Hematuria

Etiologies of Hematuria

Extrarenal (far more common)

Intra renal

Nephrolithiasis

Nephrolithiasis or crystalluria

Neoplasm: transitional cell, prostate

Neoplasm

Infection: cystitis, urethritis, prostatitis

Trauma

Foley trauma

Vascular: renal infarcts, renal vein thrombosis

Glomerulonephritis

Workup (NEJM 2003:348:2330)

• Urine dipstick: *) if >3 RBCs; ® dipstick and 0 sediment — myo- or hemoglobinuria

• Urine sediment: dysmorphic RBCs or RBC casts -♦ GN -» consider renal bx

• If no evidence of glomerulonephritis:

r oUTI Urine cytology

Renal imaging: helical CT (r o nephrolithiasis and neoplasia of upper tract), cystoscopy (r o bladder neoplasia).! U S (r o obstruction or parenchymal disease)

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