Causes

Glomerular

Primary glomerulonephritis

• Alport syndrome
• Thin basement membrane disease
• IgA nephropathy
• Pauci-immune (ANCA-related) vasculitis/anti–glomerular basement membrane disease

Secondary glomerulonephritis

• Henoch-Schönlein purpura
• Systemic lupus erythematosus
• Infection-related glomerulonephritis
• Thrombotic microangiopathies (eg, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, scleroderma renal crisis, malignant hypertension)
Associated with other glomerular pathology
• Diabetic nephropathy
• Focal segmental glomerular sclerosis
• Minimal change disease

• Membranous nephropathy

 

Tubular/interstitial
• Interstitial nephritis
• Papillary necrosis
• Analgesic nephropathy

• Pyelonephritis

 

Structural kidney disease–related
• Acquired or hereditary cystic disease
• Medullary sponge kidney
Vascular
• Renal vein thrombosis
• Renal infarct/necrosis
• Arteriovenous malformations

• Nutcracker syndrome

 

Urothelial
• Malignancy (involving the kidney, ureters, bladder, or prostate)
• Nephrolithiasis
• Nephrocalcinosis
• Hypercalciuria
• Strictures
• Indwelling catheters
• Benign prostatic hypertrophy

• Bladder or ureteral polyps

 

Medications
• Cyclophosphamide/ifosfamide
• Anticoagulation associated
Other, not rare
• Infectious (pyelonephritis, cystitis, urethritis, prostatitis, schistosomiasis, tuberculosis, polyoma virus)
• Rejection or trauma in a kidney transplant
• Pelvic radiation
• Bleeding disorders: sickle cell disease, sickle cell trait, hemophilia A or B, thrombocytopenia
• After instrumentation of the urinary tract or trauma

• Contamination from menstrual bleeding

 

Rare
• Endometriosis of the urinary tract
• Loin pain hematuria syndrome

Urinary tract infection, Cystitis, Prostatitis, Enlarged prostate, Passage of renal calculi, infection-related glomerulonephritis (or IgA nephropathy)

  • Use urinalysis to confirm hematuria (both macroscopic and microscopic) and to determine whether blood has a glomerular (nephrologic) or nonglomerular (urologic) origin by morphologic characteristics

 

Chief Complaint: Hematuria

Pivotal Assessment Finding

History

 

 

 

 

 

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