Hematuria differential diagnosis: Difference between revisions

Jump to navigation Jump to search
Line 39: Line 39:
|-
|-
| rowspan="7" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Glomerular disease|Glomerular diseases]]
| rowspan="7" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Glomerular disease|Glomerular diseases]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[IgA nephropathy|IgA nephropathy (Berger nephropathy)]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[IgA nephropathy|IgA nephropathy]]<ref name="pmid12213946">{{cite journal| author=Donadio JV, Grande JP| title=IgA nephropathy. | journal=N Engl J Med | year= 2002 | volume= 347 | issue= 10 | pages= 738-48 | pmid=12213946 | doi=10.1056/NEJMra020109 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12213946  }}</ref><ref name="pmid21949093">{{cite journal| author=Suzuki H, Kiryluk K, Novak J, Moldoveanu Z, Herr AB, Renfrow MB et al.| title=The pathophysiology of IgA nephropathy. | journal=J Am Soc Nephrol | year= 2011 | volume= 22 | issue= 10 | pages= 1795-803 | pmid=21949093 | doi=10.1681/ASN.2011050464 | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21949093 }}</ref> [[IgA nephropathy|(Berger nephropathy)]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
Line 51: Line 51:
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | '''Biopsy:'''  
| style="background: #F5F5F5; padding: 5px;" | '''Biopsy:'''  
IgA deposited in a diffuse granular patte-rn in the mesangium
[[IgA]] deposited in a diffuse [[Granular cell|granular]] pattern in the [[mesangium]]
| style="background: #F5F5F5; padding: 5px;" |Biopsy
| style="background: #F5F5F5; padding: 5px;" |Biopsy
*  
*  
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Alport syndrome|Hereditary nephritis (Alport syndrome)]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Alport syndrome|Hereditary nephritis]]<ref name="pmid11137428">{{cite journal| author=McCarthy PA, Maino DM| title=Alport syndrome: a review. | journal=Clin Eye Vis Care | year= 2000 | volume= 12 | issue= 3-4 | pages= 139-150 | pmid=11137428 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11137428 }}</ref><ref name="pmid8154501">{{cite journal| author=Bodziak KA, Hammond WS, Molitoris BA| title=Inherited diseases of the glomerular basement membrane. | journal=Am J Kidney Dis | year= 1994 | volume= 23 | issue= 4 | pages= 605-18 | pmid=8154501 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8154501 }}</ref> [[Alport syndrome|(Alport syndrome)]]
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
Line 73: Line 73:
* Cylindrical [[casts]]
* Cylindrical [[casts]]
| style="background: #F5F5F5; padding: 5px;" |'''Biopsy:'''
| style="background: #F5F5F5; padding: 5px;" |'''Biopsy:'''
* Monoclonal antibodies directed against alpha-3 (IV), alpha-4 (IV), and alpha-5 (IV) chains of typ-e IV collagen
* [[Monoclonal antibodies]] directed against alpha-3 (IV), alpha-4 (IV), and alpha-5 (IV) chains of [[Type-IV collagen|typ-e IV collage]]<nowiki/>n
| style="background: #F5F5F5; padding: 5px;" |Genetic analysis
| style="background: #F5F5F5; padding: 5px;" |[[Genetics|Genetic]] analysis
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Poststreptococcal glomerulonephritis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Post-streptococcal glomerulonephritis]]<ref name="pmid15213266">{{cite journal |vauthors=Yoshizawa N, Yamakami K, Fujino M, Oda T, Tamura K, Matsumoto K, Sugisaki T, Boyle MD |title=Nephritis-associated plasmin receptor and acute poststreptococcal glomerulonephritis: characterization of the antigen and associated immune response |journal=J. Am. Soc. Nephrol. |volume=15 |issue=7 |pages=1785–93 |date=July 2004 |pmid=15213266 |doi= |url=}}</ref><ref name="pmid20708459">{{cite journal |vauthors=Oda T, Yoshizawa N, Yamakami K, Tamura K, Kuroki A, Sugisaki T, Sawanobori E, Higashida K, Ohtomo Y, Hotta O, Kumagai H, Miura S |title=Localization of nephritis-associated plasmin receptor in acute poststreptococcal glomerulonephritis |journal=Hum. Pathol. |volume=41 |issue=9 |pages=1276–85 |date=September 2010 |pmid=20708459 |doi=10.1016/j.humpath.2010.02.006 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
Line 86: Line 86:
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Edema
* [[Edema]]
* Anemia
* [[Anemia]]
* Increased Blood Pressure
* Increased [[Blood pressure|Blood Pressure]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Urine samples for protein and blood
* Urine samples for [[protein]] and [[blood]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
'''Biopsy'''
'''Biopsy'''
* Irregularly thin and attenuated GBM
* Irregularly thin and attenuated [[GBM]]
* Splitting of GBM
* Splitting of [[GBM]]
* Scarring  
* Scarring  
* Immunoglobulin G and C3 in a diffuse granular pattern  
* [[Immunoglobulin G]] and [[C3 disease|C3]] in a diffuse [[Granule cell|granular]] pattern  
* Starr-y sky pattern
* Starry sky pattern
| style="background: #F5F5F5; padding: 5px;" |Biopsy
| style="background: #F5F5F5; padding: 5px;" |Biopsy
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Focal segmental glomerulosclerosis|Focal segmental glomerular sclerosis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Focal segmental glomerulosclerosis|Focal segmental glomerular sclerosis]]<ref name="pmid18039119">{{cite journal| author=Kwoh C, Shannon MB, Miner JH, Shaw A| title=Pathogenesis of nonimmune glomerulopathies. | journal=Annu Rev Pathol | year= 2006 | volume= 1 | issue=  | pages= 349-74 | pmid=18039119 | doi=10.1146/annurev.pathol.1.110304.100119 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18039119  }}</ref><ref name="pmid17216262">{{cite journal |vauthors=Reidy K, Kaskel FJ |title=Pathophysiology of focal segmental glomerulosclerosis |journal=Pediatr. Nephrol. |volume=22 |issue=3 |pages=350–4 |date=March 2007 |pmid=17216262 |pmc=1794138 |doi=10.1007/s00467-006-0357-2 |url=}}</ref>'''<ref name="pmid14750104">{{cite journal| author=D'Agati VD, Fogo AB, Bruijn JA, Jennette JC| title=Pathologic classification of focal segmental glomerulosclerosis: a working proposal. | journal=Am J Kidney Dis | year= 2004| volume= 43 | issue= 2 | pages= 368-82 | pmid=14750104 | doi= | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14750104  }}</ref>'''
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
Line 110: Line 110:
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Nephrotic syndrome
* [[Nephrotic syndrome]]
* ESRD  
* [[ESRD]]
* Pleural effusion
* [[Pleural effusion]]
* Ascites
* [[Ascites]]
* Abdominal pain
* [[Abdominal pain]]
**
**
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Urinalysis reveals large amounts of protein, along with hyaline and broad waxy casts
* [[Urinalysis]] reveals large amounts of protein, along with [[hyaline]] and broad waxy casts
* Hepatitis B or C infection
* [[Hepatitis B]] or [[Hepatitis C|C]] infection
* Antineutrophil cytoplasmic antibody titers, serum protein electrophoresis
* [[Anti-neutrophil cytoplasmic antibody]] titers, [[serum protein electrophoresis]]
| style="background: #F5F5F5; padding: 5px;" |'''Biopsy'''
| style="background: #F5F5F5; padding: 5px;" |'''Biopsy'''
* Segmental solidification in the perihilar region and  peripheral areas, specially the tubular pole
* Segmental solidification in the perihilar region and  peripheral areas, especially the [[tubular]] pole
* Coarsely granular deposits -of IgM and C3
* Coarsely [[Granule cell|granular]] deposits -of [[Immunoglobulin M|IgM]] and [[C3 glomerular disease|C3]]
| style="background: #F5F5F5; padding: 5px;" |Biopsy
| style="background: #F5F5F5; padding: 5px;" |Biopsy
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Rapidly progressive glomerulonephritis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Rapidly progressive glomerulonephritis]]<ref name="pmid9507491">{{cite journal| author=Couser WG| title=Pathogenesis of glomerular damage in glomerulonephritis. | journal=Nephrol Dial Transplant | year= 1998 | volume= 13 Suppl 1 | issue=  | pages= 10-5 | pmid=9507491 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9507491  }}</ref><ref name="pmid8959617">{{cite journal| author=Atkins RC, Nikolic-Paterson DJ, Song Q, Lan HY| title=Modulators of crescentic glomerulonephritis. | journal=J Am Soc Nephrol | year= 1996 | volume= 7 | issue= 11 | pages= 2271-8 | pmid=8959617 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8959617  }}</ref><ref name="pmid12631105">{{cite journal |vauthors=Jennette JC |title=Rapidly progressive crescentic glomerulonephritis |journal=Kidney Int. |volume=63 |issue=3 |pages=1164–77 |date=March 2003 |pmid=12631105 |doi=10.1046/j.1523-1755.2003.00843.x |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
Line 137: Line 137:
* Abdominal pain
* Abdominal pain
* Painful cutaneous nodules  
* Painful cutaneous nodules  
* Migratory polyarthropathy
* Migratory poly arthropathy
* Sinusitis  
* [[Rhinosinusitis|Sinusitis]]
* Cough
* [[Cough]]
* Hemoptysis.
* [[Hemoptysis]].
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Low iron
* Low [[iron]]
* Eosinophilia
* [[Eosinophilia]]
* Increased serum creatinine level
* Increased serum [[creatinine]] level
* Eleated LDH and CPK
* Eleated [[Lactate dehydrogenase|LDH]] and [[Creatine kinase|CPK]]
* Proteinuria  
* [[Proteinuria]]
| style="background: #F5F5F5; padding: 5px;" | Biopsy:
| style="background: #F5F5F5; padding: 5px;" | Biopsy:
* Diffuse, proliferative, necrotizing glomerulonephritis with cresc-ent formation
* Diffuse, proliferative, necrotizing [[Glomerular disease|glomerulonephritis]] with [[Glomerular disease|crescent]] formation
| style="background: #F5F5F5; padding: 5px;" |Biopsy
| style="background: #F5F5F5; padding: 5px;" |Biopsy
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Lupus nephritis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Lupus nephritis]]<ref name="pmid25014039">{{cite journal |vauthors=Schwartz N, Goilav B, Putterman C |title=The pathogenesis, diagnosis and treatment of lupus nephritis |journal=Curr Opin Rheumatol |volume=26 |issue=5 |pages=502–9 |date=September 2014 |pmid=25014039 |pmc=4221732 |doi=10.1097/BOR.0000000000000089 |url=}}</ref><ref name="pmid22977215">{{cite journal |vauthors=Giannico G, Fogo AB |title=Lupus nephritis: is the kidney biopsy currently necessary in the management of lupus nephritis? |journal=Clin J Am Soc Nephrol |volume=8 |issue=1 |pages=138–45 |year=2013 |pmid=22977215 |doi=10.2215/CJN.03400412 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
Line 168: Line 168:
* [[Proteinuria]]
* [[Proteinuria]]
* Cellular casts
* Cellular casts
* Low iron
* Low [[iron]]
| style="background: #F5F5F5; padding: 5px;" | Biopsy,  
| style="background: #F5F5F5; padding: 5px;" | Biopsy,  
* Different pathologies, [[Lupus nephritis|CLICK HERE]] for more- information.
* Different pathologies, [[Lupus nephritis|CLICK HERE]] for more information.
| style="background: #F5F5F5; padding: 5px;" |Biopsy
| style="background: #F5F5F5; padding: 5px;" |Biopsy
|-
|-
Line 184: Line 184:
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Hematuria
* [[Hematuria]]
* Proteinuria
* [[Proteinuria]]
| style="background: #F5F5F5; padding: 5px;" | Biopsy
| style="background: #F5F5F5; padding: 5px;" | Biopsy
| style="background: #F5F5F5; padding: 5px;" | Biopsy
| style="background: #F5F5F5; padding: 5px;" | Biopsy
Line 204: Line 204:
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard
|-
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Tubulointerstitial diseases of the kidney|Tubulointerstitial diseases]]
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Tubulointerstitial diseases of the kidney|Tubulointerstitial diseases]]<ref name="BakerPusey2004">{{cite journal|last1=Baker|first1=R. J.|last2=Pusey|first2=C. D.|title=The changing profile of acute tubulointerstitial nephritis|journal=Nephrology Dialysis Transplantation|volume=19|issue=1|year=2004|pages=8–11|issn=0931-0509|doi=10.1093/ndt/gfg464}}</ref><ref>Kelly C, Tomaszewski J, Neilson E. Immunopathogenic mechanisms of tubulointerstitial injury. In: Tisher C, Brenner B, eds, Renal Pathology: With Clinical and Functional Correlations, 2nd Edn., Vol. 1. J. B. Lippincott & Co, Philadelphia, PA, 1994; 699–722</ref><ref>Dharmarajan TS, Yoo J, Russell RO, Boateng YA. Acute post streptococcal interstitial nephritis in an adult and review of the literature. Int Urol Nephrol 1999; 31:145</ref>
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
Line 219: Line 219:
* [[Isosthenuria]]
* [[Isosthenuria]]
| style="background: #F5F5F5; padding: 5px;" |Biopsy:
| style="background: #F5F5F5; padding: 5px;" |Biopsy:
* [[Edema]] and infiltration by mononuclear cells, (principally lymphocytes)
* [[Edema]] and infiltration by [[Monocyte|mononuclear cells]], (principally lymphocytes)
* [[Eosinophils]] are present, often in large numbers.  
* [[Eosinophils]] are present, often in large numbers.  
| style="background: #F5F5F5; padding: 5px;" |Renal biopsy
| style="background: #F5F5F5; padding: 5px;" |Renal biopsy
|-
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Nephrolithiasis]]
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Nephrolithiasis]]<ref name="pmid12649987">{{cite journal |vauthors=Hochreiter W, Knoll T, Hess B |title=[Pathophysiology, diagnosis and conservative therapy of non-calcium kidney calculi] |language=German |journal=Ther Umsch |volume=60 |issue=2 |pages=89–97 |date=February 2003 |pmid=12649987 |doi=10.1024/0040-5930.60.2.89 |url=}}</ref><ref name="pmid23392537">{{cite journal |vauthors=Trinchieri A |title=Diet and renal stone formation |journal=Minerva Med. |volume=104 |issue=1 |pages=41–54 |date=February 2013 |pmid=23392537 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" |±
Line 241: Line 241:
* [[Hyperuricosuria]]
* [[Hyperuricosuria]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Hydronephrosis +/- in sonography
* Ultrasound: [[Hydronephrosis]] +/-
* Abdominal CT scan without contrast
* [[Computed tomography|Abdominal CT scan]] without contrast
| style="background: #F5F5F5; padding: 5px;" |Abdominal CT scan without contrast
| style="background: #F5F5F5; padding: 5px;" |Abdominal [[Computed tomography|CT scan]] without contrast
|-
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Reflux nephropathy|Reflux nephropathy (hydronephrosis)]]
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Reflux nephropathy|Reflux nephropathy (hydronephrosis)]]
Line 261: Line 261:
* Elevated [[WBC]] count  
* Elevated [[WBC]] count  
* Elevated [[BUN]]
* Elevated [[BUN]]
* Hyperkalemia
* [[Hyperkalemia]]


| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Ultrasound: Hydronephrosis +/-
* Ultrasound: [[Hydronephrosis]] +/-


* Biopsy: Kidney scar
* Biopsy: [[Kidney]] scar
| style="background: #F5F5F5; padding: 5px;" |–
| style="background: #F5F5F5; padding: 5px;" |–
|-
|-
| rowspan="4" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Malignancy]]
| rowspan="4" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Malignancy]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Renal cell carcinoma|Renal cell carcinoma (RCC)]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Renal cell carcinoma|Renal cell carcinoma (RCC)]]<ref name="pmid16339096">{{cite journal| author=Cohen HT, McGovern FJ| title=Renal-cell carcinoma. | journal=N Engl J Med | year= 2005 | volume= 353 | issue= 23 | pages= 2477-90 | pmid=16339096 | doi=10.1056/NEJMra043172 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16339096  }}</ref><ref name="pmid20479778">{{cite journal |vauthors=Leveridge MJ, Bostrom PJ, Koulouris G, Finelli A, Lawrentschuk N |title=Imaging renal cell carcinoma with ultrasonography, CT and MRI |journal=Nat Rev Urol |volume=7 |issue=6 |pages=311–25 |date=June 2010 |pmid=20479778 |doi=10.1038/nrurol.2010.63 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
Line 280: Line 280:
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Flank mass
* [[Flanks|Flank]] mass
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Anemia
* [[Anemia]]
* Hematuria
* [[Hematuria]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Both [[CT]] and [[MRI]] may be used to detect [[neoplastic]] masses that may define renal cell carcinoma or metastasis of the primary cancer. [[CT]] scan and use of intravenous (IV) contrast is generally used for work-up and follow-up of patients with [[Renal cell carcinoma|renal cell carcinom]]<nowiki/>a.
* Both [[CT]] and [[MRI]] may be used to detect [[neoplastic]] masses that may define renal cell carcinoma or metastasis of the primary cancer. [[CT]] scan and use of intravenous (IV) contrast is generally used for work-up and follow-up of patients with [[Renal cell carcinoma|renal cell carcinom]]<nowiki/>a.
Line 289: Line 289:
| style="background: #F5F5F5; padding: 5px;" |–
| style="background: #F5F5F5; padding: 5px;" |–
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Nephroblastoma]] ([[Wilms' tumor|Wilms tumor]])
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Nephroblastoma]] ([[Wilms' tumor|Wilms tumor]])<ref name="pmid1978">{{cite journal |vauthors=Jolly RD, Stellwagen E, Babul J, Vodkaĭlo LV, Titov VL, Moldomusaev DM, Maianskiĭ AN |title=Mannosidosis of Angus Cattle: a prototype control program for some genetic diseases |journal=Adv Vet Sci Comp Med |volume=19 |issue=23 |pages=1–21 |date=November 1975 |pmid=1978 |doi= |url=}}</ref><ref name="pmid157385942">{{cite journal |vauthors=Stefanowicz J, Sierota D, Balcerska A, Stoba C |title=[Wilms' tumour of unfavorable histology--results of treatment with the SIOP 93-01 protocol at the Gdańsk centre. Preliminary report] |language=Polish |journal=Med Wieku Rozwoj |volume=8 |issue=2 Pt 1 |pages=197–200 |date=2004 |pmid=15738594 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
Line 299: Line 299:
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Abdominal pain
* [[Abdominal pain]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Anemia]]
* [[Anemia]]
Line 319: Line 319:
| style="background: #F5F5F5; padding: 5px;" |Biopsy
| style="background: #F5F5F5; padding: 5px;" |Biopsy
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Bladder cancer]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Bladder cancer]]<ref name="pmid21360040">{{cite journal| author=Pons F, Orsola A, Morote J, Bellmunt J| title=Variant forms of bladder cancer: basic considerations on treatment approaches. | journal=Curr Oncol Rep | year= 2011 | volume= 13 | issue= 3 | pages= 216-21 | pmid=21360040 | doi=10.1007/s11912-011-0161-4 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21360040  }}</ref><ref name="pmid10918764">{{cite journal |vauthors=Metts MC, Metts JC, Milito SJ, Thomas CR |title=Bladder cancer: a review of diagnosis and management |journal=J Natl Med Assoc |volume=92 |issue=6 |pages=285–94 |date=June 2000 |pmid=10918764 |pmc=2640522 |doi= |url=}}</ref><ref name="pmid182316182">{{cite journal |vauthors=Rom M, Kuehhas FE, Djavan B |title=New findings in bladder and prostate cancer: highlights of the 22nd annual congress of the European association of urology, march 21-24, 2007, berlin, Germany |journal=Rev Urol |volume=9 |issue=4 |pages=214–9 |date=2007 |pmid=18231618 |pmc=2199502 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
Line 332: Line 332:
* [[Anemia]]
* [[Anemia]]
* [[Hematuria]]
* [[Hematuria]]
| style="background: #F5F5F5; padding: 5px;" |Ultrasound, CT scan, Biopsy
| style="background: #F5F5F5; padding: 5px;" |[[Ultrasound]], [[Computed tomography|CT scan]], Biopsy
| style="background: #F5F5F5; padding: 5px;" |Biopsy
| style="background: #F5F5F5; padding: 5px;" |Biopsy
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Prostate cancer]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Prostate cancer]]<ref name="pmid23451265">{{cite journal |vauthors=Chung SD, Liu SP, Lin HC |title=Association between prostate cancer and urinary calculi: a population-based study |journal=PLoS ONE |volume=8 |issue=2 |pages=e57743 |date=2013 |pmid=23451265 |pmc=3581486 |doi=10.1371/journal.pone.0057743 |url=}}</ref><ref name="pmid18231618">{{cite journal |vauthors=Rom M, Kuehhas FE, Djavan B |title=New findings in bladder and prostate cancer: highlights of the 22nd annual congress of the European association of urology, march 21-24, 2007, berlin, Germany |journal=Rev Urol |volume=9 |issue=4 |pages=214–9 |date=2007 |pmid=18231618 |pmc=2199502 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
Line 348: Line 348:
* [[Anemia]]
* [[Anemia]]
* [[Hematuria]]
* [[Hematuria]]
| style="background: #F5F5F5; padding: 5px;" |Ultrasound, CT scan, Biopsy
| style="background: #F5F5F5; padding: 5px;" |[[Ultrasound]], [[Computed tomography|CT scan]], Biopsy
| style="background: #F5F5F5; padding: 5px;" |Biopsy
| style="background: #F5F5F5; padding: 5px;" |Biopsy
|-
|-
Line 367: Line 367:
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Familial|Familial diseases]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Familial|Familial diseases]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Polycystic kidney disease]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Polycystic kidney disease]]'''<ref name="pmid8321262">{{cite journal |vauthors=Gabow PA |title=Autosomal dominant polycystic kidney disease |journal=N. Engl. J. Med. |volume=329 |issue=5 |pages=332–42 |date=July 1993 |pmid=8321262 |doi=10.1056/NEJM199307293290508 |url=}}</ref><ref name="pmid16523049">{{cite journal |vauthors=Adeva M, El-Youssef M, Rossetti S, Kamath PS, Kubly V, Consugar MB, Milliner DM, King BF, Torres VE, Harris PC |title=Clinical and molecular characterization defines a broadened spectrum of autosomal recessive polycystic kidney disease (ARPKD) |journal=Medicine (Baltimore) |volume=85 |issue=1 |pages=1–21 |date=January 2006 |pmid=16523049 |doi=10.1097/01.md.0000200165.90373.9a |url=}}</ref>'''
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
Line 389: Line 389:
| style="background: #F5F5F5; padding: 5px;" |Ultrasound:
| style="background: #F5F5F5; padding: 5px;" |Ultrasound:
* Unilateral or bilateral [[cysts]]
* Unilateral or bilateral [[cysts]]
CT:
[[CT-scans|CT]]:
* Hyperdense appearance,  
* Hyperdense appearance,  
* Septations  
* Septations  
Line 402: Line 402:
* Tubular atrophy
* Tubular atrophy
* Thickening and lamellation of tubular basement membranes
* Thickening and lamellation of tubular basement membranes
* Microcysts
| style="background: #F5F5F5; padding: 5px;" |[[Ultrasound]]
| style="background: #F5F5F5; padding: 5px;" |Ultrasound
|-
|-
| rowspan="3" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vascular anomaly|Vascular diseases]]
| rowspan="3" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vascular anomaly|Vascular diseases]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Renal vein thrombosis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Renal vein thrombosis]]<ref>{{Cite journal
 
| author = [[U. Kuhlmann]], [[J. Steurer]], [[A. Bollinger]], [[G. Pouliadis]], [[J. Briner]] & [[W. Siegenthaler]]
 
| title = &#91;Incidence and clinical significance of thromboses and thrombo-embolic complications in nephrotic syndrome patients&#93;
 
| journal = [[Schweizerische medizinische Wochenschrift]]
 
| volume = 111
 
| issue = 27-28
 
| pages = 1034–1040
 
| year = 1981
 
| month = July
 
| pmid = 7268357
 
}}</ref><ref>{{Cite journal
 
| author = [[F. Llach]], [[S. Papper]] & [[S. G. Massry]]
 
| title = The clinical spectrum of renal vein thrombosis: acute and chronic
 
| journal = [[The American journal of medicine]]
 
| volume = 69
 
| issue = 6
 
| pages = 819–827
 
| year = 1980
 
| month = December
 
| pmid = 7446547
 
}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
Line 417: Line 456:
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Asymptomatic  
* Asymptomatic  
* Abdominal pain
* [[Abdominal pain]]
* Acute in onset
* Acute in onset
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Elevation in serum lactate dehydrogenase
* Elevation in serum [[lactate dehydrogenase]]
* Cholesterol levels for hypercholesterolemia
* [[Cholesterol]] levels for hyper-cholesterolemia
* Albumin levels for hypoalbuminemia
* [[Albumin]] levels for hypoalbuminemia
* Serum complement levels
* Serum [[complement]] levels
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Ultrasound,
* [[Ultrasound]]
* Venography
* [[Venography]]
| style="background: #F5F5F5; padding: 5px;" |'''Renal venography:''' Gold standard
| style="background: #F5F5F5; padding: 5px;" |'''Renal venography:''' Gold standard
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Granulomatosis with polyangiitis|Wegner's granulomatosis polyangiitis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Granulomatosis with polyangiitis|Wegner's granulomatosis polyangiitis]]<ref name="pmid27733943">{{cite journal| author=Pagnoux C| title=Updates in ANCA-associated vasculitis. | journal=Eur J Rheumatol | year= 2016 | volume= 3 | issue= 3 | pages= 122-133 | pmid=27733943 | doi=10.5152/eurjrheum.2015.0043 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27733943  }}</ref><ref name="pmid12541109">{{cite journal |vauthors=Lee KS, Kim TS, Fujimoto K, Moriya H, Watanabe H, Tateishi U, Ashizawa K, Johkoh T, Kim EA, Kwon OJ |title=Thoracic manifestation of Wegener's granulomatosis: CT findings in 30 patients |journal=Eur Radiol |volume=13 |issue=1 |pages=43–51 |year=2003 |pmid=12541109 |doi=10.1007/s00330-002-1422-2 |url=}}</ref><ref name="pmid17133251">{{cite journal| author=Kallenberg CG, Heeringa P, Stegeman CA| title=Mechanisms of Disease: pathogenesis and treatment of ANCA-associated vasculitides. | journal=Nat Clin Pract Rheumatol | year= 2006 | volume= 2 | issue= 12 | pages= 661-70 | pmid=17133251 | doi=10.1038/ncprheum0355 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17133251  }}</ref><ref name="pmid93665842">{{cite journal |vauthors=Jennette JC, Falk RJ |title=Small-vessel vasculitis |journal=N. Engl. J. Med. |volume=337 |issue=21 |pages=1512–23 |date=November 1997 |pmid=9366584 |doi=10.1056/NEJM199711203372106 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
Line 439: Line 478:
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* URTI
* [[Upper respiratory tract infection|URTI]]


* CNS involvement
* [[CNS]] involvement
* Ophthalmic involvement  
* [[Ophthalmic]] involvement  
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Proteniuria
* [[Proteinuria]]
* Microscopic hematuria
* Microscopic [[hematuria]]
* RBC casts
* [[RBC casts]]
| style="background: #F5F5F5; padding: 5px;" | CT chest:
| style="background: #F5F5F5; padding: 5px;" | [[Computed tomography|CT]] chest:
* Multiple [[Pulmonary nodule|lung nodules]]
* Multiple [[Pulmonary nodule|lung nodules]]
* [[Consolidation (medicine)|Consolidation]]  
* [[Consolidation (medicine)|Consolidation]]  
Line 458: Line 497:
| style="background: #F5F5F5; padding: 5px;" |Biopsy
| style="background: #F5F5F5; padding: 5px;" |Biopsy
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Henoch-Schönlein purpura]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Henoch-Schönlein purpura]]<ref name="pmid9366584">{{cite journal |vauthors=Jennette JC, Falk RJ |title=Small-vessel vasculitis |journal=N. Engl. J. Med. |volume=337 |issue=21 |pages=1512–23 |date=November 1997 |pmid=9366584 |doi=10.1056/NEJM199711203372106 |url=}}</ref><ref name="pmid25557596">{{cite journal |vauthors=Chen JY, Mao JH |title=Henoch-Schönlein purpura nephritis in children: incidence, pathogenesis and management |journal=World J Pediatr |volume=11 |issue=1 |pages=29–34 |date=February 2015 |pmid=25557596 |doi=10.1007/s12519-014-0534-5 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
Line 468: Line 507:
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Abdominal pain
* [[Abdominal pain]]
* Rash
* [[Rash]]
* Hematuria
* [[Hematuria]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Proteniuria
* [[Proteinuria]]
* Microscopic hematuria
* Microscopic [[hematuria]]
* RBC casts
* [[Urinary casts|RBC casts]]
| style="background: #F5F5F5; padding: 5px;" |Biopsy:
| style="background: #F5F5F5; padding: 5px;" |Biopsy:


IgA deposited in a diffuse granular pattern in the mesangium
[[Immunoglobulin A|IgA]] deposited in a diffuse [[Granule cell|granular]] pattern in the [[mesangium]]
| style="background: #F5F5F5; padding: 5px;" |Renal biopsy, and clinical syndrome
| style="background: #F5F5F5; padding: 5px;" |Renal biopsy, and clinical syndrome
|-
|-
Line 506: Line 545:
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Nocturia
* [[Nocturia]]
* Other voiding symptoms
* Other voiding symptoms
** Slow urinary stream
** Slow urinary stream
** Splitting or spraying of the urinary stream
** Splitting or spraying of the [[Urinary system|urinary]] stream
** Intermittent urinary stream
** Intermittent urinary stream
** Hesitancy
** Hesitancy
Line 515: Line 554:
** Terminal dribbling
** Terminal dribbling
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Urinalysis to rule out UTI
* Urinalysis to rule out [[Urinary tract infection|UTI]]
* Elevated BUN/Cr
* Elevated [[Blood urea nitrogen|BUN]]/[[Creatinine|Cr]]
* High PSA values
* High [[Prostate specific antigen|PSA]] values
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Urine cytology to screen for bladder cancer
* Urine cytology to screen for bladder cancer
Line 523: Line 562:
| style="background: #F5F5F5; padding: 5px;" |Biopsy
| style="background: #F5F5F5; padding: 5px;" |Biopsy
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urolithiasis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urolithiasis]]<ref name="pmid126499872">{{cite journal |vauthors=Hochreiter W, Knoll T, Hess B |title=[Pathophysiology, diagnosis and conservative therapy of non-calcium kidney calculi] |language=German |journal=Ther Umsch |volume=60 |issue=2 |pages=89–97 |date=February 2003 |pmid=12649987 |doi=10.1024/0040-5930.60.2.89 |url=}}</ref><ref name="pmid24818849">{{cite journal |vauthors=Flannigan R, Choy WH, Chew B, Lange D |title=Renal struvite stones--pathogenesis, microbiology, and management strategies |journal=Nat Rev Urol |volume=11 |issue=6 |pages=333–41 |date=June 2014 |pmid=24818849 |doi=10.1038/nrurol.2014.99 |url=}}</ref><ref name="pmid25685869">{{cite journal |vauthors=Pereira DJ, Schoolwerth AC, Pais VM |title=Cystinuria: current concepts and future directions |journal=Clin. Nephrol. |volume=83 |issue=3 |pages=138–46 |date=March 2015 |pmid=25685869 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |Flank, groin pain
| style="background: #F5F5F5; padding: 5px;" |
* [[Flanks|Flank]]
* [[Groin]] pain
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Urine analysis
* [[Urine|Urine analysis]]


* High Cr
* High [[Creatinine|Cr]]
| style="background: #F5F5F5; padding: 5px;" |Abdominppelvic CT scan without contrast
| style="background: #F5F5F5; padding: 5px;" |Abdominppelvic [[Computed tomography|CT scan]] without contrast
| style="background: #F5F5F5; padding: 5px;" |Abdominppelvic CT scan without contrast
| style="background: #F5F5F5; padding: 5px;" |Abdominppelvic [[Computed tomography|CT scan]] without contrast
|-
|-
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease
Line 556: Line 597:
|-
|-
| rowspan="4" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Infectious disease|Infectious diseases]]
| rowspan="4" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Infectious disease|Infectious diseases]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pyelonephritis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pyelonephritis]]<ref name="pmid256858692">{{cite journal |vauthors=Pereira DJ, Schoolwerth AC, Pais VM |title=Cystinuria: current concepts and future directions |journal=Clin. Nephrol. |volume=83 |issue=3 |pages=138–46 |date=March 2015 |pmid=25685869 |doi= |url=}}</ref><ref name="pmid18092884">{{cite journal| author=Rosen DA, Hooton TM, Stamm WE, Humphrey PA, Hultgren SJ| title=Detection of intracellular bacterial communities in human urinary tract infection. | journal=PLoS Med | year= 2007 | volume= 4 | issue= 12 | pages= e329 | pmid=18092884 | doi=10.1371/journal.pmed.0040329 | pmc=2140087 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18092884  }}</ref>
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
Line 571: Line 612:
* Positive  [[leukocyte esterase]] test and [[nitrite test]].
* Positive  [[leukocyte esterase]] test and [[nitrite test]].
* Blood/urine cultures
* Blood/urine cultures
| style="background: #F5F5F5; padding: 5px;" |CT and ultrasound:
| style="background: #F5F5F5; padding: 5px;" |[[Computed tomography|CT]] and [[ultrasound]]:
* Enlarged kidneys
* Enlarged [[Kidney|kidneys]]
* Round swollen [[Kidney|kidneys]]
* Round swollen [[Kidney|kidneys]]
* Hypodense appearance
* Hypodense appearance
Line 578: Line 619:
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cystitis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cystitis]]<ref name="pmid16298166">{{cite journal| author=Franco AV| title=Recurrent urinary tract infections. | journal=Best Pract Res Clin Obstet Gynaecol | year= 2005 | volume= 19 | issue= 6 | pages= 861-73 | pmid=16298166 | doi=10.1016/j.bpobgyn.2005.08.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16298166  }}</ref><ref name="pmid162981662">{{cite journal| author=Franco AV| title=Recurrent urinary tract infections. | journal=Best Pract Res Clin Obstet Gynaecol | year= 2005 | volume= 19 | issue= 6 | pages= 861-73 | pmid=16298166 | doi=10.1016/j.bpobgyn.2005.08.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16298166  }}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
Line 591: Line 632:
* Supra pubic tenderness
* Supra pubic tenderness
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Pyuria]]: > 5-10 WBC/hpf or 27 [[WBC]]/microliter
* [[Pyuria]]: > 5-10 [[White blood cells|WBC]]/hpf or 27 [[WBC]]/microliter
* Positive  [[leukocyte esterase]] test and [[nitrite test]].
* Positive  [[leukocyte esterase]] test and [[nitrite test]].
* Positive urine/blood cultures
* Positive urine/blood cultures
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |[[Ultrasound|Ultrasound:]]
* Ultrasound:
* Presence of gas in the bladder wall.
* Presence of a gas in the bladder wall.


* Also help to detect the presence of a [[tumor]] or a [[Stone massage|stone]].
* Also, help to detect the presence of a [[tumor]] or a [[Stone massage|stone]].
| style="background: #F5F5F5; padding: 5px;" |Urine culture
| style="background: #F5F5F5; padding: 5px;" |Urine culture
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Prostatitis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Prostatitis]]<ref>{{Cite journal
| author = [[John N. Krieger]], [[Ulrich Dobrindt]], [[Donald E. Riley]] & [[Eric Oswald]]
| title = Acute Escherichia coli prostatitis in previously health young men: bacterial virulence factors, antimicrobial resistance, and clinical outcomes
| journal = [[Urology]]
| volume = 77
| issue = 6
| pages = 1420–1425
| year = 2011
| month = June
| doi = 10.1016/j.urology.2010.12.059
| pmid = 21459419
}}</ref><ref name="pmid20704171">{{cite journal| author=Sharp VJ, Takacs EB, Powell CR| title=Prostatitis: diagnosis and treatment. | journal=Am Fam Physician | year= 2010 | volume= 82 | issue= 4 | pages= 397-406 | pmid=20704171 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20704171  }}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
Line 613: Line 664:
* Body aches
* Body aches
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Increased [[leukocytes]] (>10 per high power field) on CBC
* Increased [[leukocytes]] (>10 per high power field) on [[Complete blood count|CBC]]
* Bacteria seen on [[urine culture]]
* Bacteria seen on [[urine culture]]
* Elevated [[C-reactive protein]]
* Elevated [[C-reactive protein]]
* Transiently elevated [[PSA]] (prostate specific antigen) levels
* Transiently elevated [[PSA]] ([[prostate specific antigen]]) levels
| style="background: #F5F5F5; padding: 5px;" |Ultrasound:
| style="background: #F5F5F5; padding: 5px;" |[[Ultrasound|Ultrasound:]]
* Focal hypoechoic region located in the peripheral part of the [[prostate]]
* Focal hypoechoic region located in the peripheral part of the [[prostate]]
CT scan:  
[[Computed tomography|CT scan:]]
* Edema of the [[prostate gland]] with diffuse enlargement,.
* Edema of the [[prostate gland]] with diffuse enlargement,.
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urethritis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urethritis]]<ref name="pmid1538163">{{cite journal |vauthors=McNagny SE, Parker RM, Zenilman JM, Lewis JS |title=Urinary leukocyte esterase test: a screening method for the detection of asymptomatic chlamydial and gonococcal infections in men |journal=J. Infect. Dis. |volume=165 |issue=3 |pages=573–6 |year=1992 |pmid=1538163 |doi= |url=}}</ref><ref name="pmid20353145">{{cite journal |vauthors=Brill JR |title=Diagnosis and treatment of urethritis in men |journal=Am Fam Physician |volume=81 |issue=7 |pages=873–8 |year=2010 |pmid=20353145 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | -/-
| style="background: #F5F5F5; padding: 5px;" | -/-
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
Line 633: Line 684:
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Urethral discharge
* [[Urethral]] discharge
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Mucoid, [[mucopurulent]], or [[purulent]] [[discharge]]  
* Mucoid, [[mucopurulent]], or [[purulent]] [[discharge]]  
Line 639: Line 690:
* Positive leukocyte esterase test.
* Positive leukocyte esterase test.
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
CT scan:
[[Computed tomography|CT scan]]:
* Diffuse, circumferential urothelial wall thickening and contrast-enhancement
* Diffuse, circumferential urothelial wall thickening and [[contrast]]-enhancement
* Periureteric or perinephric fat stranding.
* Periureteric or perinephric fat stranding.
| style="background: #F5F5F5; padding: 5px;" |Urine culture
| style="background: #F5F5F5; padding: 5px;" |[[Urine culture]]
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urogenital|Urogenital trauma]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Urogenital|Urogenital trauma]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Inserted [[bladder]] or [[Ureteral disease|ureteral catheters]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Inserted [[bladder]] or [[Ureteral disease|ureteral catheters]]
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* History of [[Physical trauma|trauma]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Hematuria]]
| style="background: #F5F5F5; padding: 5px;" |
* Retrograde urethrogram (RUG)
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* History of truma
* Retrograde urethrogram (RUG)
| style="background: #F5F5F5; padding: 5px;" |Hematuria
| style="background: #F5F5F5; padding: 5px;" |Retrograde Urethrography
| style="background: #F5F5F5; padding: 5px;" |Retrograde Urethrography
|}
|}



Revision as of 17:02, 5 February 2019

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 differential diagnosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hematuria differential diagnosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hematuria differential diagnosis

CDC on Hematuria differential diagnosis

Hematuria differential diagnosis in the news

Blogs on Hematuria differential diagnosis

Directions to Hospitals Treating Hematuria

Risk calculators and risk factors for Hematuria differential diagnosis

Steven C. Campbell, M.D., Ph.D. Associate Editor(s)-in-Chief: Omer Kamal, M.D.[1], Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]

Overview

Gross hematuria(GH) must be distinguished from pigmenturia, which may be due to endogenous sources (e.g., bilirubin, myoglobin,and porphyrins), foods ingested (e.g., beets and rhubarb), drugs (e.g., phenazopyridine), and simple dehydration. This distinction can be made easily by urinalysis with microscopy. Notably, myoglobinuria and other factors can cause false-positive chemical tests for hemoglobin, so urine microscopy is required to confirm the diagnosis of hematuria. GH also must be distinguished from vaginal bleeding in women, which usually can be achieved by obtaining a careful menstrual history, collecting the specimen when the patient is not having menstrual or gynecologic bleeding, or, if necessary, obtaining a catheterized specimen. GH may also be detected by the presence of blood spotting on the undergarments of incontinent patients. After ruling out vaginal bleeding and mimics of hematuria, a urologic source must be suspected.

Differential Diagnosis

Hematuria should be differentiated from other disease which mimic hematuria especially hemoglobinuria and myoglobinuria which are dipstick positive but negative for microscopy.

Hematuria differential diagnosis

Differentiating the diseases that can cause hematuria:

Diseases Clinical manifestations Para-clinical findings Gold standard
Symptoms Physical examina
Lab Findings Diagnosi
Low back pain Fever Nausea/

Vomiting

Urinary symptoms Hypertension Pitting edema Other
Dysuria Frequency Oliguria
Glomerular diseases IgA nephropathy[1][2] (Berger nephropathy) + - - - + + + - - Biopsy:

IgA deposited in a diffuse granular pattern in the mesangium

Biopsy
Hereditary nephritis[3][4] (Alport syndrome) - - - - - - + -
  • Cataract
  • Hearing loss
Biopsy: Genetic analysis
Post-streptococcal glomerulonephritis[5][6] +/- + - - + + + +

Biopsy

Biopsy
Focal segmental glomerular sclerosis[7][8][9] - - - - - - + + Biopsy
  • Segmental solidification in the perihilar region and peripheral areas, especially the tubular pole
  • Coarsely granular deposits -of IgM and C3
Biopsy
Rapidly progressive glomerulonephritis[10][11][12] + + + - - - + - Biopsy: Biopsy
Lupus nephritis[13][14] - + - - - - + +
  • Foamy dark urine
  • Weight gain
Biopsy,
  • Different pathologies, CLICK HERE for more information.
Biopsy
Fabry disease - - - - - - + + - Biopsy Biopsy
Disease Low back pain Fever Nausea/

Vomiting

Dysuria Frequency Oliguria Hypertension Pitting edema Other Lab Findings Diagnosis method Gold standard
Tubulointerstitial diseases[15][16][17] + + + Rash Biopsy: Renal biopsy
Nephrolithiasis[18][19] + ± + ± ± ±
  • Radiating pain to groin
Abdominal CT scan without contrast
Reflux nephropathy (hydronephrosis) + + - - - - - +
Malignancy Renal cell carcinoma (RCC)[20][21] - - - - - - ± ±
Nephroblastoma (Wilms tumor)[22][23] - - - - - - - -

Biopsy:

Biopsy
Bladder cancer[27][28][29] - - - - ± ± - - Suprapubic pain Ultrasound, CT scan, Biopsy Biopsy
Prostate cancer[30][31] ± - - - ± ± - - - Ultrasound, CT scan, Biopsy Biopsy
Disease Low back pain Fever Nausea/

Vomiting

Dysuria Frequency Oliguria Hypertension Pitting edema Other Lab Findings Diagnosis method Gold standard
Familial diseases Polycystic kidney disease[32][33] + - - - - - + + Ultrasound:
  • Unilateral or bilateral cysts

CT:

  • Hyperdense appearance,
  • Septations
  • Calcifications

Genetic testing demonstrates:

  • Frame insertions/deletions
  • Non-canonical splice site alterations
  • Combined missense changes

Biopsy:

  • Interstitial fibrosis
  • Tubular atrophy
  • Thickening and lamellation of tubular basement membranes
Ultrasound
Vascular diseases Renal vein thrombosis[34][35] + + + - - - - - Renal venography: Gold standard
Wegner's granulomatosis polyangiitis[36][37][38][39] - - - - - +/- + + CT chest:

Biopsy:

Biopsy
Henoch-Schönlein purpura[40][41] - - - - - +/- +/- + Biopsy:

IgA deposited in a diffuse granular pattern in the mesangium

Renal biopsy, and clinical syndrome
Disease Low back pain Fever Nausea/

Vomiting

Dysuria Frequency Oliguria Hypertension Pitting edema Other Lab Findings Diagnosis method Gold standard
Lower urinary tract diseases Benign prostatic hyperplasia +/- - - + + - - -
  • Nocturia
  • Other voiding symptoms
    • Slow urinary stream
    • Splitting or spraying of the urinary stream
    • Intermittent urinary stream
    • Hesitancy
    • Straining to void
    • Terminal dribbling
  • Urinalysis to rule out UTI
  • Elevated BUN/Cr
  • High PSA values
  • Urine cytology to screen for bladder cancer
  • Biopsy to rule out cancer
Biopsy
Urolithiasis[42][43][44] + +/- + + + + - - Abdominppelvic CT scan without contrast Abdominppelvic CT scan without contrast
Disease Low back pain Fever Nausea/

Vomiting

Dysuria Frequency Oliguria Hypertension Pitting edema Other Lab Findings Diagnosis method Gold standard
Infectious diseases Pyelonephritis[45][46] + + + + + + - - CT and ultrasound: -
Cystitis[47][48] - - - + + + - - Ultrasound:
  • Presence of gas in the bladder wall.
  • Also, help to detect the presence of a tumor or a stone.
Urine culture
Prostatitis[49][50] - + - + + + - -
  • Body aches
Ultrasound:
  • Focal hypoechoic region located in the peripheral part of the prostate

CT scan:

-
Urethritis[51][52] -/- + - + + + - -

CT scan:

  • Diffuse, circumferential urothelial wall thickening and contrast-enhancement
  • Periureteric or perinephric fat stranding.
Urine culture
Urogenital trauma Inserted bladder or ureteral catheters - - - + + + - -
  • Retrograde urethrogram (RUG)
  • Retrograde urethrogram (RUG)

References

  1. Donadio JV, Grande JP (2002). "IgA nephropathy". N Engl J Med. 347 (10): 738–48. doi:10.1056/NEJMra020109. PMID 12213946.
  2. Suzuki H, Kiryluk K, Novak J, Moldoveanu Z, Herr AB, Renfrow MB; et al. (2011). "The pathophysiology of IgA nephropathy". J Am Soc Nephrol. 22 (10): 1795–803. doi:10.1681/ASN.2011050464. PMID 21949093.
  3. McCarthy PA, Maino DM (2000). "Alport syndrome: a review". Clin Eye Vis Care. 12 (3–4): 139–150. PMID 11137428.
  4. Bodziak KA, Hammond WS, Molitoris BA (1994). "Inherited diseases of the glomerular basement membrane". Am J Kidney Dis. 23 (4): 605–18. PMID 8154501.
  5. Yoshizawa N, Yamakami K, Fujino M, Oda T, Tamura K, Matsumoto K, Sugisaki T, Boyle MD (July 2004). "Nephritis-associated plasmin receptor and acute poststreptococcal glomerulonephritis: characterization of the antigen and associated immune response". J. Am. Soc. Nephrol. 15 (7): 1785–93. PMID 15213266.
  6. Oda T, Yoshizawa N, Yamakami K, Tamura K, Kuroki A, Sugisaki T, Sawanobori E, Higashida K, Ohtomo Y, Hotta O, Kumagai H, Miura S (September 2010). "Localization of nephritis-associated plasmin receptor in acute poststreptococcal glomerulonephritis". Hum. Pathol. 41 (9): 1276–85. doi:10.1016/j.humpath.2010.02.006. PMID 20708459.
  7. Kwoh C, Shannon MB, Miner JH, Shaw A (2006). "Pathogenesis of nonimmune glomerulopathies". Annu Rev Pathol. 1: 349–74. doi:10.1146/annurev.pathol.1.110304.100119. PMID 18039119.
  8. Reidy K, Kaskel FJ (March 2007). "Pathophysiology of focal segmental glomerulosclerosis". Pediatr. Nephrol. 22 (3): 350–4. doi:10.1007/s00467-006-0357-2. PMC 1794138. PMID 17216262.
  9. D'Agati VD, Fogo AB, Bruijn JA, Jennette JC (2004). "Pathologic classification of focal segmental glomerulosclerosis: a working proposal". Am J Kidney Dis. 43 (2): 368–82. PMID 14750104.
  10. Couser WG (1998). "Pathogenesis of glomerular damage in glomerulonephritis". Nephrol Dial Transplant. 13 Suppl 1: 10–5. PMID 9507491.
  11. Atkins RC, Nikolic-Paterson DJ, Song Q, Lan HY (1996). "Modulators of crescentic glomerulonephritis". J Am Soc Nephrol. 7 (11): 2271–8. PMID 8959617.
  12. Jennette JC (March 2003). "Rapidly progressive crescentic glomerulonephritis". Kidney Int. 63 (3): 1164–77. doi:10.1046/j.1523-1755.2003.00843.x. PMID 12631105.
  13. Schwartz N, Goilav B, Putterman C (September 2014). "The pathogenesis, diagnosis and treatment of lupus nephritis". Curr Opin Rheumatol. 26 (5): 502–9. doi:10.1097/BOR.0000000000000089. PMC 4221732. PMID 25014039.
  14. Giannico G, Fogo AB (2013). "Lupus nephritis: is the kidney biopsy currently necessary in the management of lupus nephritis?". Clin J Am Soc Nephrol. 8 (1): 138–45. doi:10.2215/CJN.03400412. PMID 22977215.
  15. Baker, R. J.; Pusey, C. D. (2004). "The changing profile of acute tubulointerstitial nephritis". Nephrology Dialysis Transplantation. 19 (1): 8–11. doi:10.1093/ndt/gfg464. ISSN 0931-0509.
  16. Kelly C, Tomaszewski J, Neilson E. Immunopathogenic mechanisms of tubulointerstitial injury. In: Tisher C, Brenner B, eds, Renal Pathology: With Clinical and Functional Correlations, 2nd Edn., Vol. 1. J. B. Lippincott & Co, Philadelphia, PA, 1994; 699–722
  17. Dharmarajan TS, Yoo J, Russell RO, Boateng YA. Acute post streptococcal interstitial nephritis in an adult and review of the literature. Int Urol Nephrol 1999; 31:145
  18. Hochreiter W, Knoll T, Hess B (February 2003). "[Pathophysiology, diagnosis and conservative therapy of non-calcium kidney calculi]". Ther Umsch (in German). 60 (2): 89–97. doi:10.1024/0040-5930.60.2.89. PMID 12649987.
  19. Trinchieri A (February 2013). "Diet and renal stone formation". Minerva Med. 104 (1): 41–54. PMID 23392537.
  20. Cohen HT, McGovern FJ (2005). "Renal-cell carcinoma". N Engl J Med. 353 (23): 2477–90. doi:10.1056/NEJMra043172. PMID 16339096.
  21. Leveridge MJ, Bostrom PJ, Koulouris G, Finelli A, Lawrentschuk N (June 2010). "Imaging renal cell carcinoma with ultrasonography, CT and MRI". Nat Rev Urol. 7 (6): 311–25. doi:10.1038/nrurol.2010.63. PMID 20479778.
  22. Jolly RD, Stellwagen E, Babul J, Vodkaĭlo LV, Titov VL, Moldomusaev DM, Maianskiĭ AN (November 1975). "Mannosidosis of Angus Cattle: a prototype control program for some genetic diseases". Adv Vet Sci Comp Med. 19 (23): 1–21. PMID 1978.
  23. Stefanowicz J, Sierota D, Balcerska A, Stoba C (2004). "[Wilms' tumour of unfavorable histology--results of treatment with the SIOP 93-01 protocol at the Gdańsk centre. Preliminary report]". Med Wieku Rozwoj (in Polish). 8 (2 Pt 1): 197–200. PMID 15738594.
  24. Hartman DS, Sanders RC (April 1982). "Wilms' tumor versus neuroblastoma: usefulness of ultrasound in differentiation". J Ultrasound Med. 1 (3): 117–22. PMID 6152936.
  25. De Campo JF (1986). "Ultrasound of Wilms' tumor". Pediatr Radiol. 16 (1): 21–4. PMID 3003660.
  26. Cahan LD (1985). "Failure of encephalo-duro-arterio-synangiosis procedure in moyamoya disease". Pediatr Neurosci. 12 (1): 58–62. PMID 4080660.
  27. Pons F, Orsola A, Morote J, Bellmunt J (2011). "Variant forms of bladder cancer: basic considerations on treatment approaches". Curr Oncol Rep. 13 (3): 216–21. doi:10.1007/s11912-011-0161-4. PMID 21360040.
  28. Metts MC, Metts JC, Milito SJ, Thomas CR (June 2000). "Bladder cancer: a review of diagnosis and management". J Natl Med Assoc. 92 (6): 285–94. PMC 2640522. PMID 10918764.
  29. Rom M, Kuehhas FE, Djavan B (2007). "New findings in bladder and prostate cancer: highlights of the 22nd annual congress of the European association of urology, march 21-24, 2007, berlin, Germany". Rev Urol. 9 (4): 214–9. PMC 2199502. PMID 18231618.
  30. Chung SD, Liu SP, Lin HC (2013). "Association between prostate cancer and urinary calculi: a population-based study". PLoS ONE. 8 (2): e57743. doi:10.1371/journal.pone.0057743. PMC 3581486. PMID 23451265.
  31. Rom M, Kuehhas FE, Djavan B (2007). "New findings in bladder and prostate cancer: highlights of the 22nd annual congress of the European association of urology, march 21-24, 2007, berlin, Germany". Rev Urol. 9 (4): 214–9. PMC 2199502. PMID 18231618.
  32. Gabow PA (July 1993). "Autosomal dominant polycystic kidney disease". N. Engl. J. Med. 329 (5): 332–42. doi:10.1056/NEJM199307293290508. PMID 8321262.
  33. Adeva M, El-Youssef M, Rossetti S, Kamath PS, Kubly V, Consugar MB, Milliner DM, King BF, Torres VE, Harris PC (January 2006). "Clinical and molecular characterization defines a broadened spectrum of autosomal recessive polycystic kidney disease (ARPKD)". Medicine (Baltimore). 85 (1): 1–21. doi:10.1097/01.md.0000200165.90373.9a. PMID 16523049.
  34. U. Kuhlmann, J. Steurer, A. Bollinger, G. Pouliadis, J. Briner & W. Siegenthaler (1981). "[Incidence and clinical significance of thromboses and thrombo-embolic complications in nephrotic syndrome patients]". Schweizerische medizinische Wochenschrift. 111 (27–28): 1034–1040. PMID 7268357. Unknown parameter |month= ignored (help)
  35. F. Llach, S. Papper & S. G. Massry (1980). "The clinical spectrum of renal vein thrombosis: acute and chronic". The American journal of medicine. 69 (6): 819–827. PMID 7446547. Unknown parameter |month= ignored (help)
  36. Pagnoux C (2016). "Updates in ANCA-associated vasculitis". Eur J Rheumatol. 3 (3): 122–133. doi:10.5152/eurjrheum.2015.0043. PMID 27733943.
  37. Lee KS, Kim TS, Fujimoto K, Moriya H, Watanabe H, Tateishi U, Ashizawa K, Johkoh T, Kim EA, Kwon OJ (2003). "Thoracic manifestation of Wegener's granulomatosis: CT findings in 30 patients". Eur Radiol. 13 (1): 43–51. doi:10.1007/s00330-002-1422-2. PMID 12541109.
  38. Kallenberg CG, Heeringa P, Stegeman CA (2006). "Mechanisms of Disease: pathogenesis and treatment of ANCA-associated vasculitides". Nat Clin Pract Rheumatol. 2 (12): 661–70. doi:10.1038/ncprheum0355. PMID 17133251.
  39. Jennette JC, Falk RJ (November 1997). "Small-vessel vasculitis". N. Engl. J. Med. 337 (21): 1512–23. doi:10.1056/NEJM199711203372106. PMID 9366584.
  40. Jennette JC, Falk RJ (November 1997). "Small-vessel vasculitis". N. Engl. J. Med. 337 (21): 1512–23. doi:10.1056/NEJM199711203372106. PMID 9366584.
  41. Chen JY, Mao JH (February 2015). "Henoch-Schönlein purpura nephritis in children: incidence, pathogenesis and management". World J Pediatr. 11 (1): 29–34. doi:10.1007/s12519-014-0534-5. PMID 25557596.
  42. Hochreiter W, Knoll T, Hess B (February 2003). "[Pathophysiology, diagnosis and conservative therapy of non-calcium kidney calculi]". Ther Umsch (in German). 60 (2): 89–97. doi:10.1024/0040-5930.60.2.89. PMID 12649987.
  43. Flannigan R, Choy WH, Chew B, Lange D (June 2014). "Renal struvite stones--pathogenesis, microbiology, and management strategies". Nat Rev Urol. 11 (6): 333–41. doi:10.1038/nrurol.2014.99. PMID 24818849.
  44. Pereira DJ, Schoolwerth AC, Pais VM (March 2015). "Cystinuria: current concepts and future directions". Clin. Nephrol. 83 (3): 138–46. PMID 25685869.
  45. Pereira DJ, Schoolwerth AC, Pais VM (March 2015). "Cystinuria: current concepts and future directions". Clin. Nephrol. 83 (3): 138–46. PMID 25685869.
  46. Rosen DA, Hooton TM, Stamm WE, Humphrey PA, Hultgren SJ (2007). "Detection of intracellular bacterial communities in human urinary tract infection". PLoS Med. 4 (12): e329. doi:10.1371/journal.pmed.0040329. PMC 2140087. PMID 18092884.
  47. Franco AV (2005). "Recurrent urinary tract infections". Best Pract Res Clin Obstet Gynaecol. 19 (6): 861–73. doi:10.1016/j.bpobgyn.2005.08.003. PMID 16298166.
  48. Franco AV (2005). "Recurrent urinary tract infections". Best Pract Res Clin Obstet Gynaecol. 19 (6): 861–73. doi:10.1016/j.bpobgyn.2005.08.003. PMID 16298166.
  49. John N. Krieger, Ulrich Dobrindt, Donald E. Riley & Eric Oswald (2011). "Acute Escherichia coli prostatitis in previously health young men: bacterial virulence factors, antimicrobial resistance, and clinical outcomes". Urology. 77 (6): 1420–1425. doi:10.1016/j.urology.2010.12.059. PMID 21459419. Unknown parameter |month= ignored (help)
  50. Sharp VJ, Takacs EB, Powell CR (2010). "Prostatitis: diagnosis and treatment". Am Fam Physician. 82 (4): 397–406. PMID 20704171.
  51. McNagny SE, Parker RM, Zenilman JM, Lewis JS (1992). "Urinary leukocyte esterase test: a screening method for the detection of asymptomatic chlamydial and gonococcal infections in men". J. Infect. Dis. 165 (3): 573–6. PMID 1538163.
  52. Brill JR (2010). "Diagnosis and treatment of urethritis in men". Am Fam Physician. 81 (7): 873–8. PMID 20353145.

Template:WH Template:WS