Diagnostic algorithm for the evaluation of hematuria.
OBJECTIVE
To present a logical and cost-effective diagnostic approach for primary care physicians to a common symptom, hematuria.


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


CONCLUSIONS
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.


CONCLUSIONS
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.
Shen
Xinying
X
Adult Acute Care Nurse Practitioner Program, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. xinyings@yahoo.com
D000465:Algorithms; D019985:Benchmarking; D015984:Causality; D003362:Cost-Benefit Analysis; D003558:Cystoscopy; D003663:Decision Trees; D003937:Diagnosis, Differential; D006417:Hematuria / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008403:Mass Screening / Q000191:economics / Q000379:methods* / Q000451:nursing; D008487:Medical History Taking; D009722:Nurse Practitioners; D009730:Nursing Assessment; D010808:Physical Examination; D011320:Primary Health Care / Q000191:economics / Q000379:methods*; D011934:Reagent Strips; D014057:Tomography, X-Ray Computed; D016482:Urinalysis; D014567:Urography
D011934:Reagent Strips