Determining The Cause Of Microscopic Hematuria

clinical topics diabetes gu lab interpretation nephrology Nov 08, 2022

It’s not unusual to be taken by surprise when you see microscopic hematuria on urine dip results. The patients who end up with this as part of their presentation are often asymptomatic, and may even be giving you a urine sample for another reason – which can make chasing down the cause even more of a mystery.

Spoiler alert: hematuria, of any kind, is a clue to a larger issue and requires further investigation. It can be tempting to downplay the seriousness of microscopic hematuria, especially if the patient is not experiencing symptoms. But regardless of whether you expected to see microscopic hematuria as part of this visit, you found it - and it’s your responsibility to take the next steps to work it up.

Most Often, The Cause Of Microscopic Hematuria Is Either Urologic-Related Or Kidney-Related

If you don’t know where to start when it comes to determining the cause of microscopic hematuria, you’re not alone. In this video, we will cover a high-level approach to investigating a finding of microscopic hematuria. We will go over the workup for microscopic hematuria, and lots more:

What is the difference between microscopic and macroscopic hematuria?
When a urine dip is enough, and when you need to send the sample out
What white blood cells and protein in the sample can tell you
Essential history and symptom questions to ask
When to repeat the urine dip at another time

Having a simple framework for approaching the sometimes mysterious microscopic hematuria will increase your confidence and help you to take the best care of your patients. Getting to the root cause of microscopic hematuria is another critical part of taking great care of the patients you work with. And if you are interested in getting a deeper understanding of the causes of microscopic hematuria and nuances of approaches to treatment, check out the Lab Interpretation Crash Course.