Wüthrich R P, Serra A
Klinik für Nephrologie, Universitätsspital Zürich.
Ther Umsch. 2006 Sep;63(9):595-600. doi: 10.1024/0040-5930.63.9.595.
The occurrence of red urine is a disconcerting sign for the patient. Hematuria is the most common cause for the red colour of the urine. However, certain drugs and food can also cause red urine. Visible blood in the urine is called macrohematuria; when blood is only detected by microscopic examination this is termed microhematuria. The cause of micro- or macrohematuria must be determined carefully. Both renal and extrarenal diseases can cause hematuria. Among the renal diseases certain glomerulonephritides (IgA nephropathy, Alport's syndrome) are frequent causes of asymptomatic microhematuria. Extrarenal causes include nephrolithiasis, tumours, or urinary tract infections. Microscopic analysis of the urinary sediment, ultrasound examination and other radiological tests are essential to establish a correct diagnosis. The diagnostic steps and differential diagnosis for a patient with red urine or microhematuria are described in detail in the present article.
尿液发红对患者来说是一个令人不安的迹象。血尿是尿液呈红色最常见的原因。然而，某些药物和食物也会导致尿液发红。尿液中可见血液称为肉眼血尿；仅通过显微镜检查才能检测到血液时则称为镜下血尿。必须仔细确定镜下血尿或肉眼血尿的病因。肾脏疾病和肾外疾病都可导致血尿。在肾脏疾病中，某些肾小球肾炎（IgA肾病、阿尔波特综合征）是无症状镜下血尿的常见原因。肾外原因包括肾结石、肿瘤或尿路感染。对尿沉渣进行显微镜分析、超声检查和其他影像学检查对于做出正确诊断至关重要。本文详细描述了尿液发红或镜下血尿患者的诊断步骤和鉴别诊断。
