What are the upper urinary tract causes of haematuria?
o Renal cancer o Upper tract urothelial cancer o Renal stones o UTI o Glomerular o Renal trauma o Enlarged kidneys
What are the lower urinary tract causes of haematuria?
o Bladder cancer o Bladder stone o Prostate cancer o UTI o Radiation cystitis o Bladder/urethral trauma o Schistosomiasis
What in the history would you ask about?
• Colour of urine
• Pain
Colic or Dull ache
• Fevers
• Weight loss
• Smoking
• Occupation exposures (dyes)
• Medications
Aspirin
NSAIDs
Cyclophosphamide
• Past Hx
HTN
TB
Radiotherapy
Procedures
• Family Hx
Autosomal dominant PSK (ADPSK)
Von Hippel Lindau (VHL)What is macroscopic/gross/frank haematuria?
Visible
What is microscoic haematuria?
Found on dipstick/microscopy, >5 RBC per high power field
Why would you do a MSU?
Rule out infection
What should patients >45 with macroscopic haematuria in the absence of UTI be investigated with?
- Cystoscopy
- Upper tract imaging
In patients <45 with microscopic haematuria, they only require urological investigation if…
- Increased urinary frequency
- Loin pain
What else can cause red urine?
- Haemoglobin
- Myoglobin
- Beetroot
- Rifampicin
- Porphyrins
How does IgA nephropathy most commonly present?
Macroscopic haematuria in young people 1-2 days following an upper respiratory tract infection
What is IgA nephropathy associated with?
- Alcoholic cirrhosis
- HSP vasculitis
- Coeliac disease/dermatitis herpetiformis
