Hematuria: Difference between revisions

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Revision as of 14:00, 9 August 2011

For patient information click here

Hematuria
ICD-10 N02, R31
ICD-9 599.7, 791.2
DiseasesDB 19635
MeSH D006417

Template:Search infobox Steven C. Campbell, M.D., Ph.D.

Please Join in Editing This Page and Apply to be an Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [1] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

Overview

Hematuria (or "haematuria") is the presence of red blood cells (erythrocytes) in the urine. Occasionally the term "hemoglobinuria" is used synonymously, although more precisely it refers only to hemoglobin in the urine.

Types of Hematuria

Red discoloration of the urine can have various causes:

Symptoms

In assessing the underlying cause of hematuria, the patient should be asked the following questions::

  • Have you passed any blood clots?
  • Has a kidney stone been passed (have you heard a noise in toilet bowl)?
  • Is the red color mixed in completely, or does the color change during an episode of urination?
  • Does it occur only after getting up?
  • Have you recently had a sore throat?

Diagnosis

Often, the diagnosis is made on the basis of the medical history and some blood tests—especially in young people in whom the risk of malignancy is negligible and the symptoms are generally self-limited.

Ultrasound investigation of the renal tract is often used to distinguish between various sources of bleeding. X-rays can be used to identify kidney stones, although CT scanning is more precise.

In older patients, cystoscopy with biopsy of suspected lesions is often employed to investigate for bladder cancer.

A more complete evaluation would include the following:

  • C3 levels
  • Red blood cells casts
  • Cyroglobulins
  • Hepatitis C antibodies
  • Anti-glomerular basement membranes (GBM)
  • Antinuclear anitbodies (ANA)
  • Antineutrophil cytoplasmic antibodies (ANCA)
  • Antistreptolysin O antibodies (ASO)

Common Causes

Common causes of macroscopic hematuria/ haematuria (i.e. blood visible in the urine) include:

Differential Diagnosis

In alphabetical order. [2] [3]

Main Causes

Other Causes

References

  1. ↑ http://www.emoryhealthcare.org/departments/urology/sub_menu/upj.html
  2. ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  3. ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

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Epidemiology and Demographics

  • 2.5% of the general population has asymptomatic hematuria

Other Diagnostic Studies

  • Three-tube test
  • Centrifuge urine sample
  • Urine cytology
  • Urine cytoscopy
  • Renal biopsy


Treatment

  • Older patients with transient hematuria should be evaluated for urinary tract cancers
  • Urologic consult if necessary
  • Treat underlying etiologies
  • Increase hydration (stones)

Pharmacotherapy

Acute Pharmacotherapies

  • Antibiotics (UTI)
  • Analgesics (stones)

Surgery and Device Based Therapy

  • Biopsy for patients for glomerular sources

Acknowledgements

The content on this page was first contributed by Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]


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