RENAL INX-HAEMATURIA CAUSES

SUMMARY

1. Determine if hematuria is due to intrinsic renal disease or genitourinary bleeding.

GLOMERULAR BLEEDING
2. Hematuria assoc. with proteinuria, dysmorphic cells and/or RBC casts is always due to glomerular bleeding.

3. Isolated glomerular hematuria (normal renal function, no proteinuria): IgA nephropathy, thin basement membrane disease & early Alport syn­drome.

MICROSCOPIC/MACROSCOPIC, NON-GLOMERULAR BLEEDING
4. Isolated microscopic or gross hematuria is more likely to be urologic in origin. Complete GU imaging with renal U/S, MRI, or CT must be performed to exclude renal cell or other GU tract carcinomas.

5. Strenuous exercise can cause transient hematuria.

6. Patients with sickle cell trait may also have hematuria.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].