User:Copene/sandbox
Hematuria is the presence of red blood cells (erythrocytes) in the urine. Gross hematuria is easily identified, as it causes red discoloration of the urine. Microscopic hematuria is invisible to the naked eye and is often found incidentally on urinalysis or urine dipstick.[1] Any part of the kidneys or urinary tract (ureters, urinary bladder, prostate, and urethra) can cause blood in the urine. Hematuria can be benign and temporary, but it can also signal trauma of the urinary system or a tumor in the bladder. Occasionally "hemoglobinuria" is used synonymously, although it refers more precisely to hemoglobin in the urine.
Red discoloration of the urine can have various causes:
- Red blood cells
- Microscopic hematuria (small amounts of blood) is seen only on urinalysis or light microscopy
- Macroscopic hematuria or "frank" or "gross" hematuria
- Hemoglobin (only the red pigment, not the red blood cells)
Other pigments
- Myoglobin in myoglobinuria
- Porphyrins in porphyria
- Betanin, after eating beets
- Drugs such as rifampicin, phenazopyridine, and sulphonamides
- Alkaptonuria
Sources
[edit]The most common causes of hematuria[2] are:
- Urinary tract infection with bacteria. Escherichia coli is the cause of most UTIs, followed by Klebsiella pneumonia and Staphylococcus saprophyticus
- Nephrolithiasis: stones in the kidney, bladder, or ureter
- Polycystic kidney disease[3]
- Trauma
- Cancer of the kidney, prostate or bladder
- Benign prostatic hyperplasia, in older men, especially those over 50
- Indwelling urinary catheter
- Vigorous exercise
- No cause found
Other, less common causes of hematuria include:
- Glomerular bleeding: e.g.: IgA nephropathy ("Berger's disease"), Alport syndrome, thin basement membrane disease
- Sickle cell disease
- Schistosomiasis (caused by Schistosoma haematobium) - a major cause for hematuria in many African and Middle-Eastern countries
- Recent instrumentation of the urinary tract
- Prostatitis
- Urethritis
- Kidney diseases[4]
- Arteriovenous malformation of the kidney (rare, but may impress like renal cell carcinoma on scans as both are highly vascular)
Rare causes include:
- Paroxysmal nocturnal hemoglobinuria - a rare disease where hemolysis of cells leads to hemoglobin in the urine
- Fibrinoid necrosis of the Glomeruli (as a result of malignant hypertension)
- Vesical varices may rarely develop secondary to obstruction of the inferior vena cava[5][6]
- Allergy may rarely cause episodic gross hematuria in children[7]
- Left renal vein hypertension, also called "nutcracker phenomenon" or "nutcracker syndrome," is a rare vascular abnormality responsible for gross hematuria[8]
- Ureteral Pelvic Junction Obstruction (UPJ) is a rare congenital condition in which the ureter is blocked between the kidney and bladder, resulting in hematuria[9]
- March hematuria secondary to repetitive impacts on the body, usually the feet
- Athletic nephritis secondary to strenuous exercise
- Alport syndrome
Others signs that resemble hematuria include:
 | This is a user sandbox of Copene. You can use it for testing or practicing edits. This is not the place where you work on your assigned article for a dashboard.wikiedu.org course. Visit your Dashboard course page and follow the links for your assigned article in the My Articles section. |
- ^ Cohen, Robert A.; Brown, Robert S. (2003-06-05). "Clinical practice. Microscopic hematuria". The New England Journal of Medicine. 348 (23): 2330–2338. doi:10.1056/NEJMcp012694. ISSN 1533-4406. PMID 12788998.
- ^ "Etiology and evaluation of hematuria in adults".
- ^ Norman L. Browse/4th/436
- ^ Hematuria Causes Original Date of Publication: 15 Jun 1998. Reviewed by: Stacy J. Childs, M.D., Stanley J. Swierzewski, III, M.D. Last Reviewed: 10 Jul 2008
- ^ Koshy, CG.; Govil, S.; Shyamkumar, NK.; Devasia, A. (Jan 2009). "Bladder varices--rare cause of painless hematuria in idiopathic retroperitoneal fibrosis". Urology. 73 (1): 58–9. doi:10.1016/j.urology.2008.06.039. PMID 18722652.
- ^ Gaspar, Yves, M.D.; Olivier, Detry, M.D.; de Leval, Jean, M.D., Ph.D. (November 15, 2001). "Vesical Varices in a Patient with Portal Hypertension". New England Journal of Medicine (345): 1503-1504. doi:10.1056/NEJM200111153452018.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Graham, DM.; McMorris, MS.; Flynn, JT. (Nov 2002). "Episodic gross hematuria in association with allergy symptoms in a child". Clin Nephrol. 58 (5): 389–92. doi:10.5414/cnp58389. PMID 12425491.
- ^ Russo, D.; Minutolo, R.; Iaccarino, V.; Andreucci, M.; Capuano, A.; Savino, FA. (Sep 1998). "Gross hematuria of uncommon origin: the nutcracker syndrome". Am J Kidney Dis. 32 (3): E3. doi:10.1053/ajkd.1998.v32.pm10074588. PMID 10074588.
- ^ Ureteral Pelvic Junction Obstruction (UPJ) / Ureteral Obstruction Archived 2007-06-10 at the Wayback Machine