Hematuria classification: Difference between revisions
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==Overview== | ==Overview== | ||
Hematuria may be classified based on its source, visibility, duration and pathophysiology. | [[Hematuria]] may be classified based on its source, visibility, duration and pathophysiology. | ||
==Classification== | ==Classification== | ||
===Hematuria may be classified by its source=== | ===Hematuria may be classified by its source<ref name="pmid25382080">{{cite journal |vauthors=Bagnall P |title=Haematuria: classification, causes and investigations |journal=Br J Nurs |volume=23 |issue=20 |pages=1074–8 |date=2014 |pmid=25382080 |doi=10.12968/bjon.2014.23.20.1074 |url=}}</ref>=== | ||
#'''Extrarenal hematuria::''' More than 60% of cases of hematuria occur from a source outside the kidney.The most common nonmalignant causes of hematuria outside the kidney are infections such as cystitis , prostatitis , and urethritis . | #'''Extrarenal hematuria::''' More than 60% of cases of hematuria occur from a source outside the kidney.The most common nonmalignant causes of hematuria outside the kidney are infections such as [[cystitis]] , [[prostatitis]] , and [[urethritis]] . | ||
#'''Nonglomerular renal hematuria:''' Renal stones and pyelonephritis will present with episodic pain and pyelonephritis with fever. Polycystic kidney disease (PKD) will usually present with recurring gross hematuria. <ref name="pmid23098784">Davis R, Jones JS, Barocas DA, Castle EP, Lang EK, Leveillee RJ et al. (2012) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=23098784 Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline.] ''J Urol'' 188 (6 Suppl):2473-81. [http://dx.doi.org/10.1016/j.juro.2012.09.078 DOI:10.1016/j.juro.2012.09.078] PMID: [https://pubmed.gov/23098784 23098784]</ref>Although the degree of proteinuria correlates with the severity and progression of renal disease, microscopic hematuria does not have such correlation. | #'''Nonglomerular renal hematuria:''' Renal stones and [[pyelonephritis]] will present with episodic pain and pyelonephritis with [[fever]]. [[Polycystic kidney disease|Polycystic kidney]] disease (PKD) will usually present with recurring gross hematuria. <ref name="pmid23098784">Davis R, Jones JS, Barocas DA, Castle EP, Lang EK, Leveillee RJ et al. (2012) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=23098784 Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline.] ''J Urol'' 188 (6 Suppl):2473-81. [http://dx.doi.org/10.1016/j.juro.2012.09.078 DOI:10.1016/j.juro.2012.09.078] PMID: [https://pubmed.gov/23098784 23098784]</ref>Although the degree of [[proteinuria]] correlates with the severity and progression of renal disease, [[microscopic hematuria]] does not have such correlation. | ||
#'''Glomerular hematuria:''' IgA nephropathy is the most common cause of isolated glomerular microscopic hematuria (without significant proteinuria). It is usually asymptomatic and often is diagnosed as an incidental finding. | #'''Glomerular hematuria:''' [[IgA nephropathy]] is the most common cause of isolated glomerular microscopic hematuria (without significant proteinuria). It is usually asymptomatic and often is diagnosed as an incidental finding. | ||
===Classification by the visibility of hematuria=== | ===Classification by the visibility of hematuria=== | ||
#'''Visible hematuria:''' Also known as Frank hematuria/ Macroscopic hematuria/ Gross hematuria.<ref name="Pan2006">{{cite journal|last1=Pan|first1=Cynthia G.|title=Evaluation of Gross Hematuria|journal=Pediatric Clinics of North America|volume=53|issue=3|year=2006|pages=401–412|issn=00313955|doi=10.1016/j.pcl.2006.03.002}}</ref> Visible hematuria can be visualized | #'''Visible hematuria:''' Also known as Frank hematuria/ Macroscopic hematuria/ Gross hematuria.<ref name="Pan2006">{{cite journal|last1=Pan|first1=Cynthia G.|title=Evaluation of Gross Hematuria|journal=Pediatric Clinics of North America|volume=53|issue=3|year=2006|pages=401–412|issn=00313955|doi=10.1016/j.pcl.2006.03.002}}</ref> Visible hematuria can be visualized and is also known as frank, gross or macroscopic hematuria. | ||
##'''Initial hematuria:''' May indicate urethral pathology | ##'''Initial hematuria:''' May indicate urethral pathology | ||
##'''Terminal hematuria:''' Hematuria at the end of the stream that comes from the proximal urethra (bladder neck/prostate). | ##'''Terminal hematuria:''' Hematuria at the end of the stream that comes from the proximal [[urethra]] (bladder neck/prostate). | ||
##'''Complete hematuria:''' Hematuria throughout the entire stream suggests bladder, ureteric or renal pathology. | ##'''Complete hematuria:''' Hematuria throughout the entire stream suggests [[bladder]], ureteric or [[renal]] pathology. | ||
#'''Non-visible hematuria:''' Non-visible hematuria encompasses dipstick and microscopic hematuria.<ref>{{cite web |url=http://www.surgeryjournal.co.uk/article/S0263-9319(10)00199-7/abstract |title=www.surgeryjournal.co.uk |format= |work= |accessdate=}}</ref> | #'''Non-visible hematuria:''' Non-visible hematuria encompasses dipstick and microscopic hematuria.<ref>{{cite web |url=http://www.surgeryjournal.co.uk/article/S0263-9319(10)00199-7/abstract |title=www.surgeryjournal.co.uk |format= |work= |accessdate=}}</ref> | ||
===Classification by the duration of hematuria=== | ===Classification by the duration of hematuria=== | ||
#'''Transient hematuria:''' A single urinalysis with hematuria is common and can result from menstruation, viral illness, allergy, exercise, fever, or mild trauma. | #'''Transient hematuria:''' A single urinalysis with hematuria is common and can result from [[menstruation]], [[Virus|viral]] illness, [[allergy]], exercise, fever, or mild [[trauma]]. | ||
#'''Persistent or Significant hematuria:''' >3 RBCs/HPF on three urinalyses, a single urinalysis with >100 RBCs, or gross hematuria. | #'''Persistent or Significant hematuria:''' >3 RBCs/HPF on three urinalyses, a single urinalysis with >100 RBCs, or gross hematuria. | ||
===Classification by Pathophysiology=== | ===Classification by Pathophysiology<ref name="pmid23896092">{{cite journal |vauthors=Lee JY, Chang JS, Koo KC, Lee SW, Choi YD, Cho KS |title=Hematuria grading scale: a new tool for gross hematuria |journal=Urology |volume=82 |issue=2 |pages=284–9 |date=August 2013 |pmid=23896092 |doi=10.1016/j.urology.2013.04.048 |url=}}</ref>=== | ||
Common causes of microscopic hematuria may be classified broadly according to the underlying etiology as glomerular and non glomerular, as follows: | Common causes of microscopic hematuria may be classified broadly according to the underlying etiology as [[glomerular]] and non glomerular, as follows: | ||
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Revision as of 00:39, 25 June 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]
Overview
Hematuria may be classified based on its source, visibility, duration and pathophysiology.
Classification
Hematuria may be classified by its source[1]
- Extrarenal hematuria:: More than 60% of cases of hematuria occur from a source outside the kidney.The most common nonmalignant causes of hematuria outside the kidney are infections such as cystitis , prostatitis , and urethritis .
- Nonglomerular renal hematuria: Renal stones and pyelonephritis will present with episodic pain and pyelonephritis with fever. Polycystic kidney disease (PKD) will usually present with recurring gross hematuria. [2]Although the degree of proteinuria correlates with the severity and progression of renal disease, microscopic hematuria does not have such correlation.
- Glomerular hematuria: IgA nephropathy is the most common cause of isolated glomerular microscopic hematuria (without significant proteinuria). It is usually asymptomatic and often is diagnosed as an incidental finding.
Classification by the visibility of hematuria
- Visible hematuria: Also known as Frank hematuria/ Macroscopic hematuria/ Gross hematuria.[3] Visible hematuria can be visualized and is also known as frank, gross or macroscopic hematuria.
- Non-visible hematuria: Non-visible hematuria encompasses dipstick and microscopic hematuria.[4]
Classification by the duration of hematuria
- Transient hematuria: A single urinalysis with hematuria is common and can result from menstruation, viral illness, allergy, exercise, fever, or mild trauma.
- Persistent or Significant hematuria: >3 RBCs/HPF on three urinalyses, a single urinalysis with >100 RBCs, or gross hematuria.
Classification by Pathophysiology[5]
Common causes of microscopic hematuria may be classified broadly according to the underlying etiology as glomerular and non glomerular, as follows:
| Common Causes of Renal | Common Causes of Non-Renal Hematuria | ||
|---|---|---|---|
| Glomerular hematuria | Non-glomerular renal hematuria | Upper urinary tract | Lower urinary Tract |
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References
- ↑ Bagnall P (2014). "Haematuria: classification, causes and investigations". Br J Nurs. 23 (20): 1074–8. doi:10.12968/bjon.2014.23.20.1074. PMID 25382080.
- ↑ Davis R, Jones JS, Barocas DA, Castle EP, Lang EK, Leveillee RJ et al. (2012) Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline. J Urol 188 (6 Suppl):2473-81. DOI:10.1016/j.juro.2012.09.078 PMID: 23098784
- ↑ Pan, Cynthia G. (2006). "Evaluation of Gross Hematuria". Pediatric Clinics of North America. 53 (3): 401–412. doi:10.1016/j.pcl.2006.03.002. ISSN 0031-3955.
- ↑ "www.surgeryjournal.co.uk".
- ↑ Lee JY, Chang JS, Koo KC, Lee SW, Choi YD, Cho KS (August 2013). "Hematuria grading scale: a new tool for gross hematuria". Urology. 82 (2): 284–9. doi:10.1016/j.urology.2013.04.048. PMID 23896092.