Acute Medicine | Renal | Investigation and management of haematuria

Investigation and Management of Haematuria
Session Overview
Description
The session covers the features in the history and examination along with initial tests that can help distinguish between glomerular and urological causes of haematuria. An algorithm including indications for referral to Nephrology and Urology will be covered.

Learning Objectives
By the end of this session you will be able to:

• Classify visible and non-visible haematuria
• Recall the basic anatomy of the renal tract and apply this to describe the main causes of haematuria
• Describe the key features in the examination, and what simple bedside tests to perform, in order to determine whether the haematuria is likely to be glomerular or from the urological tract
• Order and interpret initial investigations for haematuria
• Identify the indications for nephrological or urological opinion
• Identify when a rapidly progressive glomerulonephritis may be present and describe the indications for urgent nephrological opinion

Non-visible haematuria is common, occurring in around 4% of the population [1]. It can signify serious disease or follow a more benign course so it is important to be able risk stratify patients to identify those who need urgent urological or nephrological evaluation.

There is frequently confusion regarding whether a patient should be referred to Urology or Nephrology and this can delay the appropriate investigations and management.

A thorough history and examination in combination with simple tests can distinguish between patients who can be reassured and those who need referral to Nephrology or Urology.