Hematuria: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
 
(42 intermediate revisions by 11 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
{{Infobox_Disease |
  Name          = {{PAGENAME}} |
  Image          = |
  Caption        = |
  DiseasesDB    = 19635 |
  ICD10          = {{ICD10|N|02||n|00}}, {{ICD10|R|31||r|30}} |
  ICD9          = {{ICD9|599.7}}, {{ICD9|791.2}} |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = |
  MeshID        = D006417 |
}}
{{Hematuria}}
{{Hematuria}}
{{SCC}}
'''For patient information, click [[{{PAGENAME}} (patient information)|here]]'''
{{SK}} Haematuria
==Overview==


'''Hematuria''' 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.
{{CMG}}; {{AE}} {{Adnan Ezici}} {{SCC}} {{VSKP}} {{AIDA}}


== Types of Hematuria==
{{SK}} Haematuria; urinary tract bleeding; blood in urine<br><br>'''To view a comprehensive algorithm of common findings of urine composition and urine output, click [[Urine#Algorithm of Common Urinary Findings|here]]'''<br>
Red discoloration of the urine can have various causes:
* [[Red blood cell]]s
** [[Microscopic hematuria]] (small amounts of blood, can be seen only on [[urinalysis]] or [[light microscopy]])
** Macroscopic hematuria (or "frank" or "gross") hematuria
* [[Hemoglobin]] (only the red pigment, not the [[red blood cell]]s)
* Other pigments
** [[Porphyrin]]s in [[porphyria]]
** [[Betanin]], after eating [[beet]]s


==Symptoms==
==[[Hematuria overview|Overview]]==
In assessing the underlying cause of hematuria, the patient should be asked the following questions::
* Have you passed any [[blood clot]]s?
* 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 ==
==[[Hematuria definition|Definition]]==
Often, the diagnosis is made on the basis of the medical history and some [[blood test]]s&mdash;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-ray]]s can be used to identify [[kidney stone]]s, although [[computed axial tomography|CT scanning]] is more precise.
==[[Hematuria historical perspective|Historical Perspective]]==


In older patients, [[cystoscopy]] with [[biopsy]] of suspected lesions is often employed to investigate for [[bladder cancer]].
==[[Hematuria classification|Classification]]==


* [[Urinalysis]] for all patients
==[[Hematuria pathophysiology|Pathophysiology]]==
* [[Complete blood count]] ([[CBC]])
* [[Calcium]]
* [[Uric acid]]
* [[Prothrombin time]] / [[Partial thromboplastin time]] ([[PT]] / [[PTT]])
* [[Blood urea nitrogen]] ([[BUN]]) / [[creatinine]]


A more complete evaluation would include the following:
==[[Hematuria causes|Causes]]==
* 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 ==
==[[Hematuria differential diagnosis|Differentiating Hematuria from other Diseases]]==
Common causes of ''macroscopic hematuria/ haematuria'' (i.e. blood visible in the urine) include:
* [[Thin basement membrane disease|Benign familial hematuria]]
* Urinary [[Schistosomiasis]] (caused by ''[[Schistosoma haematobium]]'') - a major cause for hematuria in many African and Middle-Eastern countries;
* [[IgA nephropathy]] ("Berger's disease") - occurs during viral infections in predisposed patients;
* [[Kidney stone]]s (or [[bladder stone]]s, now a rare disease);
* [[Bladder cancer]];
* [[Renal cell carcinoma]] - occasionally presents with bleeding;
* [[Paroxysmal nocturnal hemoglobinuria]] - a [[rare disease]] where [[hemoglobin]] of [[hemolysis|hemolysed]] cells is passed into the urine.
* [[Urinary tract infection]] with some bacterial species including strains of [[Escherichia coli#Urinary tract infections|EPEC]] and [[Staphylococcus saprophyticus]]
* [[Sickle cell trait]] can precipitate large amounts of red blood cell discharge, but only a small number of individuals endure this problem
* [[Arteriovenous malformation]] of the kidney (rare, but may impress like renal cell carcinoma on scans as both are highly vascular)
* Nephritic syndrome ( a condition associated with post-streptococcal and rapidly progressing glomerulonephritis.
* Ureteral Pelvic Junction Obstruction (UPJ) is a rare condition beginning from birth in which the ureter is blocked between the kidney and bladder.  This condition may cause blood in the urine.<ref>http://www.emoryhealthcare.org/departments/urology/sub_menu/upj.html</ref>


== Differential Diagnosis ==  
==[[Hematuria epidemiology and demographics|Epidemiology and Demographics]]==


In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
==[[Hematuria risk factors|Risk Factors]]==


=== Main Causes ===
==[[Hematuria screening|Screening]]==
* [[Bladder carcinoma]]
* Contamination during menstruation
* [[Cystitis]]
* [[Glomerulonephritis]]
* [[Prostatic hypertrophy]]
* [[Pyelonephritis]]
* [[Prostatitis]]
* [[Renal carcinoma]]
* [[renal stones|Stones]]
* [[Urinary Tract Infection]] ([[UTI]])


=== Other Causes ===
==[[Hematuria natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
* Acute/chronic [[Cystitis]]
* Acute intestinal [[nephritis]]
* [[Adenovirus]]
* After [[Endocarditis]]
* Allergic [[Granulomatosis]]
* [[Alport's Syndrome]]
* Analgesic kidney
* [[Arteriosclerosis]]
* [[Balkan Nephropathy]]
* [[Beeturia]]
* [[Benign familial hematuria]]
* [[Berger's Disease]]
* [[Bilharziosis]]
* Bladder infiltration
* Bladder [[tuberculosis]]
* [[Calyx Diverticulum]]
* [[Chemotherapeutics]]
* Consumption coagulopathy
* [[Crescentic glomerulonephritis]]
* Cystic kidneys
* [[Cytomegalovirus]] ([[CMV]])
* [[Dermatosclerosis]]
* [[Diabetes Mellitus]]
* Diabetic glomerulosclerosis/[[diabetic nephropathy]]
* [[Drug]]s
* [[ECHO viruses]] ('''E'''nteric '''C'''ytopathic '''H'''uman '''O'''rphan)
* [[E.coli]]
* [[Endometriosis]]
* [[Fabry's Disease]]
* Factor lack
* [[Filaria]]
* [[Fistula]]
* Focal glomerulotnephritis
* Foods
* Foreign body in urethra
* [[Goodpasture's Syndrome]]
* [[Heart failure]]
* Heavy exercise
* [[Hemoglobinopathy]]
* [[Hemophilia]]
* [[Hemolytic Uremic Syndrome]]
* [[Hemorrhage]] from bladder outlet
* [[Hemorrhage]] from urethra
* [[Hepatitis B]]
* [[Hydronephrosis]]
* [[Hypernephroma]]
* [[Hypertension]]
* [[Inflammation]]
* [[Influenza]]
* [[Injury]]
* Kidney [[Amyloidosis]]
* Kidney cell [[carcinoma]]
* Kidney [[tuberculosis]]
* [[Legionella]] Infection
* [[Systemic Lupus Erythematosus]]
* Malignant [[Hypertension]]
* [[Masturbation]]
* [[Meatus Stenosis]]
* [[Megaureter]]
* [[Membranoproliferative glomerulonephritis]]
* [[Metastases]]
* [[Mononucleosis]]
* [[Multiple Myeloma]]
* [[Mycoplasma]]
* [[Myoglobinuria]]
* [[Nail-Patella Syndrome]]
* [[Neoplasm]]
* [[Nephrocalcinosis]]
* [[Nephrolithiasis]]
* [[Osler's Disease]]
* [[Polyarteritis Nodosa]]
* [[Polycystic Kidney Disease]]
* [[Polycythemia Vera]]
* [[Porphyria]]
* [[Postinfectious glomerulonephritis]]
* [[Plasmodium]]
* Prostate [[adenoma]]
* [[Prostate carcinoma]]
* Prostate [[hyperplasia]]
* Prostate [[tuberculosis]]
* [[Pseudomonas]]
* [[Pyelonephritis]]
* Radiation nephropathy
* Renal artery aneurysm
* [[Renal cyst]]
* Renal [[hyperplasia]]
* Renal infarct
* Renal pelvis carcinoma
* [[Renal Stones]]
* Renal trauma
* Renal vein infarct
* [[Renal Vein Thrombosis]]
* [[Salmonella]]
* [[Sarcoidosis]]
* [[Schistosoma]]
* Schonlein-Henoch's Disease
* [[Shock]]
* Shunt nephritis
* [[Sickle Cell Anemia]]
* Sponge kidney
* [[Staphylococci]]
* [[Streptococci]]
* [[Thalassemia]]
* [[Thin Basement Membrane Disease]]
* Thrombocytopathies
* [[Thrombocytopenia]]
* [[Thrombotic Thrombocytopenic Purpura]]
* [[Toxin]]s
* [[Toxoplasma]]
* [[Trauma]]
* Traumatic kidney lesion
* [[Trichinella Spiralis]]
* [[Tubulointerstitial nephropathies]], [[nephritis]]
* [[Tumor]]
* [[Urate]] [[nephropathy]]
* [[Ureter]] [[carcinoma]]
* [[Ureter]] [[tuberculosis]]
* [[Urethra]] [[carcinoma]]
* [[Urethral]] [[carbuncle]]
* [[Urethral]] valves
* [[Urethritis]]
* Urethrolithiasis
* Urogential tuberculosis
* [[Urolithiasis]]
* [[Urothelium]] [[carcinoma]]
* [[Varicella]]
* Vesical calculi
* Vesico-ureteral-renal reflux
* [[Warfarin]] therapy (overdose)
* [[Wegener's Granulomatosis]]
* [[Wilms' Tumor]]


==References==
==Diagnosis==
{{reflist|2}}
[[Hematuria diagnostic evaluation| Diagnostic Evaluation]] | [[Hematuria history and symptoms| History and Symptoms]] | [[Hematuria physical examination | Physical Examination]] | [[Hematuria laboratory findings|Laboratory Findings]] | [[Hematuria electrocardiogram|Electrocardiogram]] | [[Hematuria x ray|X-ray]] | [[Hematuria echocardiography and ultrasound|Echocardiography and Ultrasound]] | [[Hematuria CT|CT]] | [[Hematuria other imaging findings|Other Imaging Findings]] | [[Hematuria other diagnostic studies|Other Diagnostic Studies]]


[[ar:بول دموي]]
==Treatment==
[[de:Hämaturie]]
[[Hematuria medical therapy|Medical Therapy]] | [[Hematuria interventions|Interventions]] | [[Hematuria surgery|Surgery]] | [[Hematuria primary prevention|Primary Prevention]] | [[Hematuria secondary prevention|Secondary prevention]] | [[Hematuria cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Hematuria future or investigational therapies|Future or Investigational Therapies]]
[[es:Hematuria]]
[[fr:Hématurie]]
[[it:Ematuria]]
[[he:המטוריה]]
[[ja:血尿]]
[[pt:Hematúria]]
[[qu:Yawar ispay]]
[[ru:Гематурия]]
[[fi:Verivirtsaisuus]]
[[zh:血尿]]
 
= 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 {{CMG}}
 
<br>


==Case Studies==
[[Hematuria case study one|Case #1]]
[[pl:Hematuria]]


{{WH}}
{{WS}}


[[Category:Nephrology]]
[[Category:Nephrology]]
[[Category:Urology]]
[[Category:Urology]]
[[Category:Emergency medicine]]
[[Category:Urologic Disease]]
[[Category:Urologic Disease]]
[[Category:Signs and symptoms]]
[[Category:Emergency medicine]]
[[pl:Hematuria]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Latest revision as of 18:05, 16 September 2021

Hematuria Microchapters

Home

Patient Information

Overview

Definition

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hematuria from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Interventions

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hematuria On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hematuria

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hematuria

CDC on Hematuria

Hematuria in the news

Blogs on Hematuria

Directions to Hospitals Treating Hematuria

Risk calculators and risk factors for Hematuria

For patient information, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Adnan Ezici, M.D[2] Steven C. Campbell, M.D., Ph.D. Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [3] Aida Javanbakht, M.D.

Synonyms and keywords: Haematuria; urinary tract bleeding; blood in urine

To view a comprehensive algorithm of common findings of urine composition and urine output, click here

Overview

Definition

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hematuria from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Evaluation | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X-ray | Echocardiography and Ultrasound | CT | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Interventions | Surgery | Primary Prevention | Secondary prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Template:WH Template:WS