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approach to hematuria/proteinuria

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by

Omar Eltawansy

on 12 April 2014

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Transcript of approach to hematuria/proteinuria

Approach to a patient with
Haematuria
/
Proteinuria

causes
bleeding !
Macroscopic
Microscopic
dipstick test
+ve
Hematuria
Haemoglobinuria
Myoglobinuria
Urine Microscopy
No RBCs
WBCs
abnormal
epith. cells
Red cell
casts
investigations
Haematuria on repeated
urine dipsticks
Exclude menstruation,
infection, trauma
Red cells confirmed on urine microscopy
infection absent on culture
Renal imaging
to exclude anatomical
bleeding lesion: renal US, cystoscopy
anatomical lesion
present
full assessment
and management
(urology/oncology)
anatomical lesion
absent
Are there features of significant
renal disease?
e.g.
Proteinuria
Hypertension
Abnormal renal function
Family history of renal disease
Yes
No
consider renal
biopsy
observation
Urine test, Bp, creatinine
every 6 - 24 months
Re-refer if anything changes
investigations
Microalbuminuria
Nephrotic syndrome
Bence Jones
Proteinuria
Reference
:
Davidson's principles and practice
of medicine 21nd edition
Full transcript