HEMATURIA

HEMATURIA Hematuria Red blood cells on urine microscopy. Must exclude false positives from myoglobinuria, beet, drugs (pyridium, phenytoin, rifampin, nitrofurantoin), or menstruation Glomerular (Dysmorphic RBCs and/or RBC casts) Extraglomerular (Isomorphic RBCs with no casts) Upper Tract (above bladder) Lower Tract (bladder &below) Isolated Dysmorphic Hematuria (injury to epithelial side of glomerular capillary wall) Dysmorphic Hematuria and Nephrotic Range Proteinuria (>3.5g/day) (injury to both endothelial and epithelial capillary wall) • Anti-GBM antibodies • Immune-complex deposition (IgA, post-strep, lupus) • Pauci-immune disease (Wegener's) • IgA nephropathy • Thin GBM disease • Hereditary nephritis (Alport’s) Urinary Tract Infection? (Pyuria +/- nitrites with bacteria on microscopy) Dysmorphic Hematuria and Proteinuria (injury to the endothelial side of glomerular capillary wall) • Membranoproliferative glomerulonephritis • Lupus glomerulonephritis • Post-Infectious glomerulonephritis • Vascular • Tubulointerstitia l • Calculi (see scheme for renal colic) • Trauma • Neoplasm/Cyst (see schemes for renal mass) • Trauma • Neoplasm • BPH • Calculi Isolated extraglomerular hematuria is presumed to be secondary to malignancy until proven otherwise