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Hematuria

Tracy O. Middleton, DO Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Gross (visible) or microscopic (nonvisible) blood in the urine

  • Symptomatic or asymptomatic

EPIDEMIOLOGY

Prevalence

  • Microscopic hematuria in school-aged children: 0.4–4%

  • Microscopic hematu...

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

None indicated for undiagnosed hematuria 

ISSUES FOR REFERRAL

  • Prompt nephrology referral for proteinuria, red cell casts, elevated serum creatinine, and albumin:creatinine ratio ≥30 ...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

Some experts still recommend periodic urinalysis; recent literature suggests that, after thorough initial negative investigations (imaging, cyst...

REFERENCES

1
Davis R, Jones JS, Barocas DA, et al. Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline. J Urol.  2012;188(Suppl 6):2473–2481. [View A...

SEE ALSO

Algorithm: Hematuria 

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.

  • Asymptomatic hematuria and hematuria persisting after treatment of UTIs must be evalu...

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