Renal biopsy will give the final answer for the diagnosis of the
kidney lesion causing proteinuria.
HAEMATURIA
Definitions
Normally the number of RBC's in urine should not be more than 5
RBCs/high power field on microscopic examination of fresh
centrifuged urine sample. So, haematuria is defined as a secretion of
more than 5 RBCs/HPF in urine.
Haematuria may be the only symptom or associated with other
symptoms, according to the etiologic cause e.g. loin pain and fever
with infection and renal colic with renal stones.
Haematuria could be gross (causing red-coloured urine) or
microscopic (urine appears normal. But RBCs are seen on
microscopic examination).
In gross hematuria, urine looks red if alkaline, but brown or coca-cola
like if urine is acidic due to denaturation of the hemoglobin.
Also, hematuria could be glomerular (because of glomerular disease,
sometimes called medical); or non glomerular (sometimes called
surgical). Glomerular could be differentiated from non glomerular
haematuria by:
The shape of RBCs in urine is dysmorphic in cases with
glomerular haematuria while it will be normal in case of non
glomerular haematuria.
The size of RBCs whose mean corpuscular volume in urine of
patient with glomerular haematuria which is smaller than it is in
peripheral blood. But in non glomerular cases it is equal.
