Macroscopic haematuria is Urology
Microscopic haematuria is Nephrology, or in people over say 40-50 may be urological. It is common in healthy people and investigation should be limited and proportionate. Microscopic haematuria can be detected by testing urine with a urine dipstick test. These are commercially available biochemical tests on a strip. This is an example of a near-patient test.
Actual confirmation of dipstick detected microscopic haematuria by light microscopy may not be helpful as erythrocytes may lyse in acidic urine and after prolonged storage. The Papanicolaou staining process also includes a fixation step with glacial acetic acid, that also causes haemolysis.
- Urinary tract malignancy, e.g. urothelial carcinoma or renal cell carcinoma
- Polycystic kidney disease
- Glomerulonephritides, particularly those which result in nephritic syndrome
- Renal stones
- Thin basement membrane disease
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