Question and Answer.

hello guys.

shocked to see a post from me right?!
hmm. im here because, on last friday i was asked to answer a qn that was asked by ms chew.
and finally, i've found the answer. (:


Heres the qn:
Why is there detection of the hemoglobion and blood (2 different parameters instead of just one since they are all RBCs) in the urine dipstick analysis?

Brief Answer:
Cause of RBCs/Hb in urine:
Erythrocytes in the blood transport oxygen from the lung to the tissues by binding it to haemoglobin. Excretion of unphysiological amounts of erythrocytes into the urine - i.e. more than about 130.000/24 h - is most often caused by inflammation or other lesions in the urogenital tract. Free hemoglobin originating from lysed erythrocytes (intravascularily or in the sample during storage/transport) may be found in the urine as well. This can be due to a variety of other diseases. Hemoglobin passes into the urine when the binding capacity of the plasma and the tubular re-absorption capacity have been exceeded. This usually occurs with plasma hemoglobin concentrations of around 60 µmol/l.

The interpretation of results: The practical detection limit of the test pad for blood of the Combur-Test® urine test strips is about 5 erythrocytes/µl and for hemoglobin the amount corresponding to 10 erythrocytes/µl. A homogeneous color change indicates the presence of lysed erythrocytes or free hemoglobin in the urine specimen (hemoglobinuria).
Green dots will show up if intact RBCs cells are present on the test paper (hematuria).
Reference range: 0 - 5 erythrocytes/µl

Difference between Hemoglobinuria & Hematuria
Hemoglobinuria is a condition in which the oxygen transport protein hemoglobin is found in abnormally high concentrations in the urine. The condition is often associated with hemolytic anemia, in which RBCs are destroyed, thereby increasing levels of free plasma hemoglobin. The excess hemoglobin is filtered by the kidneys, which release it into the urine, giving urine a red colour.
Hematuria is the presence of blood in the urine. It is a sign of a large number of diseases of the kidneys and the urinary tract, ranging from trivial to lethal.
p.s. Occasionally "hemoglobinuria" is used synonymously, although more precisely it refers only to hemoglobin in the urine.

Interpretation
Transient micro-hematuria
-Heavy physical training or exhausting activities
-Urinary tract infections
-Trauma to the kidneys or urinary tract
Permanent or recurrent micro-hematuria
-Urolithiasis
-Tumours of the kidneys or the urinary tract
-Glomerulonephritis
-Pyelonephritis
Medicines possibly causing micro-hematuria
Phenytoin, rifampicine, danazole, anticoagulants including acetylic salicylic acid, NSAIDs like ibuprofen, cytostatics like cyclophosphamide


Hope it clears the doubt of yall too! (: seeya!
Natalie
TG01