Urine Test Results: Hematuria and Kidney Stones Explained

Q: Urine Test Results: Hematuria and Kidney Stones Explained

Hello： The interpretation of stones in ultrasound is quite subjective, which can lead to different conclusions (it is likely that you have small stones or crystals in both kidneys). <br>Sometimes, drinking plenty of water or exercising for several consecutive days can lead to cha

Urinalysis shows trace hematuria +/-

Dr.
Du: Hello, Doctor, I'm back again with issues regarding kidney stones and hematuria.
I have a few questions:
1.
Last September, an abdominal ultrasound showed a 0.6 cm stone in my right kidney, but when I visited the urology department for a kidney ultrasound, I was informed that both kidneys had fine sand but no stones, and I was advised to return in six months.

2.
Last month, I underwent a follow-up abdominal ultrasound for my liver and gallbladder, and this time the results indicated a 0.44 cm stone in my right kidney, while the left kidney had fine sand measuring 3.5/18.

3.
I went to the lab for blood and urine tests, and the urine test results showed hematuria as (+/-) and leukocyte esterase as (+/-).

4.
Today, on May 22, I went for a follow-up and asked the doctor about the stone issue.
He advised me to undergo a more advanced urological ultrasound in two days.
Today's urine test still showed hematuria (+/-), but the doctor mentioned that there were no red blood cells in the urine, suggesting that it might be due to skin flakes or other debris.
Given all this, does this indicate that my urinary system is not functioning well? Is there a significant problem? Additionally, I looked up foods to avoid for calcium oxalate stones, and it seems like there’s almost nothing I can eat.

Er Mao, 50~59 year old female. Ask Date: 2017/05/22

Dr. Du Shixi reply Urology

Hello: The interpretation of stones in ultrasound is quite subjective, which can lead to different conclusions (it is likely that you have small stones or crystals in both kidneys).
Sometimes, drinking plenty of water or exercising for several consecutive days can lead to changes, such as passing them.
If there is hematuria without red blood cells, it is mostly influenced by other substances, such as vitamin C (therefore, you should closely monitor your urine for any discoloration; if it appears bloody, a thorough examination is necessary, although most tests may not yield clear results).
Regarding dietary issues related to stones, my advice to patients is that all foods can be consumed, but beverages should be minimized (such as coffee, cola, tea, etc., whether homemade or purchased).
Water intake should not be insufficient, and urine color should reach a light yellow (the first urine in the morning may appear yellow, so do not be overly concerned).
A little bit of exercise is beneficial, as sedentary individuals are also prone to stones.
Your urinary system is comparable to that of an average person and is not worse; nowadays, many people drink more beverages and less water, with some under 20 already having crystals.
Therefore, you should have regular check-ups once or twice a year, pay attention to the color of your urine during urination, and adjust your water intake accordingly.
If you experience back pain, frequent urination, or hematuria, seek medical attention.

Reply Date: 2017/05/22

More Info

Understanding urine test results, particularly in the context of hematuria (blood in urine) and kidney stones, is crucial for diagnosing and managing urinary tract issues. Your situation involves a series of tests and evaluations that indicate potential complications, and it’s important to interpret these results carefully.

1. Hematuria: The presence of blood in urine can be alarming and is often a sign of underlying issues. In your case, the urine test results show hematuria as (+/-), which suggests that there may be a small amount of blood present, but it is not definitively positive. This could be due to various reasons, including urinary tract infections, kidney stones, or even benign conditions. The absence of red blood cells in the urine, as noted by your physician, may indicate that the blood could be due to contaminants like skin cells or debris rather than a significant pathological process.

2. Kidney Stones: Your history of kidney stones, particularly the 0.6 cm stone in the right kidney and the recent finding of a 0.44 cm stone, is significant. Kidney stones can cause hematuria when they irritate the lining of the urinary tract or when they obstruct urine flow, leading to increased pressure and potential bleeding. The presence of "fine sand" in both kidneys suggests that you may have a tendency to form stones, particularly calcium oxalate stones, which are the most common type.

3. Urinary Tract Health: The combination of hematuria and the presence of stones or sand indicates that your urinary system may be under stress. While the current tests do not show significant abnormalities, the recurring nature of your symptoms suggests that ongoing monitoring and management are necessary. The recommendation for a more advanced ultrasound is a prudent step to assess the situation more thoroughly and to rule out any complications such as hydronephrosis (swelling of a kidney due to a build-up of urine).

4. Dietary Considerations: You mentioned concerns about dietary restrictions related to calcium oxalate stones. It is true that certain foods can contribute to stone formation, and managing your diet is an important aspect of prevention. However, it’s essential to maintain a balanced diet that supports overall health. Foods high in oxalates (like spinach, nuts, and chocolate) should be moderated, but you should also ensure adequate calcium intake, as low calcium can paradoxically increase the risk of stone formation.

5. Next Steps: Given your situation, it’s important to follow up with your healthcare provider regarding the advanced ultrasound and any further tests they may recommend. If kidney stones are confirmed, your doctor may discuss treatment options, which can range from increased hydration and dietary modifications to medical therapies or procedures to remove stones if they are causing significant issues.

In summary, while your urine test results indicate some concerns, they do not necessarily point to a severe problem at this moment. However, ongoing monitoring and a proactive approach to managing your urinary health, including dietary adjustments and regular follow-ups, are essential to prevent complications and maintain kidney function. Always consult with your healthcare provider for personalized advice and treatment options tailored to your specific situation.

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