Microscopic Hematuria In Patients Research Articles

Prognostic value of preoperative microscopic hematuria in patients with non-metastatic renal cell carcinoma who underwent nephrectomy.

Microscopic hematuria is associated with various urinary system diseases and is commonly used for the diagnosis of these conditions. Its prognostic role in non-metastatic renal cell carcinoma (RCC) patients who underwent nephrectomy remains unclear. A retrospective analysis of non-metastatic RCC patients who underwent nephrectomy in West China Hospital of Sichuan University from 2011 to 2013 was performed. Significant microscopic hematuria (SMH), defined as a threshold with a significant impact on disease-free survival (DFS) and overall survival (OS), was determined by Kaplan-Meier curves and the Maximally Selected Log-Rank Statistic. Kaplan-Meier curves were then used to estimate patients' DFS and OS, and the log-rank test was used to examine statistical significance. Logistic regression was utilized to identify clinical-pathological factors associated with SMH, while Cox regression was employed to determine independent factors of survival. A total of 773 patients were included, and 20 red blood cells per high-power field was identified as the cutoff of SMH, of which 90 patients had preoperative SMH (11.6%) and 683 patients (88.4%) did not. Larger tumor size (OR = 1.10 [per cm], 95% CI 1.01-1.19, p = 0.036) and higher Fuhrman grade (grade 3 vs. grade 1-2, OR = 1.76, 95% CI 1.09-2.83, p = 0.02; grade 4 vs. grade 1-2, OR = 2.15, 95% CI 0.73-6.31, p = 0.164) were predictors of SMH. Compared to non-SMH patients, SMH patients had poorer DFS (HR = 3.16, 95% CI 2.07-4.83, p < 0.001) and OS (HR = 2.11, 95% CI 1.34-3.32, p = 0.001). In summary, preoperative SMH is associated with larger tumor size and higher Fuhrman grade, and it is also independently correlated with poorer DFS and OS in non-metastatic RCC patients who underwent nephrectomy.

Predictors of Gross Hematuria After SARS-CoV-2 mRNA Vaccination in Patients with IgA Nephropathy.

Background There have been several reports of IgA nephropathy (IgAN) patients with gross hematuria and acute deterioration of urinary findings and kidney function following SARS-CoV-2 mRNA vaccination. Recent case series studies have indicated a possible link between the status of urinary findings at the time of vaccination and the subsequent appearance of gross hematuria. In this study, we aimed to determine whether the status of pre-vaccination urinary findings was associated with post-vaccination gross hematuria in patients already diagnosed with IgAN. Methods Outpatients with IgAN who had been followed up before vaccination were included. We analyzed the association between the remission of pre-vaccination microscopic hematuria (urine sediment <5 red blood cell/high power field) or proteinuria (<0.3 g/gCr) and post-vaccination gross hematuria. Results A total of 417 Japanese patients with IgAN (median age, 51 years; 56% female; estimated glomerular filtration rate (eGFR), 58 mL/min/1.73 m2) were included. The frequency of gross hematuria following vaccination was higher in 20/123 patients (16.3%) with microscopic hematuria than in 5/294 patients (1.7%) without microscopic hematuria prior to vaccination (P <0.001). There was no association between pre-vaccination proteinuria and post-vaccination gross hematuria. After adjusting for potential confounders, such as sex (female), age (<50 years), eGFR (≥60 mL/min/1.73 m2), and histories of tonsillectomy and corticosteroid therapy, pre-vaccination microscopic hematuria was still associated with post-vaccination gross hematuria (OR 8.98, P <0.001). As the severity of pre-vaccination microscopic hematuria increased, the incidence of post-vaccination gross hematuria increased (P <0.001). Conclusions Pre-vaccination microscopic hematuria in patients with IgAN is a major predictor of post-vaccination gross hematuria, regardless of potential confounders including previous treatments for IgAN.

MP22-11 ASYMPTOMATIC MICROSCOPIC HEMATURIA IN PATIENTS ON ANTICOAGULATION THERAPY. SHOULD WE DO A FULL WORK-UP OR JUST FOLLOW UP?

You have accessJournal of UrologyCME1 Apr 2023MP22-11 ASYMPTOMATIC MICROSCOPIC HEMATURIA IN PATIENTS ON ANTICOAGULATION THERAPY. SHOULD WE DO A FULL WORK-UP OR JUST FOLLOW UP? Amr Elkady, Abdelrahman Swidan, Ashraf Mosharafa, Ahmed Abdelaziz, Mohamed Elgammal, and Mohamed Abdelwahab Amr ElkadyAmr Elkady More articles by this author , Abdelrahman SwidanAbdelrahman Swidan More articles by this author , Ashraf MosharafaAshraf Mosharafa More articles by this author , Ahmed AbdelazizAhmed Abdelaziz More articles by this author , Mohamed ElgammalMohamed Elgammal More articles by this author , and Mohamed AbdelwahabMohamed Abdelwahab More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003247.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is no debate regarding the need to do a full work-up for patients presenting with gross hematuria. This work-up includes cystoscopy and upper urinary tract cross sectional imaging. However; the need for this work-up in patients with asymptomatic microscopic hematuria (AMH) is debatable. This debate is even more in patients on anticoagulant therapy (ACT). The objective of this study is to assess the prevalence of AMH in patients on ACT presenting for a check-up program and to study possible risk factors for hematuria and the workup results for these patients. METHODS: Data of patients participating in our tertiary centre’s check-up program during the period between January 2018 and June 2019 were reviewed. The use of ACT and presence of microscopic hematuria were noted. Risk factors for microscopic hematuria as well as patients’ work up results were reviewed. RESULTS: The data of 3000 check-up patients were reviewed. We found 408 patients (13.6%) on ACT, while 371 patients (12.4%) had microscopic hematuria. Prevalence of hematuria among patients on ACT was 15.9%, not significantly different from the total cohort (p value=0.167). Factors associated with hematuria included hypertension, older age and female sex. The workup of patients with microscopic hematuria revealed 2 cases of bladder masses (0.54%) and 2 cases of renal tumors (0.54%), while 154 cases (41.5%) had negative urologic work up. The rest of cases had benign causes of hematuria. CONCLUSIONS: In our check-up cohort, the prevalence of microscopic hematuria in patients receiving ACT was not significantly different from patients not receiving it. Older age, female gender and hypertension were associated with increased risk of microscopic hematuria. We found a few cases with positive findings for bladder and renal tumors. Our findings suggest that patients with microscopic hematuria receiving ACT should follow the same workup as for patients not on ACT. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e300 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Amr Elkady More articles by this author Abdelrahman Swidan More articles by this author Ashraf Mosharafa More articles by this author Ahmed Abdelaziz More articles by this author Mohamed Elgammal More articles by this author Mohamed Abdelwahab More articles by this author Expand All Advertisement PDF downloadLoading ...

Vitamin K antagonist-associated microscopic hematuria.

Vitamin K antagonists (VKA) are the most widely used anticoagulants for the prevention of thrombotic events. Several renal adverse effects have been associated with the use of VKA. The main aim of our study was to explore the association between international normalized ratio (INR) levels and microscopic hematuria in patients with VKA. We performed a cross-sectional study of patients treated with VKA that attended the outpatient clinic for routine INR control. A simple urinalysis was performed on the day of the INR control and the precise number of red cells in the urine sediment was quantified. Demographic data, kidney function tests, comorbidities, anticoagulant dose and concomitant treatment were registered. A total of 337 patients were included with median INR levels of 2.6 (IQR 2.1-3.3). 11.9% of the patients presented microscopic hematuria (≥14 RBCs/µl). There was a significant correlation between INR levels and the number of red blood cells in the urine sediment (r=0.201, p=0.024). In the univariate analysis, microscopic hematuria was associated with having an INR >3.5 (19% vs. 10.2%, p=0.046), bacteriuria (15.2% vs. 3.6%, p=0.015), leukocyturia (14.8% vs. 6.6%, p= 0.026), hypertension (16.2% vs. 9.5%, p=0.053), and the use of renin-angiotensin system (RAS) blockers (6.9% vs. 17.2%, p=0.004). Multivariate logistic regression showed an association between microscopic hematuria and RAS blockade (OR 0.38, CI 95% 0.163-0.886, p=0.025), independent from INR levels, hypertension, leukocyturia or bacteriuria. INR overdose was significantly associated with the presence of microscopic hematuria. RAS blockade is an independent protective factor for the presence of microscopic hematuria in anticoagulated patients.

Microhematuria in Women Presenting for Overactive Bladder.

Microscopic hematuria and overactive bladder are two common urologic conditions. The objective of this review is to provide an overview of current literature as well as highlight important guidelines that will aid physicians in the diagnostic workup of microscopic hematuria in patients experiencing symptoms of overactive bladder. Updated microscopic hematuria guidelines provide a structured and appropriate workup for women based on risk factors, which stratifies patients to prevent unnecessary procedures and imaging. Women presenting with microscopic hematuria in the setting of overactive bladder should undergo microscopic hematuria workup according to their risk stratification while receiving appropriate treatment for their overactive bladder. The physician should consider the presence of irritative voiding symptoms during the investigation and management of microscopic hematuria in patients with overactive bladder and should not delay overactive bladder treatment due to the presence of microscopic hematuria.

PREVALENCE OF HEMATURIA IN PATIENTS WITH HEMOPHILIA A AND B AND ITS ASSOCIATION WITH COMORBIDITIES: EXPERIENCE FROM A BRAZILIAN CENTER

Hemophilia A and B are X-linked inherited bleeding disorders. Hematuria is a common manifestation among patients, resulting in a worsening of quality of life. Results of previous studies regarding the association between hematuria and hemophilia have been inconsistent, leading to the need for further analysis. Determine the prevalence of macroscopic or microscopic hematuria in patients with hemophilia, as well as its association with comorbidities. Transversal unicenter study with adult patients (≥18 years old) bearing hemophilia A or B under active outpatient clinic in a reference center over the year of 2019. Hematuria was defined as any macroscopic episode or ≥3 red blood cells per high power field in urine analysis. Using simple and multivariable logistic analysis, age, diagnosis type, disease severity, comorbidities and creatinine clearance have been studied as potential characteristics associated with the prevalence of hematuria. In total, 179 male patients were included. Mean age was 26 years (sd = 15), the majority of them were diagnosed with hemophilia A (76%) and 66% presented a severe disease. Despite our young population, the prevalence of comorbidities was high, mainly hypertension (10%), dyslipidemia (10%), diabetes (5%) and obesity (10%). The prevalence of hematuria was 39% (95% CI 32% - 47%), of these a half presented at least one macroscopic episode. Age (OR = 1.03[1.01-1.05]), hemophilia B (OR = 0.47[0.21-0.99]), hypertension (OR = 3.88[1.45-11.55]), obesity (OR = 2.92[1.11-8.24]) and creatinine clearance (OR = 0.99[0.98-1.00]) were associated with hematuria in univariable analysis. No independent factors were found in multivariable analysis. Hematuria is common among patients with hemophilia and further studies are needed to elucidate the relationship between hematuria and increased morbidity.

Relationship between microscopic haematuria and hydronephrosis in urolithiasis

The aim of this study was to investigate the relationship between the degree of hydronephrosis and the presence of microscopic haematuria in patients who presented to the emergency department (ED) with ureteral stones. The records of patients who presented to our ED due to urolithiasis between January 2017 and December 2020 were retrospectively analysed. Patients aged 18years or older who underwent non-contrast computed tomography (CT abdomen/pelvis) and urinalysis (UA) and were diagnosed with ureteral stones were included in the study. Radiology reports were reviewed for stone size, localisation and degree of hydronephrosis. Patients with and without microscopic haematuria and the degree of hydronephrosis were compared. A total of 476 patients were included, which consisted of 391 with microscopic haematuria and 85 without microscopic haematuria. The median stone size was 4.1mm in the presence of microscopic haematuria and 5.5mm in the absence of microscopic haematuria. Logistic regression analysis was performed to determine the factors associated with the development of hydronephrosis. Stone size [odds ratio (OR):2.15, 95% confidence interval (CI):1.12-4.16, P<.001), presence of pyuria (OR: 2.58, 95% CI: 1.78-3.48, P<.001) and absence of microscopic haematuria (OR: 1.31, 95% CI 1.04-2.89, P=.017) were identified as risk factors for moderate and severe hydronephrosis. We consider that imaging studies may be necessary for the diagnosis, and treatment of emergency cases in which microscopic haematuria is not detected in urinalysis since their stone size may be larger and degree of hydronephrosis may be more severe.

Development of acute kidney injury with massive granular casts and microscopic hematuria in patients with COVID-19: two case presentations with literature review

BackgroundComplications of acute kidney injury (AKI) are common in patients with coronavirus disease in 2019 (COVID-19). However, clinical characteristics of COVID-19-associated AKI are poorly described. We present two cases of severe COVID-19 patients with AKI.Case presentationA 77-year-old woman was suspected of having vancomycin-associated AKI, and a 45-year-old man was suspected of having heme pigment-induced AKI caused by rhabdomyolysis. The granular cast, which is known to be a valuable diagnostic tool for confirming the diagnosis of acute tubular necrosis, was detected in both patients at the onset of AKI. Interestingly, both patients also developed microscopic hematuria at the occurrence of AKI, and one patient had elevated d-dimer and low platelet levels simultaneously.ConclusionsSome reports suggested that COVID-19-associated microangiopathy contributed to the kidney damage. Therefore, it is possible that our patients might have accompanied renal microangiopathy, and that this pathological background may have caused exaggerated tubular damage by vancomycin or heme pigment. The etiology of AKI in patients with COVID-19 is multifactorial. Superimposition of nephrotoxin(s) and virus-associate intra-renal microangiopathy may be a crucial trigger of kidney injury leading to severe AKI in COVID-19 patients. Therefore, in COVID-19 patients, risk factors for AKI should be taken into consideration to prevent its progression into severe AKI.

P0227VITAMIN K ANTAGONIST-ASSOCIATED MICROSCOPIC HEMATURIA: ASSOCIATION WITH INR LEVELS AND PROTECTIVE EFFECT OF RAAS BLOCKADE

Abstract Background and Aims Vitamin K antagonists (VKA) are the most widely used anticoagulants in the daily clinical practice for the prevention of thrombotic events. Several renal adverse effects have been associated with the use of VKA, from hemodynamic effects due to massive urological hemorrhage associated with VKA overdose, to non-hemodynamic effects that include glomerular hemorrhage and renal tubular obstruction due to red cell casts. The main aim of our study was to establish an association between INR levels and microscopic hematuria in patients with VKA, and identify possible risk and protective factors associated with development of microscopic hematuria in these patients. Method We performed a transversal study that included patients with oral anticoagulation with coumarin derivatives (warfarin or acenocoumarol), that attended the Hematology outpatient clinic from October to December 2019 for routine INR control. A urine specimen was collected on the day of the INR control. We performed a simple urinalysis to all patients and quantified the precise number of red cells in the urine sediment by flow cytometry. Demographic data, kidney function tests including serum creatinine and albuminuria, comorbidities, anticoagulant dose and concomitant treatment were registered. Results 337 patients were included in the study, with an average age of 68.6 ± 12.2 years, 51% were females, 95% were treated with acenocoumarol and 5% with warfarin. Median INR levels were 2.6 (IQR 2.1-3.3) and the median number of urine red cells in the sediment were 11 RBCs/µl (IQR 0-13). 11.9% of the patients presented microscopic hematuria (≥14 RBCs/µl). There was a significant correlation between INR levels and the number of RBCs in the urine sediment (Spearman’s rho= 0.119, p= 0.029), independent from the type of anticoagulant used. This correlation was stronger after excluding those patients who had concomitant bacteriuria (Spearman’s rho= 0.201, p= 0.024). We found no correlation between time elapsed from start of anticoagulation or total weekly dose with the intensity of microscopic hematuria. In the univariate analysis, microhematuria was associated with having an INR &amp;gt;3.5 (19% vs. 10.2%, p=0.046), bacteriuria (15.2% vs. 3.6%, p=0.015), leukocyturia (14.8% vs. 6.6%, p= 0.026), hypertension (16.2% vs. 9.5%, p=0.053), and the use of RAAS blockers (17.2% vs. 6.9%, p=0.004). After performing a multivariate logistic regression that included the aforementioned variables, the association between microhematuria and RAAS blockade with either an ACE inhibitor or ARB was maintained (OR 0.38, CI 95% 0.163-0.886, p=0.025), independent from INR levels, hypertension, leukocyturia or bacteriuria. We found no association between serum creatinine, albuminuria or antiplatelet treatment with the presence of microscopic hematuria. Conclusion INR overdose is significantly associated with the presence of microscopic hematuria, independent from the type of VKA used or the total weekly dose. RAAS blockade is an independent protective factor for the presence of microscopic hematuria in anticoagulated patients.

Prognostic Value of Microscopic Hematuria after Induction of Remission in Antineutrophil Cytoplasmic Antibodies-Associated Vasculitis

Background: Pauci-immune glomerulonephritis (PIGN) is a major prognostic factor in antineutrophil cytoplasmic antibodies-associated vasculitis (AAV). Renal remission is usually defined as improvement or stabilization of serum creatinine and proteinuria levels but the significance of hematuria is unclear. We evaluated the prognostic value of microscopic hematuria in patients in remission from a first flare of PIGN. Methods: A multicenter retrospective study was conducted of all patients with histologically proven PIGN in northern France who presented a first renal flare of AAV between 2003 and 2013. All patients received conventional induction treatment and were considered in remission. Two groups were defined by the presence (H+) or absence (H–) of hematuria (dipstick 1+ and/or cytology ≥10,000 erythrocytes/mL). The primary outcome measure was the occurrence of renal relapse (RR) and/or end-stage renal disease (ESRD). Results: Eighty-six patients were included: 41 (48%) had hematuria at remission. The median follow-up time was 44 ± 34 months. There was no significant difference between the groups in terms of the primary endpoint or the number of RR. However, the survival rate without RR was significantly lower in the H+ group (p = 0.002). In multivariate analysis, risk factors for RR were hematuria at remission for relapses within 44 months (hazard ratio [HR] 4.15; 95% CI 1.15–15.01; p = 0.03) and the duration of maintenance immunosuppressive therapy (HR 0.96 per additional month; 95% CI 0.94–0.99; p = 0.002). Conclusion: Hematuria at remission after a first PIGN flare was not associated with ESRD but with the occurrence of RR within 44 months of remission.

Plasma and urine DNA levels are related to microscopic hematuria in patients with bladder urothelial carcinoma

a) Objective: An increase in cell-free DNA was observed in the plasma of many cancer patients. This major biomarker can be used to differentiate patients with malignant neoplasms from those with benign neoplasms or healthy patients. Depending on the characteristic of the tumor, there are qualitative variations in the circulating cell-free DNA. Today, studies on the concentration of fragments of circulating cell-free DNA and their respective sizes in patients with bladder cancer are not plentiful in the literature. A 100% effective plasma tumor marker, which would help in the diagnosis and follow-up of bladder cancer, is yet to be developed; therefore, cell-free DNA levels in the plasma may represent a valuable biomarker for the diagnosis, prognosis and follow-up of patients with this type of tumor. b) Design and methods: In this study we analyze the kinetics of plasma and urine DNA concentrations in patients with bladder cancer, relating them to the other clinical laboratory variables. c) Results: Patients with hematuria showed a positive correlation with urine DNA. d) Conclusion: An increase in plasma and urine DNA was unprecedentedly reported over time, a fact that may come in handy in the prognosis of patients. Furthermore, microscopic haematuria is correlated with plasma and urinary DNA levels.

Simple Renal Cysts: Prevalence, Associated Risk Factors and Follow-Up in a Health Screening Cohort.

To investigate the prevalence of simple renal cysts in an adult health-screening cohort, and to evaluate clinical characteristics, associated risk factors and the natural course. Between April and November 2008, a thousand individuals diagnosed with simple renal cyst by ultrasonography in a check-up program were chart-reviewed for demographic-clinical characteristics and cyst features. Follow-up was done via electronic patient records. Univariate and multivariate analyses to evaluate the relationship of outcomes and correlation analysis were done to measure the degree of association between parameters. The prevalence was 7.7%. There were 123 cysts in 77 patients, followed for 3.5 years (mean). Individuals with cysts were older (P < .01). Prevalence rates were 2.7% in individuals younger than 40 years and 23.9% in older than 60. The cysts were predominantly (94.8%) detected in males and most (63.6%) were solitary. No relation with Body Mass Index and total cholesterol levels was found but serum creatinine values were significantly increased in individuals with cysts (P < .01). There was no difference in the diagnosis of hypertension and microscopic hematuria in patients with renal cysts, however diabetes/hyperglycemia were more common and increasing age correlated with higher number of cysts (all P < .05). Follow-up revealed that the number of cysts were increased and/or the same in 86.5%; the sizes of cysts were larger and/or the same in 78.4% of patients, while in 14% of patients the cyst disappeared. In a cohort of adults undergoing a health-screening, the prevalence of simple renal cyst was found 7.7% by ultrasonography. Renal cysts were more common in males and elders, and associated with increased levels of serum creatinine and diabetes.

Microscopic Haematuria and Clinical Outcomes in Patients With Stage 3-5 Nondiabetic Chronic Kidney Disease.

Microscopic haematuria is proposed as a prognostic factor for renal outcomes in patients with glomerulonephritis. However, the role of haematuria in patients with advanced chronic kidney disease (CKD) or heavy proteinuria has not been investigated. We divided 1799 patients with stage 3–5 nondiabetic CKD into 3 groups according to the results from 3 urinalyses: no haematuria (0–2 red blood cells [RBCs]/hpf ≥2 times), mild haematuria (2–5 RBCs/hpf ≥2 times) and moderate haematuria (≥5–10 RBCs/hpf ≥2 times). The estimated glomerular filtration rate was 25.4 mL/min/1.73 m2, with a urine protein-to-creatinine ratio (UPCR) of 881 mg/g. The hazard ratios (HRs) of mild and moderate haematuria for end-stage renal disease (ESRD) were 1.28 (95% confidence interval [CI]: 1.05–1.56, P = 0.024) and 1.34 (95% CI: 1.03–1.74, P = 0.030), respectively. The HR of moderate haematuria for mortality was 1.56 (95% CI: 1.11–2.20, P = 0.011). According to subgroup analysis, the HR of moderate haematuria for ESRD in patients with a UPCR of <500 mg/g was more prominent than that in patients with a UPCR of ≥500 mg/g. Microscopic haematuria in patients with stage 3–5 nondiabetic CKD is associated with increased risks of ESRD and mortality.

Persistent or New Onset Microscopic Hematuria in Patients with Small Vessel Vasculitis in Remission: Findings on Renal Biopsy

Persistent or New Onset Microscopic Hematuria in Patients with Small Vessel Vasculitis in Remission: Findings on Renal Biopsy

Persistent or New Onset Microscopic Hematuria in Patients with Small Vessel Vasculitis in Remission: Findings on Renal Biopsy

Hematuria is considered a sign of active renal disease in patients with small-vessel vasculitis. In patients who are in apparent clinical remission, presence of persistent or new-onset microscopic hematuria may reflect active vasculitis, damage, or other glomerular pathology. We identified 74 patients from the Johns Hopkins Renal Pathology database between 1995 and 2009 with the diagnosis of pauciimmune glomerulonephritis (GN). Among them we identified 9 who were in clinical remission and underwent a renal biopsy for evaluation of persistent or new-onset hematuria. Nine patients with small-vessel vasculitis, 8 antineutrophil cytoplasmic antibody (ANCA)-positive and 1 ANCA-negative, underwent a renal biopsy at variable time periods after remission of vasculitis (6 to 164 months) for persistent microscopic hematuria (n = 6) or new-onset microscopic hematuria (n = 3). All patients were in apparent clinical remission at the time of renal biopsy. Of the 3 patients presenting with new-onset hematuria, 2 had crescentic IgA nephropathy and 1 had healed crescentic pauciimmune GN. Of the 6 patients with persistent hematuria, 2 had arteriosclerosis, 2 had focal segmental glomerulosclerosis, and 2 had global and segmental glomerulosclerosis and healed crescentic GN, and none had active vasculitis. Microscopic hematuria in patients with renal vasculitis otherwise in remission could represent chronic glomerular injury from prior episode of vasculitis or may represent new glomerular pathology. Renal biopsy should be considered in these patients to guide therapy.

POS-01.107: Asymptomatic microscopic hematuria and urinary lithiasis

Asymptomatic Microscopic Hematuria is a common cause of urologic referrals, this may be due to a variety of underlying conditions ranging from insignificant to potentially life threatening lesions. We survey the underlying causes of Asymptomatic Microscopic Hematuria in patients who were referred to the clinic.

UP-02.80: Asymptomatic microscopic hematuria and urinary lithiasis

Asymptomatic microscopic hematuria is a common cause of urologic referring that may be due to a variety of underlying conditions ranging from insignificant to potentially life threatening lesions. We survey the underlying causes of asymptomatic microscopic hematuria in patients who were referred to clinic.

Urinary albumin excretion: a predictor of glomerular findings in adults with microscopic haematuria

Microscopic haematuria without proteinuria is a common clinical finding. When urological causes are excluded, usual findings on renal biopsy are IgA nephropathy (which can progress to end-stage renal failure) or thin basement membrane nephropathy (which has an excellent prognosis). A non-invasive test to discriminate between the two would be useful. To examine the value of measurement of urinary albumin excretion in discriminating glomerular causes of microscopic haematuria in patients without proteinuria on urine dipstick tests. Single-centre retrospective cross-sectional observational study. Adult patients who underwent renal biopsy for microscopic haematuria over a 6-year period from January 1994 were identified. Study entry required normal renal function, no proteinuria detected by dipstick, and urinary albumin excretion <300 mg/24 h. Patients with IgA nephropathy had follow-up for a mean of 58 months after biopsy. Of 169 patients fulfilling study criteria, 119 (70%) had normoalbuminuria (<30 mg/24 h); 52 (30%) had microalbuminuria (30-299 mg/24 h). Of those with normoalbuminuria, 106 (89%) had thin basement membrane nephropathy or no glomerular abnormality. Thirteen (11%) had IgA nephropathy, and of 12 of these followed-up for a mean 64 months, none developed overt, dipstick-positive proteinuria. In contrast, 24 (48%) of those with microalbuminuria had IgA nephropathy, and of 22 followed-up for a mean 55 months, five developed overt proteinuria. Urinary albumin excretion is an indicator of likely glomerular findings in microscopic haematuria, and may influence whether a renal biopsy is necessary.

Hematuria and Ureteral Stones: It Depends When You Test the Urine

Clinicians usually look for microscopic hematuria in patients with symptoms that are suggestive of ureteral stones. But sometimes hematuria is absent

Multisystem diseases and the kidney

The finding of microscopic haematuria in patients with non-specific symptoms, signs and laboratory findings may point to a multisystem disorder A normal plasma creatinine concentration does not exclude significant renal disease Kidney involvement is common in small vessel vasculitis and provides an accessible organ from which to make a specific tissue diagnosis Cholesterol crystal embolisation may mimic many of the features of small vessel vasculitis but can be distinguished histologically.