Urine Asymptomatic haematuria
Haematuria Aetiology
Aetiology 1. IgA nephropathy
Renal congenital: PKD, trauma, infection: Commonest GN in developed world
pyelonephritis, neoplasm, immune: GN Signs + symptoms
Extra-renal trauma: stones/catheter, Young male w/ episodic macroscopic
infection: cystitis, prostatitis, urethritis, haematuria occurring a few days after URTI
neoplasm: bladder, prostate, drugs:
Rapid recovery between attacks
NSAIDs, furosemide, ciprofloxacin,
cephalosporins High IgA can occasionally nephritic
Ix biopsy IgA deposition in mesangium
Proteinuria Mx steroids/cyclophosphamide if reduced
30mg/dL = + renal function
300mg/dL = +++ 2. Thin basement membrane
PCR < 20mg/mM = normal Autosomal dominant
PCR > 300mg/mM = nephrotic Commonest cause of asymptomatic
Aetiology DM, minimal change, haematuria
membranous, amyloidosis, SLE Signs + symptoms
Persistent, asymptomatic microscopic
Microalbuminaemia
Albumin: 30-300mg/24h haematuria, very small risk of ESRF
Aetiology DM, high BP, minimal change 3. Alport syndrome
GN 85% X-linked recessive
Casts Haematuria, proteinuria progressive RF
RBC glomerular haematuria SNHL, lens dislocation + cataracts, renal
WBC interstitial nephritis/pyelonephritis ‘flecks’
Tubular ATN Females: haematuria only
Urea + Creatinine Haematuria Mx
Creatinine Testing
Synthesized during muscle turnover Urine dipstick is the test of choice for
Freely filtered + small portion secreted by detecting haematuria
PCT Persistent non-visible = blood present
Increase muscle mass high creatinine: 2/3 samples tested 2-3 weeks apart
age, sex, race Renal function ACR, PCR + BP should be
Plasma Cr doesn’t rise above normal until
tested
50% reduction in GFR
MCS
Urea
Produced from NH3 by liver in ornithine Urgent referral (i.e. w/i 2 weeks)
cycle Aged ≥ 45 yrs + unexplained visible
High w/ protein meal (e.g. upper GI bleed,
haematuria w/o UTI
supplements)
Low w/ hepatic impairment
OR visible haematuria that
10-70% absorbed back: depends on urine persists/recurs after Rx for UTI
flow Aged ≥ 60 yrs + unexplained non-visible
Low flow High urea reabsorption (e.g. haematuria + either dysuria/raised WCC
dehydration) Non-urgent referral
Interpretation
Aged ≥ 60 yrs + recurrent/persistent
Isolated high urea = low flow (e.g. unexplained UTI
hypoperfusion/ dehydration)
High urea + creatinine = low filtration (i.e.
renal failure)
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Noteorious. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for £2.99. You're not tied to anything after your purchase.
