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¿Qué problemas puede esconder orinar con sangre?

La presencia de sangre en la orina, conocida en términos médicos como hematuria, es una afección muy frecuente, y, aunque suele ser muy llamativa, no tienen por qué esconder enfermedades graves en riñón o vegija. De hecho, muchas de las causas de la hematuria son bastante comunes y fácilmente tratables. Aun así, puesto que también puede esconder problemas graves, la presencia de sangre en la orina debe ser rápidamente consultada con el médico.

La presencia de sangre en la orina suele detectarse con facilidad, pues basta con observar su color cuando vamos al baño. Una orina con sangre suele ser de color rosado, café, té, parecido al de un refresco de cola… Sin embargo, hay veces en las que la cantidad de orina es tan pequeña que no se detecta a simple vista, sino que es necesario hacer un análisis detectarla. Es lo que se conoce como microhematuria.

La hematuria puede ser un síntoma aislado o estar acompañado de otros, como:

•Molestias al orinar

•Dificultades para iniciar la micción

•Micciones frecuentes o urgentes, también por la noche.

•Fiebre

•Náuseas y/o vómitos

•Dolores en el abdomen, el costado o la espalda

La hematuria tiene que ser siempre revisada por un médico, pero en caso de que se presente alguno de estos síntomas, deberá hacerse cuanto antes.

La hematuria es un síntoma, no una enfermedad en sí. Por ello, una vez que aparezca, habrá que buscar las posibles causas, que pueden ser varias y de distinta gravedad.

•Infecciones en las vías urinarias. Son más frecuentes en mujeres y suelen acompañarse de dolor y ardor al orinar y a veces fiebre. Se suele producir cuando entran bacterias a través de la uretra.

•Infecciones renales. Se producen cuando las bacterias ingresan en los riñones. Además de hematuria y de síntomas parecidos a los de las infecciones urinarias, suelen provocar dolor en el costado.

•Cálculos, ya sea en los riñones -los más frecuentes- o en la vejiga. A menudo, la hematuria, o microhematuria, es el único síntoma hasta que los cálculos producen un bloqueo o pasen por las vías urinarias, algo que suele ser muy doloroso.

•Agrandamiento de la próstata. Cuando la glándula es muy grande, comprime la uretra, se bloquea parcialmente el flujo de orina y puede aparecer sangre en ella, además de dificultades para orinar y micción frecuente.

•Enfermedades renales. Hay varias enfermedades del riñón que pueden causar hematuria, como glomerulonefritis, una inflamación del sistema de filtración de los riñones; enfermedad renal después de una faringitis estreptocócica, poliquistosis renal, insuficiencia renal, síndrome de Alport, etc.

•Lesiones renales, causadas por accidentes, golpes, etc. pueden hacer que aparezca sangre en la orina.

Cáncer. La presencia de orina en sangre puede ser un síntoma de cáncer de riñón o de vejiga.

•Medicamentos. Ha fármacos, como la ciclofosfamida, un medicamento que se usa contra el cáncer, la penicilina o algunos anticoagulantes (ácido acetilsalicílico, heparina), que pueden provocar sangrado urinario.

•Algunos trastornos, como la hemofilia o la trombocitopenia

•Ejercicio extenuante. Aunque es raro, hay veces que los ejercicios muy extenuantes pueden provocar sangrados visibles en la orina. Aunque no se sabe con certeza, se cree que puede deberse a un traumatismo en la vejiga o la deshidratación. De hecho, existe lo que se conoce como ‘hematuria del corredor’, relativamente frecuente en corredores de largas distancias.

Hay veces en las que la causa es fácil de encontrar, sobre todo en el caso de las infecciones, pues solo hace falta un análisis de orina y la presencia de algunos síntomas para diagnosticarla. En otras ocasiones, la causa no está clara, por lo que será necesario hacer pruebas, algunas de ellas complejas:

•Ecografía abdominal o de los riñones

•Análisis de sangre y orina más completos

•Biopsia de los riñones

•TAC

•Citología urinaria

•Cultivos

•Recolección de orina 24 horas

•Cistoscopia (introducir una cámara en la vejiga), etc.

Con estas pruebas debería encontrarse la causa de la hematuria, aunque hay veces que el origen es desconocido y no se encuentra nada. En este caso, se recomendarán revisiones periódicas (cada uno o dos años) por si apareciera la causa.

El tratamiento dependerá, por tanto, de la causa de la presencia de sangre en orina. En ocasiones, bastará con un tratamiento de antibióticos (infecciones), pero en otras, se requerirán tratamientos más complejos e incluso operaciones, quimioterapia, etc.


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