Please help! Scared of urinalysis results.

[turtle221]

I am a 29 year old female.  I an not overweight and I don't smoke, drink or take meds.  I run 3 miles a day, almost every day.  I had a urinalysis at a local clinic because my Dr. didn't believe that I had a problem after a negative dipstick.  I went to the clinic and demanded the routine dipstick but also the microscopic. The dipstick came out perfectly normal but there were Red Blood Cells discovered during the microscopic of my urine sediment.  The range was 10-19.

Of course I find this out on Friday after my Dr. gone for the weekend.  I am really upset.  I have read all kind of reasons that the dipstick would be negative and the microscopic would be positive.  I am scared that whatever caused the supression of the RBC's also supressed the protein levels on the dipstick.  If anyone knows anything about this or has any advice or insight, please let me know.  

[HeinrikMD]

Hi,
What was the problem you were seeking the doctor about before the request for the urinalysis was performed? When was your last menstrual period?

The simplest reason I could think of for a female is contamination of menstrual blood in the urine.

Another possibility is a stone along the kidney and/or its associated organs. This is usually associated with pain in the flanks or above the groin. The stone causes injury and hence, blood.  

Another possibility is an infection along the urinary tract. This is usually associated with some pain, and other elements of the urine would be involved such as the white blood cells.

Another possibility is due to muscle breakdown after strenuous exercise. Muscle elements when broken down in a state of relative dehydration may cause injuries in the kidney. This may present with some blood in the urine. Severe conditions could cause kidney failure (these are not usually due to exercise but would involve traumatized muscles such as what happens if a patient sustains blunt force trauma particular to large muscle groups like the thighs). You could avoid this by ensuring that you are adequately hydrated when you exercise.

Another possibility is an immune-mediated disorder. This means that there is a defect in the immune system, instead of serving its protective function – the immune system damages the kidneys, hence the bleeding. This is usually associated with other symptoms, like rash, arthritis, swelling or edema.

A rare possibility for your age group would be cancer in the bladder, the kidney or the ureters (these are the tubes that connect the kidney to the bladder).

If the problem is persistent, then more testing may be warranted. A particularly useful test is to look at the shape (morphology) of the blood elements as this would give an indication of the origin of the bleeding site.

It would be best to discuss matters with your doctor. Bear in mind also, that the test is also not fool-proof. There is a tendency to believe in tests because they are deemed more objective than the symptom appraisal of the doctor, but at the end of the day, it is still the doctor who must make go after the probable from the endless possibles

Stay positive.

[turtle221]

Thanks for the response.  I am so glad you have taken the time to help me.

I went to the Dr. because of some particles in my urine and some back pain.  Because I do run alot and there are many hills in my regular route, I thought the back pain might be muscular.  My last period ended about 4 days before the urinalysis.  Along the the low back and flank pain, which is not constant, I have had some pains immediatly above my pubic bone.  The white blood cell level in my urine was 1-4.  I do not have any indications of an auto-immune disorder.  In January I had a a sed-rate test and it was not even close to elevated.  I think that would be raised in an auto-immune situation.

I am freaked out because my dad died of kidney cancer at 63 years old.  He worked with many harsh chemicles in his life and in those days people were on aware of proper handling practices and gloves were seldom worn.  The exposure to these may have had something to do with his cancer.  My Dr. said that that I do not run a greatly increased risk of kidney cancer because my dad had it.  

I also wanted to let you know that about 7 months ago, while diagnosing a gall bladder problem I had a CT of my abdomen and my kidneys were listed as normal at the time.  Also, I had an ultrasound that involved my right kidney and that was also listed as normal at the time.  

I just talked with an on-call physician for my Dr. who said that he thinks I have a low grade infection and prescribed an antibiotic.  He said to repeat the test several days after finishing the antibiotic.  

Thank you for taking the time to read this please let me know if you have any insight.

Turtle

[turtle221]

I was hoping for some insight from my original post on how come the dipstick could be negative for blood but the microscopic found red blood cells.  As mentioned above the range was 10-19.  I'm scared.  If anyone can help, please help.