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Kidney Diseases

Abnormal urinalysis result

03/07/2008

Question:

Hi, I`m 40 years old and weighted 114 pound. My Doctor ordered an urinalysis (microscopic) for me since I have a occasional high blood pressure and all day fatigue for some a period of time. In the result, it shows 2+ of urine blood HGB, and >30 Epithelial cells (normal reference is 0~5 /lpf.) and present of mucus (normal should be none present). Please tell me if the test means serious disease or what other test I should do to find out the reason. Thanks!

Answer:

Are you a woman, and if so, do you have periods?  The urinalysis that you describe could be seen in someone who has (or has just finished) a menstrual period.  If that was the case, the urinalysis should be repeated at a time when you are not on your period.  What your doctor was looking for was protein in the urine, which would be a sign of kidney damage.  If protein was present, it would be important to determine the exact amount by doing another urine test.  Also, blood tests (specifically for BUN and creatinine) and kidney imaging such as an ultrasound can help determine whether or not you have kidney disease as either a result or a cause of your hypertension.

If the blood in your urine was not associated with a menstrual period, or if you are a man, then there is a possibility that the blood is coming from the bladder, the prostate, or from the kidney itself (such as from a tumor or as a result of a kidney stone).  If an imaging study reveals nothing, a cystoscopy (direct exam of the bladder with a lighted flexible tube) may be needed.  There are also some diseases causing blood in the urine that can be diagnosed only by a kidney biopsy, such as IgA nephropathy.  This is a disease that is more often seen in people of southeast Asian or western European (especially France, Belgium, Netherlands), or Navajo Indian descent.

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Response by:

Mildred   Lam, MD Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University