Investigating asymptomatic invisible haematuria.

Barnaby Hole, Charles Tomson, Timothy Whittlestone

Research output: Contribution to journalArticle (Academic Journal)

Abstract

When invisible haematuria is detected ask the patient about urinary tract symptoms

Regard two out of three positive dipstick tests as confirmation of persistent invisible haematuria

Visible haematuria is associated with cancer in 8-25% of cases, but invisible haematuria in only 2.6%. Fewer than 0.5% of people investigated for asymptomatic invisible haematuria aged under 50 years have cancer

A focused history and examination, estimated glomerular filtration rate, and urinary albumin:creatinine ratio inform further management. Proteinuria and loss of excretory renal function are associated with greater risk of progressive kidney disease—a nephrology opinion is warranted in such cases. Many patients do not need a biopsy and can be monitored in the community

Current UK and US guidelines advocate urological referral to exclude cancer in smokers and people over 35-40 years of age, but patients should be made aware that fewer than 3% of investigated cases have cancer
Original languageEnglish
Pages (from-to)349
JournalBMJ
DOIs
Publication statusPublished - 17 Nov 2014

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