Haematuria: Difference between revisions

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<section begin="clinical biochemistry" />'''Haematuria''' refers to the presence of blood in the urine. We distinguish between microscopic haematuria, when the concentration of blood is too low to be macroscopically visible, and macroscopic haematuria, where the concentration is so high that the urine is visible coloured red.
<section begin="urology" /><section begin="clinical biochemistry" />'''Haematuria''' refers to the presence of blood in the urine. We distinguish between microscopic haematuria, when the concentration of blood is too low to be macroscopically visible, and macroscopic haematuria, where the concentration is so high that the urine is visible coloured red. Haematuria is defined as the presence of > 3 RBCs per field of view at 400x when examining a urine sample under the microscope, or by it's detection by laboratory methods.


Haematuria may be a sign of kidney or urinary tract pathology, including [[glomerulonephritis]], [[urinary tract infection]], and [[bladder cancer]]. In many, however, haematuria is transient or no underlying pathology can be found.
Haematuria may be a sign of kidney or urinary tract pathology, including [[glomerulonephritis]], [[urinary tract infection]], and [[bladder cancer]]. In many, however, haematuria is transient or no underlying pathology can be found.
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Microscopic haematuria, also called microhaematuria, where the urine is mixed with so little blood that it cannot be seen macroscopically but it can be measured on biochemical tests.<section end="clinical biochemistry" />
Microscopic haematuria, also called microhaematuria, where the urine is mixed with so little blood that it cannot be seen macroscopically but it can be measured on biochemical tests.<section end="clinical biochemistry" />
* Origin of bleeding according to which part of the urine stream which is bloody
** Initial part (initial haematuria)
*** Anterior urethral bleeding
** Terminal part (terminal haematuria)
*** Posterior urethral bleeding
*** Bladder neck bleeding
*** Trigone bleeding
** The whole stream (total haematuria)
*** Bleeding above the level of the bladder


== Clinical features ==
== Clinical features ==
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Because malignancy may be an underlying cause, patients with otherwise unexplained haematuria must be thoroughly evaluated for malignancy. The first step is usually to rule out bladder malignancy with [[cystoscopy]].<section end="clinical biochemistry" />
Because malignancy may be an underlying cause, patients with otherwise unexplained haematuria must be thoroughly evaluated for malignancy. The first step is usually to rule out bladder malignancy with [[cystoscopy]].<section end="clinical biochemistry" />
{| class="wikitable"
!
!'''Glomerular haematuria'''
!'''Non-glomerular haematuria'''
|-
!'''Causes'''
|Glomerulonephritis
|Papillary necrosis, stone, cystitis, kidney cancer, urothelial cancer, etc.
|-
!'''Colour'''
|Cola-coloured
|Red or pink
|-
!'''Clots'''
|No
|Sometimes
|-
!'''RBC morphology'''
|Dysmorphic RBCs
|Normal RBCs
|-
!'''RBC casts'''
|Sometimes
|No
|-
!'''Proteinuria'''
|> 500 mg/day
|< 500 mg/day
|}<section end="urology" />
[[Category:Nephrology]]
[[Category:Nephrology]]
[[Category:Pathophysiology]]
[[Category:Urology]]