Hematuria

Jyothi R Patri, MD, MHA, FAAFP, HMDC Reviewed 06/2022

BASICS

DESCRIPTION

Gross (visible) or microscopic (nonvisible) blood in the urine, either symptomatic or asymptomatic

EPIDEMIOLOGY

Prevalence

Children: gross: 0.13%; asymptomatic microscopic hematuria (A...

DIAGNOSIS

HISTORY

Considerations

Burning, urgency, frequency: UTI
Dark cola-colored urine: glomerular origin
Clots: extraglomerular bleeding
Arthritis/arthralgias/rash: lupus, vasculitis, Henoch-Schönlein...

TREATMENT

MEDICATION

First Line

Treatment of the underlying cause of hematuria is the first line. Discontinue drugs that cause hematuria.

ISSUES FOR REFERRAL

Nephrology referral for proteinuria, red cell...

ONGOING CARE

Close follow-up by specialists indicated based on the underlying cause. Primary care physicians play a critical role in identifying secondary causes of hematuria and ensuring multi-discip...

REFERENCES

Linder BJ, Bass EJ, Mostafid H, et al. Guideline of guidelines: asymptomatic microscopic haematuria. BJU Int. 2018;121(2):176–183. [View Abstract on OvidMe...

CODES

ICD10

R31.9 Hematuria, unspecified
R31.1 Benign essential microscopic hematuria
R31.0 Gross hematuria
R31.2 Other microscopic hematuria
N02.9 Recurrent and perst hematuria w unsp morphologic changes
N...

CLINICAL PEARLS

Screening asymptomatic patients for microscopic hematuria is an “I” recommendation from the USPSTF.
AMH and hematuria persisting after treatment of UTIs must be evaluated.
Patients with ...

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