Hematuria

Notes
  • Hematuria is defined as the presence of blood in urine, specifically more than three RBCs per high-power field on urine sediment examination.
  • It is a symptom/sign of an underlying renal disease.

##Causes of hematuria:

  • UTIs
  • Schistosoma hematobium
  • TB
  • Acute glomerulonephritis
  • Tumors
  • Trauma
  • Congenital abnormalities
  • Sickle cell disease
  • Coagulation disorders
  • Anticoagulation therapy
  • Meatal ulcers
  • Urinary tract stones
  • Drug toxicity such as sulphonamides, cyclophosphamide and NSAIDS
  • Benign prostatic hypertrophy (BPH)
  • Prostate cancer
  • Child abuse
  • Menstruation

##Types of hematuria:

  • Visible hematuria (VH, macroscopic hematuria or gross hematuria). The most important causes of NVH are UTI, BPH and urinary calculi.
  • Non-visible hematuria (NVH or microscopic hematuria or dipstick-positive hematuria)
  • Symptomatic non-visible hematuria (s-NVH)
  • Asymptomatic non-visible hematuria (a-NVH)
Symptoms
  • The presence of blood in the urine
Diagnosis
  • Clinical evaluation
  • Test to confirm suspected underlying cause(s)
  • Full blood count (FBC)
  • Cytological examination of urine
  • Ultrasound of the renal tract
  • Cystoscopy may be necessary
  • Intravenous urography for suspected urinary tract stones
  • Abdominal X-ray
  • Renal angiography
Differential
  • Foods such as beets, rhubarb, some food coloring
  • Nitrofurantoin
  • Rifampicin
  • Methyldopa
  • Senna
  • Bilirubinuria
  • Haemoglobinuria
  • Myoglobinuria
  • Porphyria
Prevention
  • Prevention to be determined by underlying cause(s)
Management

Treatment of underlying cause(s)

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