Hematuria: Blood in the Urine

Total Page:16

File Type:pdf, Size:1020Kb

Hematuria: Blood in the Urine Hematuria: Blood in the Urine National Kidney and Urologic Diseases Information Clearinghouse What is hematuria? Hematuria is blood in the urine. Two types of blood in the urine exist. Blood that can be seen in the urine is called gross hematu- U.S. Department of Health and ria. Blood that cannot be seen in the urine, Human Services except when examined with a microscope, is called microscopic hematuria. NATIONAL INSTITUTES OF HEALTH What are the symptoms of Kidneys hematuria? Most people with microscopic hematuria do not have symptoms. People with gross hematuria have urine that is pink, red, or cola-colored due to the presence of red blood cells (RBCs). Even a small amount of Bladder blood in the urine can cause urine to change Ureters color. In most cases, people with gross hematuria do not have other symptoms. However, people with gross hematuria that Urethra includes blood clots in the urine may have pain. The urinary tract What is the urinary tract? the two kidneys process about 200 quarts The urinary tract is the body’s drainage of blood to produce about 1 to 2 quarts of system for removing wastes and extra water. urine, composed of wastes and extra water. The urinary tract includes two kidneys, two The urine flows from the kidneys to the ureters, a bladder, and a urethra. The kid- bladder through tubes called ureters. The neys are two bean-shaped organs, each about bladder stores urine until releasing it through the size of a fist. They are located near the urination. When the bladder empties, urine middle of the back, just below the rib cage, flows out of the body through a tube called one on each side of the spine. Every day, the urethra at the bottom of the bladder. What causes hematuria? Who is at risk for Hematuria can be caused by menstruation, hematuria? vigorous exercise, sexual activity, viral illness, Almost anyone, including children and teens, trauma, or infection, such as a urinary tract can have hematuria. Factors that increase infection (UTI). More serious causes of the chance a person will have hematuria hematuria include include • cancer of the kidney or bladder • a family history of kidney disease • inflammation of the kidney, urethra, • an enlarged prostate, which typically bladder, or prostate—a walnut-shaped occurs in men age 50 or older gland in men that surrounds the urethra at the neck of the bladder and supplies • urinary stone disease fluid that goes into semen • certain medications including aspirin • polycystic kidney disease—an inherited and other pain relievers, blood thinners, disorder characterized by many grape- and antibiotics like clusters of fluid-filled cysts that • strenuous exercise such as long-distance make both kidneys larger over time, tak- running ing over and destroying working kidney tissue • a recent bacterial or viral infection • blood clots How is hematuria • blood clotting disorders, such as diagnosed? hemophilia Hematuria is diagnosed with urinalysis, • sickle cell disease—an inherited disor- which is testing of a urine sample. The urine der in which RBCs form an abnormal sample is collected in a special container in crescent shape, resulting in less oxygen a health care provider’s office or commercial delivered to the body’s tissues, clogging facility and can be tested in the same loca- of small blood vessels, and disruption of tion or sent to a lab for analysis. For the test, healthy blood flow a nurse or technician places a strip of chemi- cally treated paper, called a dipstick, into the urine. Patches on the dipstick change color when RBCs are present in urine. When blood is visible in the urine or a dipstick test of the urine indicates the presence of RBCs, a health care provider examines the urine with a microscope to make an initial diagno- sis of hematuria. The next step is to diag- nose the cause of the hematuria. 2 Hematuria: Blood in the Urine The health care provider will take a thorough • Cystoscopy. Cystoscopy is a procedure medical history. If the history suggests a that uses a tubelike instrument to look cause that does not require treatment, the inside the urethra and bladder. Cys- urine should be tested again after 48 hours toscopy is performed by a health care for the presence of RBCs. If two of three provider in the office, an outpatient urine samples show too many RBCs when facility, or a hospital with local anes- viewed with a microscope, more serious thesia. However, in some cases, seda- causes should be explored. The health care tion and regional or general anesthesia provider may order one or more of the fol- are needed. Cystoscopy may be used lowing tests: to look for cancer cells in the bladder, particularly if cancer cells are found • Urinalysis. Further testing of the urine with urinalysis. For more informa- may be done to check for problems that tion about cystoscopy, see the National can cause hematuria, such as infection, Kidney and Urologic Diseases Informa- kidney disease, and cancer. The pres- tion Clearinghouse (NKUDIC) fact ence of white blood cells signals a UTI. sheet Cystoscopy and Ureteroscopy at RBCs that are misshapen or clumped www.urologic.niddk.nih.gov. together to form little tubes, called casts, may indicate kidney disease. • Kidney imaging tests. Intravenous Large amounts of protein in the urine, pyelogram (IVP) is an x ray of the uri- called proteinuria, may also indicate nary tract. A special dye, called contrast kidney disease. The urine can also be medium, is injected into a vein in the tested for the presence of cancer cells. person’s arm, travels through the body to the kidneys, and makes urine vis- • Blood test. A blood test involves draw- ible on the x ray. The contrast medium ing blood at a health care provider’s also shows any blockage in the urinary office or commercial facility and send- tract. When a small mass is found ing the sample to a lab for analysis. A with IVP, another imaging test, such as blood test can show the presence of high an ultrasound, CT scan, or magnetic levels of creatinine, a waste product of resonance imaging (MRI), can be used normal muscle breakdown, which may to further study the mass. Imaging tests indicate kidney disease. are performed in an outpatient center • Biopsy. A biopsy is a procedure that or hospital by a specially trained tech- involves taking a piece of kidney tissue nician, and the images are interpreted for examination with a microscope. The by a radiologist—a doctor who special- biopsy is performed by a health care izes in medical imaging. Anesthesia provider in a hospital with light seda- is not needed, though light sedation tion and local anesthetic. The health may be used in some cases. Imaging care provider uses imaging techniques tests may show a tumor, a kidney or such as ultrasound or a computerized bladder stone, an enlarged prostate, tomography (CT) scan to guide the or other blockage of the normal flow biopsy needle into the kidney. The of urine. For more information about kidney tissue is examined in a lab by a imaging tests used to examine the pathologist—a doctor who specializes urinary tract, see the NKUDIC fact in diagnosing diseases. The test helps sheet Imaging of the Urinary Tract at diagnose the type of kidney disease www.urologic.niddk.nih.gov. causing hematuria. 3 Hematuria: Blood in the Urine How is hematuria treated? • When blood is visible in the urine or a dipstick test of the urine indicates Hematuria is treated by treating its underly- the presence of RBCs, the urine is ing cause. If no serious condition is causing examined with a microscope to make hematuria, no treatment is needed. Hema- an initial diagnosis of hematuria. The turia caused by a UTI is treated with antibi- next step is to diagnose the cause of the otics; urinalysis should be repeated 6 weeks hematuria. after antibiotic treatment ends to be sure the infection has resolved. • If a thorough medical history suggests a cause that does not require treatment, the urine should be tested again after Eating, Diet, and Nutrition 48 hours for the presence of RBCs. If Eating, diet, and nutrition have not been two of three urine samples show too shown to play a role in causing or preventing many RBCs when viewed with a micro- hematuria. scope, more serious causes should be explored. Points to Remember • One or more of the following tests • Hematuria is blood in the urine. may be ordered: urinalysis, blood test, biopsy, cytoscopy, and kidney imaging • Most people with microscopic hematu- tests. ria do not have symptoms. People with gross hematuria have urine that is pink, • Hematuria is treated by treating its red, or cola-colored due to the presence underlying cause. of red blood cells (RBCs). • Hematuria can be caused by menstrua- Hope through Research tion, vigorous exercise, sexual activity, In recent years, researchers have learned viral illness, trauma, or infection, such a great deal about kidney disease. The as a urinary tract infection (UTI). More National Institute of Diabetes and Digestive serious causes of hematuria include and Kidney Diseases (NIDDK) sponsors – cancer of the kidney or bladder several programs aimed at understanding kidney and urologic problems that can lead – inflammation of the kidney, urethra, to hematuria. The NIDDK’s Division of bladder, or prostate Kidney, Urologic, and Hematologic Diseases – polycystic kidney disease supports basic research into normal kidney function and the diseases that impair normal – blood clots function at the cellular and molecular levels, – blood clotting disorders, such as including diabetes, high blood pressure, glo- hemophilia merulonephritis, and cystic kidney diseases.
Recommended publications
  • Uremic Toxins Affect Erythropoiesis During the Course of Chronic
    cells Review Uremic Toxins Affect Erythropoiesis during the Course of Chronic Kidney Disease: A Review Eya Hamza 1, Laurent Metzinger 1,* and Valérie Metzinger-Le Meuth 1,2 1 HEMATIM UR 4666, C.U.R.S, Université de Picardie Jules Verne, CEDEX 1, 80025 Amiens, France; [email protected] (E.H.); [email protected] (V.M.-L.M.) 2 INSERM UMRS 1148, Laboratory for Vascular Translational Science (LVTS), UFR SMBH, Université Sorbonne Paris Nord, CEDEX, 93017 Bobigny, France * Correspondence: [email protected]; Tel.: +33-2282-5356 Received: 17 July 2020; Accepted: 4 September 2020; Published: 6 September 2020 Abstract: Chronic kidney disease (CKD) is a global health problem characterized by progressive kidney failure due to uremic toxicity and the complications that arise from it. Anemia consecutive to CKD is one of its most common complications affecting nearly all patients with end-stage renal disease. Anemia is a potential cause of cardiovascular disease, faster deterioration of renal failure and mortality. Erythropoietin (produced by the kidney) and iron (provided from recycled senescent red cells) deficiencies are the main reasons that contribute to CKD-associated anemia. Indeed, accumulation of uremic toxins in blood impairs erythropoietin synthesis, compromising the growth and differentiation of red blood cells in the bone marrow, leading to a subsequent impairment of erythropoiesis. In this review, we mainly focus on the most representative uremic toxins and their effects on the molecular mechanisms underlying anemia of CKD that have been studied so far. Understanding molecular mechanisms leading to anemia due to uremic toxins could lead to the development of new treatments that will specifically target the pathophysiologic processes of anemia consecutive to CKD, such as the newly marketed erythropoiesis-stimulating agents.
    [Show full text]
  • Glomerulonephritis Management in General Practice
    Renal disease • THEME Glomerulonephritis Management in general practice Nicole M Isbel MBBS, FRACP, is Consultant Nephrologist, Princess Alexandra lomerular disease remains an important cause Hospital, Brisbane, BACKGROUND Glomerulonephritis (GN) is an G and Senior Lecturer in important cause of both acute and chronic kidney of renal impairment (and is the commonest cause Medicine, University disease, however the diagnosis can be difficult of end stage kidney disease [ESKD] in Australia).1 of Queensland. nikky_ due to the variability of presenting features. Early diagnosis is essential as intervention can make [email protected] a significant impact on improving patient outcomes. OBJECTIVE This article aims to develop However, presentation can be variable – from indolent a structured approach to the investigation of patients with markers of kidney disease, and and asymptomatic to explosive with rapid loss of kidney promote the recognition of patients who need function. Pathology may be localised to the kidney or further assessment. Consideration is given to the part of a systemic illness. Therefore diagnosis involves importance of general measures required in the a systematic approach using a combination of clinical care of patients with GN. features, directed laboratory and radiological testing, DISCUSSION Glomerulonephritis is not an and in many (but not all) cases, a kidney biopsy to everyday presentation, however recognition establish the histological diagnosis. Management of and appropriate management is important to glomerulonephritis (GN) involves specific therapies prevent loss of kidney function. Disease specific directed at the underlying, often immunological cause treatment of GN may require specialist care, of the disease and more general strategies aimed at however much of the management involves delaying progression of kidney impairment.
    [Show full text]
  • Pyelonephritis (Kidney Infection)
    Pyelonephritis (Kidney Infection) Cathy E. Langston, DVM, DACVIM (Small Animal) BASIC INFORMATION urine collected from the bladder to be negative despite infection in the Description kidney. Abdominal x-rays and an ultrasound may be recommended. Bacterial infection of the kidney is termed pyelonephritis . Infection Although culture of a piece of kidney tissue obtained by biopsy may occur within kidney tissue or in the renal pelvis, the area of increases the chance of finding the infection, the invasiveness of the kidney where urine collects before being transported to the the procedure makes it too risky for general use (the biopsy would bladder. need to be taken from deeper within the kidney than the average Causes kidney biopsy). Contrast x-ray studies, such as an excretory uro- In most cases, a urinary tract infection starts in the bladder and gram (intravenous pyelogram), are sometimes helpful. An excre- the bacteria travel upstream to the kidney. Anything that decreases tory urogram involves taking a series of x-rays after a dye (that the free flow of urine, such as obstruction of the urethra (tube shows up white on x-rays) is given intravenously. Other tests may that carries urine from the bladder to the outside), bladder, ureter be recommended to rule out diseases that cause similar clinical (tube that carries urine from the kidney to the bladder), or kid- signs and other causes of kidney disease. ney, increases the risk that the infection will spread to the kid- ney. The presence of stones and growths in the bladder and kidney TREATMENT AND FOLLOW-UP also increases the risk.
    [Show full text]
  • Urinalysis and Kidney Disease: What You Need to Know
    URINALYSIS AND KIDNEY DISEASE What You Need To Know www.kidney.org About the Information in this Booklet Did you know that the National Kidney Foundation (NKF) offers guidelines and commentaries that help your healthcare provider make decisions about your medical treatment? The information in this booklet is based on those recommended guidelines. Stages of Kidney Disease There are five stages of kidney disease. They are shown in the table below. Your healthcare provider determines your stage of kidney disease based on the presence of kidney damage and your glomerular filtration rate (GFR), which is a measure of your kidney function. Your treatment is based on your stage of kidney disease. Speak to your healthcare provider if you have any questions about your stage of kidney disease or your treatment. STAGES OF KIDNEY DISEASE Glomerular Stage Description Filtration Rate (GFR)* Kidney damage (e.g., protein 1 90 or above in the urine) with normal GFR Kidney damage with mild 2 60 to 89 decrease in GFR 3 Moderate decrease in GFR 30 to 59 4 Severe reduction in GFR 15 to 29 5 Kidney failure Less than 15 *Your GFR number tells your healthcare provider how much kidney function you have. As chronic kidney disease progresses, your GFR number decreases. What is a urinalysis (also called a “urine test”)? A urinalysis is a simple test that looks at a small sample of your urine. It can help find conditions that may need treatment, including infections or kidney problems. It can also help find serious diseases in the early stages, like chronic kidney disease, diabetes, or liver disease.
    [Show full text]
  • High Blood Pressure and Chronic Kidney Disease: for People
    HIGH BLOOD PRESSURE AND CHRONIC KIDNEY DISEASE For People with CKD Stages 1–4 www.kidney.org National Kidney Foundation's Kidney Disease Outcomes Quality Initiative Did you know that the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (NKF-KDOQI™) has guidelines and commentaries that help your doctor and healthcare team make important decisions about your medical treatment? The information in this booklet is based on the NKF- KDOQI recommended guidelines and commentaries. What is your stage of kidney disease? There are five stages of kidney disease. They are shown in the table below. Your doctor determines your stage of kidney disease based on the presence of kidney damage and your glomerular filtration rate (GFR), which is a measure of your level of kidney function. Your treatment is based on your stage of kidney disease. Speak to your doctor if you have any questions about your stage of kidney disease or your treatment. STAGES of KidNEY DISEASE AGES of KidNEY DISEASE STAGES OF KIDNEY DISEASE Stage Description Glomerular Filtration Rate (GFR)* Kidney damage (e.g., protein 1 90 or above in the urine) with normal GFR Kidney damage with mild 2 60 to 89 decrease in GFR 3 Moderate decrease in GFR 30 to 59 4 Severe reduction in GFR 15 to 29 5 Kidney failure Less than 15 *Your GFR number tells your doctor how much kidney function you have. As chronic kidney disease progresses, your GFR number decreases. 2 NATIONAL KIDNEY FOUNDATION TABLE of ConTEntS Did you know? ...............................4 What is chronic kidney disease? ................5 What is high blood pressure? ...................6 How are high blood pressure and kidney disease related? ..............................6 How do I know if my blood pressure is too high? ..................................7 How is blood pressure measured? How often should it be checked? ...............8 I have high blood pressure but am not sure if I have CKD.
    [Show full text]
  • What Is Lupus Nephritis
    What is lupus nephritis (LN)? Lupus nephritis (LN) is inflammation of the kidney that occurs as a common symptom of systemic lupus erythematosus (SLE), also known as lupus. Proteins in the immune system called antibodies damage important structures in the kidney. ⅱ Why are the kidneys important? To understand how lupus nephritis damages the kidney, it is important to understand how the kidneys work. The kidneys’ main function is to filter out excess waste and water from the blood through the urine. Kidneys also balance the salts and minerals circulating in the blood, help control blood pressure and make red blood cells. So, when the kidneys are damaged or fail, they can’t do their job as well. As a result, the kidneys are not able to filter out waste and water into the urine causing it to stay in the blood. What are the signs and symptoms of LN? Signs to ask the doctor about include blood in the urine or foamy urine which can mean that there is excess protein. Other signs to notice are swelling of legs, ankles, hands or tissue around the eyes as well as weight gain that can be caused by fluid the body isn’t getting rid of. ⅲ Symptoms of lupus nephritis also include high blood pressure, joint/muscle pain, high levels of waste (creatinine) in the blood, or impaired/failing kidney. ⅳ How common is LN? Lupus nephritis is the most common complication of lupus. Five out of 10 adults with lupus will have lupus nephritis, while eight out of 10 children with lupus will have kidney damage, which usually stems from lupus nephritis.
    [Show full text]
  • Urinary System Diseases and Disorders
    URINARY SYSTEM DISEASES AND DISORDERS BERRYHILL & CASHION HS1 2017-2018 - CYSTITIS INFLAMMATION OF THE BLADDER CAUSE=PATHOGENS ENTERING THE URINARY MEATUS CYSTITIS • MORE COMMON IN FEMALES DUE TO SHORT URETHRA • SYMPTOMS=FREQUENT URINATION, HEMATURIA, LOWER BACK PAIN, BLADDER SPASM, FEVER • TREATMENT=ANTIBIOTICS, INCREASE FLUID INTAKE GLOMERULONEPHRITIS • AKA NEPHRITIS • INFLAMMATION OF THE GLOMERULUS • CAN BE ACUTE OR CHRONIC ACUTE GLOMERULONEPHRITIS • USUALLY FOLLOWS A STREPTOCOCCAL INFECTION LIKE STREP THROAT, SCARLET FEVER, RHEUMATIC FEVER • SYMPTOMS=CHILLS, FEVER, FATIGUE, EDEMA, OLIGURIA, HEMATURIA, ALBUMINURIA ACUTE GLOMERULONEPHRITIS • TREATMENT=REST, SALT RESTRICTION, MAINTAIN FLUID & ELECTROLYTE BALANCE, ANTIPYRETICS, DIURETICS, ANTIBIOTICS • WITH TREATMENT, KIDNEY FUNCTION IS USUALLY RESTORED, & PROGNOSIS IS GOOD CHRONIC GLOMERULONEPHRITIS • REPEATED CASES OF ACUTE NEPHRITIS CAN CAUSE CHRONIC NEPHRITIS • PROGRESSIVE, CAUSES SCARRING & SCLEROSING OF GLOMERULI • EARLY SYMPTOMS=HEMATURIA, ALBUMINURIA, HTN • WITH DISEASE PROGRESSION MORE GLOMERULI ARE DESTROYED CHRONIC GLOMERULONEPHRITIS • LATER SYMPTOMS=EDEMA, FATIGUE, ANEMIA, HTN, ANOREXIA, WEIGHT LOSS, CHF, PYURIA, RENAL FAILURE, DEATH • TREATMENT=LOW NA DIET, ANTIHYPERTENSIVE MEDS, MAINTAIN FLUIDS & ELECTROLYTES, HEMODIALYSIS, KIDNEY TRANSPLANT WHEN BOTH KIDNEYS ARE SEVERELY DAMAGED PYELONEPHRITIS • INFLAMMATION OF THE KIDNEY & RENAL PELVIS • CAUSE=PYOGENIC (PUS-FORMING) BACTERIA • SYMPTOMS=CHILLS, FEVER, BACK PAIN, FATIGUE, DYSURIA, HEMATURIA, PYURIA • TREATMENT=ANTIBIOTICS,
    [Show full text]
  • Role of Urinalysis in the Diagnosis of Chronic Kidney Disease (CKD)
    Research and Reviews Role of Urinalysis in the Diagnosis of Chronic Kidney Disease (CKD) JMAJ 54(1): 27–30, 2011 Kunitoshi ISEKI*1 Abstract As of the end of Year 2008, 1 out of 450 people was a dialysis patient in Japan, and patients with chronic kidney disease (CKD) at stages 3 and 4 accounted for nearly 10% of the total population. An epidemiological study in Okinawa that used the introduction of dialysis treatment as the outcome revealed that the 10-year cumulative incident rate of end-stage renal disease (ESRD) was about 3% of the participants who were positive (Ն 1ϩ) for both proteinuria and hematuria, while there was hardly any difference between those who were positive for hematuria alone and those who were negative for both proteinuria and hematuria. When the incidence of ESRD (dialysis introduction) was examined in relation to the severity of proteinuria (5 grades ranging from [Ϫ] to [Ն 3ϩ]) as determined by dipstick, the cumulative incidence rate during the 17-year observation period was 16% for proteinuria (Ն 3ϩ) and about 7% for proteinuria (2ϩ). In contrast, among participants who were negative for proteinuria, the rate of dialysis introduction in 10 years is about 1 out of 1 million. The CKD Practice Guide of the Japanese Society of Nephrology recommends referral to a nephrologist when a case meets any of the following 3 criteria: 1) 0.5g/g creatinine or higher, or proteinuria (Ն 2ϩ), 2) an estimated glomerular filtration rate of less than 50ml/min/1.73m2, or 3) positive results (Ն 1ϩ) for both proteinuria and hematuria tests.
    [Show full text]
  • Chronic Kidney Disease (Ckd)
    CHRONIC KIDNEY DISEASE ISSUE BRIEF prevent and control progressiveawareness obesity untreated end-stage renal disease kidney failure heart disease high blood pressure lifestyle changes stages complications family history damage to kidneys diabetes CKD few signs or symptoms PROGRESSION OF CHRONIC KIDNEY DISEASE (CKD) RISK FACTORS FOR CKD MAY INCLUDE ■ Heart Disease ■ Lupus ■ Diabetes ■ Family History of CKD ■ High Blood Pressure ■ Age ■ Obesity ■ High Cholesterol REDUCED INCREASED KIDNEY KIDNEY NORMAL KIDNEY RISK DAMAGE FUNCTION FAILURE Preventing CKD and its complications is possible by managing risk factors and treating the disease to slow its progression and reduce the risk of complications PROGRESSION OF CHRONIC KIDNEY DISEASE (CKD) What Is Chronic Kidney Disease? Fast Fact: Kidney diseases are the 9th leading cause of death in the United States. ■ Chronic kidney disease (CKD) is a condition in which a person has damaged kidneys or reduced kidney function for more than 3 months. During this time, the kidneys cannot properly filter waste out of the blood. If not detected and treated early, CKD can cause many health problems and even lead to kidney failure and early death. ■ CKD can start at any age, but the chances of developing it increase as people get older. It is most common among adults aged 70 years or older. ■ Once a person has CKD, it usually gets worse over time and lasts for the rest of the person’s life. Kidney failure—also called end-stage renal disease—is the final stage of CKD, when the kidneys stop working completely. How Big Is the CKD Problem and Who Is at Risk? Fast Fact: CDC estimates that more 6% than 20 million US adults aged 20 Unknown years or older have CKD—or more than 10% of the US adult population.
    [Show full text]
  • Hematuria in the Child
    Hematuria and Proteinuria in the Pediatric Patient Laurie Fouser, MD Pediatric Nephrology Swedish Pediatric Specialty Care Hematuria in the Child • Definition • ³ 1+ on dipstick on three urines over three weeks • 5 RBCs/hpf on three fresh urines over three weeks • Prevalence • 4-6% for microscopic hematuria on a single specimen in school age children • 0.3-0.5% on repeated specimens Sources of Hematuria • Glomerular or “Upper Tract” – Dysmorphic RBCs and RBC casts – Tea or cola colored urine – Proteinuria, WBC casts, renal tubular cells • Non-Glomerular or “Lower Tract” – RBCs have normal morphology – Clots/ Bright red or pink urine The Glomerular Capillary Wall The Glomerular Capillary Wall Glomerular Causes of Hematuria • Benign or self-limiting – Benign Familial Hematuria – Exercise-Induced Hematuria – Fever-Induced Hematuria Glomerular Causes of Hematuria • Acute Glomerular Disease – Poststreptococcal/ Postinfectious – Henoch-Schönlein Purpura – Sickle Cell Disease – Hemolytic Uremic Syndrome Glomerular Causes of Hematuria • Chronic Glomerular Disease – IgA Nephropathy – Henoch-Schönlein Purpura or other Vasculitis – Alport Syndrome – SLE or other Collagen Vascular Disease – Proliferative Glomerulonephritis Non-Glomerular Hematuria • Extra-Renal • UTI • Benign urethralgia +/- meatal stenosis • Calculus • Vesicoureteral Reflux, Hydronephrosis • Foreign body • Rhabdomyosarcoma • AV M • Coagulation disorder Non-Glomerular Hematuria • Intra-Renal • Hypercalciuria • Polycystic Kidney Disease • Reflux Nephropathy with Renal Dysplasia •
    [Show full text]
  • Hematuria Is a Risk Factor Towards End-Stage Renal
    Nephrology and Renal Diseases Research Article Hematuria is a risk factor towards end-stage renal disease - A propensity score analysis Tomoko Shima* Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan Abstract Background: It remains unclear whether microscopic hematuria accelerates the progression of chronic kidney disease (CKD). Since the risk of microscopic hematuria was expected very weak, we employed a propensity score analysis. Methods: A retrospective CKD cohort of 803 participants in a single institution was analyzed. The degree of microscopic hematuria was scaled as 0, 0.5, 1, 2, 3 for negative, ±, 1+, 2+, 3+ in the urinary qualitative analysis by dipstick, respectively. Time-averaged microscopic hematuria (TA-MH) was calculated by trapezoidal rule. The propensity score was estimated using 23 baseline covariates by multivariate binary logistic regression for the threshold of TA-MH at ≥ 0.5 or ≥ 1.0. Kaplan-Meier analysis after propensity score matching was also examined. Results: The incidence rate of end-stage renal disease (ESRD) was 33.9 per 1,000 person-years over median follow-up of 4.3 years. A Cox regression analysis stratified by quintile on the propensity scores showed that TA-MH ≥ 0.5 was a risk for ESRD (HR 1.72, 95% CI 1.08-2.75, p = 0.023) but not TA-MH ≥ 1.0 (HR 1.34, 95% CI 0.76-2.40, p = 0.315). Kaplan-Meier analysis after propensity score matching reproduced the similar results (TA-MH ≥ 0.5, HR 1.80, 95% CI 1.03-3.12, p = 0.046; TA-MH ≥ 1.0, HR 1.73, 95% CI 0.84-3.54, p = 0.145).
    [Show full text]
  • 2012 CKD Guideline
    OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF NEPHROLOGY KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease VOLUME 3 | ISSUE 1 | JANUARY 2013 http://www.kidney-international.org KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease KDIGO gratefully acknowledges the following consortium of sponsors that make our initiatives possible: Abbott, Amgen, Bayer Schering Pharma, Belo Foundation, Bristol-Myers Squibb, Chugai Pharmaceutical, Coca-Cola Company, Dole Food Company, Fresenius Medical Care, Genzyme, Hoffmann-LaRoche, JC Penney, Kyowa Hakko Kirin, NATCO—The Organization for Transplant Professionals, NKF-Board of Directors, Novartis, Pharmacosmos, PUMC Pharmaceutical, Robert and Jane Cizik Foundation, Shire, Takeda Pharmaceutical, Transwestern Commercial Services, Vifor Pharma, and Wyeth. Sponsorship Statement: KDIGO is supported by a consortium of sponsors and no funding is accepted for the development of specific guidelines. http://www.kidney-international.org contents & 2013 KDIGO VOL 3 | ISSUE 1 | JANUARY (1) 2013 KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease v Tables and Figures vii KDIGO Board Members viii Reference Keys x CKD Nomenclature xi Conversion Factors & HbA1c Conversion xii Abbreviations and Acronyms 1 Notice 2 Foreword 3 Work Group Membership 4 Abstract 5 Summary of Recommendation Statements 15 Introduction: The case for updating and context 19 Chapter 1: Definition, and classification
    [Show full text]