Diagnostic algorithm for the evaluation of hematuria.

PURPOSE

To present a logical and cost-effective diagnostic approach for primary care physicians to a common symptom, hematuria.

DATA SOURCE

Selected research, review articles, as well as medical textbooks and current government guidelines.

CONCLUSION

Dipstick test and microscopic urinalysis are two common screening tests for hematuria. Once hematuria is discovered, its etiology should be investigated through a comprehensive history, a focused physical examination, laboratory studies, and radiographic imaging. Microscopic urinalysis is simple yet important in distinguishing glomerular from nonglomerular sources of bleeding. Intravenous urography, renal ultrasonography, or computed tomography may be needed to determine the location and characteristics of lesions. Cytoscopy is important in evaluating lower urinary tract lesions.

IMPLICATIONS FOR PRACTICE

Hematuria is a frequently encountered symptom that has a broad differential diagnosis ranging from insignificant etiology to potentially life-threatening neoplastic lesions. A systematic method can be useful in efficiently and cost-effectively managing hematuria. Early and appropriate diagnosis of this common symptom results in improved clinical outcomes.