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
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 language | English |
|---|---|
| Pages (from-to) | 349 |
| Journal | BMJ |
| DOIs | |
| Publication status | Published - 17 Nov 2014 |