MRCP NEPHROLOGY AND UROLOGY NOTES
RENAL ANATOMY
,
,
, HAEMATURIA
Microscopic or dipstick positive haematuria is increasingly termed non-visible haematuria whilst macroscopic haematuria is termed visible haematuria.
Causes of transient or spurious non-visible haematuria
• UTI
• Menstruation
• Vigorous exercise (this normally settles after around 3 days)
• Sexual intercourse.
Causes of persistent non-visible haematuria
• Cancer (bladder, renal, prostate)
• Stones
• BPH
• Prostatitis
• Urethritis e.g. chlamydia
• Renal causes: IgA nephropathy, thin basement membrane disease
Spurious causes - red/orange urine, where blood is not present on dipstick
• Foods: beetroot, rhubarb
• Drugs:: rifampicin, doxorubicin
MANAGEMENT
The incidence of non-visible haematuria is visible in pt taking aspirin/warfarin to the general population hence they should also be investigated.
Testing
• Urine dipstick is the test of choice for detecting haematuria.
• Persistent non-visible haematuria is often defined as blood being present in 2 out of 3 samples tested 2 - 3 weeks apart.
• Renal function, albumin:creatinine (ACR) or protein:creatinine ratio (PCR) and BP should also be checked.
• Urine microscopy may be used but time to analysis significantly affects the no. of RBCs detected.
RENAL ANATOMY
,
,
, HAEMATURIA
Microscopic or dipstick positive haematuria is increasingly termed non-visible haematuria whilst macroscopic haematuria is termed visible haematuria.
Causes of transient or spurious non-visible haematuria
• UTI
• Menstruation
• Vigorous exercise (this normally settles after around 3 days)
• Sexual intercourse.
Causes of persistent non-visible haematuria
• Cancer (bladder, renal, prostate)
• Stones
• BPH
• Prostatitis
• Urethritis e.g. chlamydia
• Renal causes: IgA nephropathy, thin basement membrane disease
Spurious causes - red/orange urine, where blood is not present on dipstick
• Foods: beetroot, rhubarb
• Drugs:: rifampicin, doxorubicin
MANAGEMENT
The incidence of non-visible haematuria is visible in pt taking aspirin/warfarin to the general population hence they should also be investigated.
Testing
• Urine dipstick is the test of choice for detecting haematuria.
• Persistent non-visible haematuria is often defined as blood being present in 2 out of 3 samples tested 2 - 3 weeks apart.
• Renal function, albumin:creatinine (ACR) or protein:creatinine ratio (PCR) and BP should also be checked.
• Urine microscopy may be used but time to analysis significantly affects the no. of RBCs detected.
