Hematuria

Hematuria

Microscopic hematuria
Classification and external resources
Specialty Nephrology, urology
ICD-10 N02, R31
ICD-9-CM 599.7, 791.2
DiseasesDB 19635
MedlinePlus 003138
eMedicine ped/951
Patient UK Hematuria
MeSH D006417

In medicine, hematuria, or haematuria, is the presence of red blood cells (erythrocytes) in the urine. It may be idiopathic and/or benign, or it can be a sign that there is a kidney stone or a tumor in the urinary tract (kidneys, ureters, urinary bladder, prostate, and urethra), ranging from trivial to lethal. If white blood cells are found in addition to red blood cells, then it is a signal of urinary tract infection.

Occasionally "hemoglobinuria" is used synonymously, although more precisely it refers only to hemoglobin in the urine.

Types

Red discoloration of the urine can have various causes:

Diagnosis

Acute hematuria due to trauma.

Sometimes the cause of hematuria can be elucidated solely on the basis of the medical history and urine testing, or urinalysis. This is especially true for young people, in whom the risk of malignancy is very low. For example, in a young woman who is found to have hematuria along with a simple urinary tract infection, she likely only needs antibiotics for her UTI, and does not need further workup for her hematuria. Similarly, high-intensity exercise can occasionally cause hematuria.[1] As such, an athlete with blood in their urine after vigorous exercise usually just needs a repeat urine test.

For patients with suspected kidney stones, a common cause of hematuria, CT scanning or Ultrasound is often the first step. For most other patients with continued, unexplained hematuria, because of the risk of cancer of the bladder, prostate, ureters, or kidney is a concern, further imaging is usually done. This includes directly looking at the urethra and bladder with cystoscopy and more sensitive radiographic imaging with computed tomography urography.

If combined with flank pain, loin pain hematuria syndrome is a rare but possible cause. .[2]

Causes

The most common causes of hematuria [3] are:

Other, less common causes of hematuria include:

Rare causes include:

Others signs that resemble hematuria include:

References

  1. Jones (April 1997). "Sport-related hematuria: a review.". Clinical Journal of Sports Medicine 7 (2): 119–125.
  2. Spetie, DN.; Nadasdy, T.; Nadasdy, G.; Agarwal, G.; Mauer, M.; Agarwal, AK.; Khabiri, H.; Nagaraja, HN.; et al. (Mar 2006). "Proposed pathogenesis of idiopathic loin pain-hematuria syndrome". Am J Kidney Dis 47 (3): 419–27. doi:10.1053/j.ajkd.2005.11.029. PMID 16490620.
  3. http://www-uptodate-com.ucsf.idm.oclc.org/contents/etiology-and-evaluation-of-hematuria-in-adults?source=search_result&search=hematuria&selectedTitle=1~150
  4. Norman L. Browse/4th/436
  5. 1 2 Hematuria Causes Original Date of Publication: 15 Jun 1998. Reviewed by: Stacy J. Childs, M.D., Stanley J. Swierzewski, III, M.D. Last Reviewed: 10 Jul 2008
  6. Koshy, CG.; Govil, S.; Shyamkumar, NK.; Devasia, A. (Jan 2009). "Bladder varices--rare cause of painless hematuria in idiopathic retroperitoneal fibrosis.". Urology 73 (1): 58–9. doi:10.1016/j.urology.2008.06.039. PMID 18722652.
  7. Graham, DM.; McMorris, MS.; Flynn, JT. (Nov 2002). "Episodic gross hematuria in association with allergy symptoms in a child.". Clin Nephrol 58 (5): 389–92. doi:10.5414/cnp58389. PMID 12425491.
  8. Russo, D.; Minutolo, R.; Iaccarino, V.; Andreucci, M.; Capuano, A.; Savino, FA. (Sep 1998). "Gross hematuria of uncommon origin: the nutcracker syndrome.". Am J Kidney Dis 32 (3): E3. doi:10.1053/ajkd.1998.v32.pm10074588. PMID 10074588.
  9. Ureteral Pelvic Junction Obstruction (UPJ) / Ureteral Obstruction
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