Abstract
Hematuria is a common clinical finding and has a wide spectrum of possible causes.
Erythrocytes can originate from any part of the genitourinary tract. An urine dipstick
test is the first step in diagnostic approach. Medical history may help to narrow
down the range of causes: arterial hypertension or a family history of renal disease
may indicate a renal disease. Risk factors for an urinary tract malignoma point to
an urological origin. If the microscopy shows more than 5 % acanthocytes in the urine
sediment, a glomerular cause can be assumed. Normal erythrocytes suggest a non-glomerular
cause. A nephrologist should be consulted if urine sediment microscopy and other clinical
features (e. g. clinically relevant proteinuria, elevated serum creatinine) indicate
a renal disease. In this case, a renal biopsy should be considered to confirm the
diagnosis of glomerulopathy and to develop a treatment plan. If an urological pathology
is suspected, sonography should be complemented by a multi-phasic computed tomography.
Based on the imaging results, a retrograde ureteroscopy should be considered. Repeated
urinalysis on an annual basis for two consecutive years is recommended, if no diagnosis
can be established.
Der Nachweis von Blut im Urin ist ein häufiger Befund im klinischen Alltag. Die detektierten
Blutzellen können dabei aus dem gesamten Harntrakt stammen: Von den glomerulären Filtereinheiten
der Niere bis hin zum Ausgang der Harnröhre. Da die Hämaturie auf schwerwiegende Erkrankungen
hinweisen kann, ist eine strukturierte Abklärung notwendig [1].
Schlüsselwörter
Hämaturie - Algorithmus - Glomerulonephritis - Harnblasentumor
Key words
hematuria - algorithm - glomerulonephritis - urinary bladder neoplasm
