Hematuria - causes
Hematuria - common causes:
Def: American Urological Assoc: 3 or more RBCs per HPF in two of three urine samples.
Gross hematuria in an adult represents malignacy until proven otherwise.
Glomerular causes: look for dysmorphic RBCs, erythrocyte casts in addition to proteinuria.
- Familial: Fabry's dz, Alport's synd., Nail-patella synd., Thin-basement-membrane dz.
- Primary Glomerulonephritis:
FSGN, Goodpature's dz, Henoch-Shonlein purpura, **IgA nephropathy (Berger's dz) is the most common cause of glomerular hematuria**, mesangioproliferative GN, postinfectious GN, RPGN
- Secondary Glomerulonephritis: hemolytic-uremic synd, SLE, TTP, vasculitis
Renal causes: no dysmorphic RBCs or erythrocyte casts. Proteinuria present.
AVM, hypercalciuria, hyperuricosuria, loin pain-hematuria synd., malignant HTN, medullary sponge kidney, tubulointerstitial causes, vascular cause
- Metabolic causes: papillary necrosis, PKD, renal artery thrombosis, renal artery embolism, SCD or trait.
- Urologic causes: no dysmorphic RBCs, or erythrocyte casts, or proteinuria.
BPH, CA (kidney, ureteral, bladder, prostate, and urethral), cystitis, pyelonephritis, nephrolithiasis, prostatitis, schistosoma hematobium infection, TB.
Other causes: Drugs (NSAIDs, heparin, warfarin, cyclophosphamide, Trauma (contact sports, running, Foley catheter)
S: stones, SCC, schistosomiasis, SLE, scleroderma, and sulfonamides.
W: Wegener's granulomatosis
I: infection, instrumentation, iatrogenic (analgesis, anticoagulants, cyclophosphamide), interstitial nephritis
T: trauma, TB, tubulointerstitial dz, tumor, and TTP.
C: cryoglobulinemia
H: HUS, hypercalciuria, hemophilia, Henoch-Schonlein purpura
G: Goodpasture's dz, GN
P: papillary necrosis, PKD, PN
S: medullary sponge kidney.