J Korean Med Assoc.
2023 Jun;66(6):348-354. 10.5124/jkma.2023.66.6.348.
Renal diseases causing hematuria
- Affiliations
-
- 1Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Korea
- 2Department of Internal Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- 3Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- KMID: 2543848
- DOI: http://doi.org/10.5124/jkma.2023.66.6.348
Abstract
- Background
Hematuria is a common laboratory finding in clinical practice, occurring mostly in the kidneys. However, it can occur in the rest of the urinary system, including the ureters, bladder, and urethra, as well as in the prostate in men. This paper will discuss cases of hematuria observed in various diseases, especially kidney disease.
Current Concepts
Hematuria is diagnosed when three or more red blood cells are found in a high-power field microscopic urinalysis. Identifying urine sediment is critical in differentiating between glomerular and nonglomerular hematuria, classified according to location. If hematuria is accompanied by proteinuria, dysmorphic red blood cells, or cellular casts in urine microscopy, as well as hypertension or renal function decline, glomerular disease may be present; thus, a nephrologist should be consulted. Hematuria is also observed in renal vascular diseases, including renal infarction, renal artery dissection, and nutcracker syndrome. In polycystic kidney disease, hematuria may present in combination with renal stones or malignancy. Diabetic nephropathy can manifest hematuria, which is a negative prognosticator of end-stage kidney disease.
Discussion and Conclusion
Hematuria is a laboratory finding for various diseases, and appropriate diagnosis and treatment should be provided according to its clinical features.
