematuria is caused by various causes such as severe exercise, trauma, infection, kidney disease, and drugs. Therefore, it is important to receive an accurate diagnosis and then receive appropriate treatment. In particular, if you have an underlying disease such as high blood pressure or diabetes, it is recommended to have a urine and blood test once or twice a year even if you have no symptoms.
If hematuria occurs and you go to the hospital, you will be given a urine test, a urine cell test, a bladder endoscopy, and, if necessary, imaging tests such as computed tomography (CT) or magnetic resonance imaging (MRI). Men may add a prostate-specific antigen (PSA) test.
◇Hematuria due to damage to the glomeruli in the kidney
The kidneys perform various functions, such as filtering waste products from the blood and excreting them in the urine, regulating the concentration of electrolytes in the blood, and regulating blood pressure. The core filter that filters waste from the kidneys is the glomerulus. The glomerulus is a bundle of thin blood vessels that filter waste from the blood, and there are 1 million in each kidney.
When the glomeruli are damaged, blood and protein are excreted in the urine, resulting in brown or blood-like hematuria and foamy proteinuria. The more severe the damage, the more proteinuria comes out, and the damaged glomerulus is lost without recovery, and the number gradually decreases, exacerbating chronic kidney disease.
The glomeruli can be damaged for a variety of reasons. Because it is a bundle of blood vessels, if diseases that damage blood vessels such as high blood pressure and diabetes are prolonged, the glomeruli can be damaged. However, immunological damage from various causes can also cause problems with the glomeruli.
Immune cells activated in the body due to a cold or the like attack the glomeruli for no particular reason, or antibodies are generated in the glomerulus, which damages the glomerulus.
Lee Sang-ho, a professor of nephrology at Gangdong Kyunghee University Hospital, said, “If glomerulonephritis is detected early and treated appropriately, most cases do not require dialysis. It progresses to end-stage renal failure requiring transplantation,” he said.
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The color of urine can be used as an indicator to know whether organs such as the kidneys and liver are working properly. Getty Images Bank |
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◇30-50% of urolithiasis recur within 5 years… Stay hydrated to prevent
Urolithiasis is a phenomenon in which stones form in the way (urinary tract) where urine is produced, transported, stored, and excreted. It is formed when calcium and other components aggregate and enlarge in urine. More than 90% of patients with urolithiasis have microhematuria. Hematuria is observed with the eyes in 5-10% of cases.
Gu Gyo-cheol, a professor of urology at Gangnam Severance Hospital, said, “If you suddenly have pain in your side and hematuria, you should suspect a urolithiasis.”
Symptoms vary depending on the location of the stone. Kidney stones are painless, but if you drink a lot of water and urinate, your side may hurt. On the other hand, ureteric stones cause pain in the flanks or costal vertebrae (the area from the flank to the side of the back). Even a slight tap on the side is very painful.
If you sweat a lot in a hot environment and don’t drink enough water, you can easily form stones due to water loss. In addition, high exposure to sunlight in summer increases the risk of stone stones even when vitamin D production is activated.
If the stone size is less than 4 or 5 mm, 60-80% is naturally excreted through water intake and drug treatment. If the size is more than 6 mm or the position is in the upper ureter, a shock wave is emitted from outside the body to break the stone and induce it to be discharged naturally.
Professor Park Hyeong-geun of the Department of Urology at Asan Medical Center in Seoul said, “30-50% of urolithiasis patients recur within 5 years, and to prevent this, you need to drink 2 to 3 liters of water a day.”
◇ Bladder and kidney cancers also cause hematuria
Hematuria can also occur with cancer of the urinary system, such as bladder or kidney cancer. In particular, hematuria occurs in about 85% of bladder cancer patients, the most common cancer occurring in the urinary tract that produces and discharges urine.
Professor Park Gwan-jin of the Department of Urology at Seoul National University Hospital said, “Hematuria is a typical symptom of urinary cancer including bladder cancer and renal ureteric cancer.
Hematuria may make the urine appear red or dark brown or dark red. However, only 12% of patients with hematuria are actually caused by bladder cancer.
Professor Ham Won-sik of the Department of Urology at Severance Hospital said, “When hematuria is clearly visible, even if hematuria appears and disappears only once, it is advisable for adults to be screened for bladder cancer. “You have to look at the colors carefully.”
Even with kidney cancer, blood in the urine appears. Seo Joon-kyo, a professor of urology at Asan Medical Center in Seoul, said, “In the early stages, kidney cancer usually has no symptoms, but when it gets worse, you can see blood in the urine.”
Kwon Dae-ik, medical reporter [email protected]
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