Hematuria/proteinuria

Basics

Description

  • Microscopic hematuria: ≥3 red blood cells per high-power field in 2 of the 3 properly collected urine specimens
  • Gross hematuria: Visible blood in properly collected urine specimen
  • Proteinuria: Urinary protein excretion of >150 mg/d
  • Risk factors for disease in asymptomatic proteinuria:
    • Diabetes
    • HTN
    • NSAID abuse
    • Heroin use
  • Risk factors for disease in asymptomatic hematuria:
    • Tobacco use
    • Occupational exposure to benzenes, aromatic amines, and dyes
    • History of gross hematuria
    • Age >40 yr old
    • History of urologic disorder or disease
    • History of painful voiding
    • History of UTI
    • Analgesic abuse
    • History of pelvic irradiation

Etiology

  • Proteinuria:
    • Glomerular:
      • Nephritic (postinfectious, IgA, lupus, vasculitis)
      • Nephrotic (minimal change, diabetes, preeclampsia)
    • Tubular
    • Overflow (hemolysis, rhabdomyolysis, multiple myeloma)
    • Postrenal proteinuria
  • Hematuria:
    • UTI
    • Stones (renal, bladder)
    • BPH
    • Cancer (bladder, renal, prostate)
    • Transient unexplained
    • Acute glomerulonephritis

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