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.