What is the differential diagnosis for hematuria?

October 17, 2020 12:34 am Published by

Pre-renal causes:

  • Hematologic (coagulopathy, sickle cell disease, thromboembolism)
  • Leukemia
  • Neoplasms
  • Drugs (anticoagulants)

Renal causes:

  • Trauma
  • Infarct
  • Obstruction (renal colic, urolithiasis)
  • Neoplasms (renal cell carcinoma, bladder cancer, prostate cancer, Wilms tumor)
  • Inflammation (pyelonephritis, glomerulonephritis, interstitial nephritis)
  • Connective tissue disorders (Wegner’s, Goodpasture’s disease, SLE, Churg-Strauss, Henoch-Schonlein purpura, polyarteritis nodosa)
  • Hereditary (polycystic kidneys, Alport’s syndrome, arteriovenous malformation)

Post-renal causes:

  • Obstruction (nephrolithiasis, polyps, tumor, urethral stricture)
  • Inflammation (prostatitis, cystitis, urethritis)

Pseudohematuria:

  • Vaginal bleeding
  • Dyes (beets, rhodamine B)
  • Hemoglobin (hemolytic anemia)
  • Myoglobin (rhabdomyolysis)
  • Drugs (rifampin, phenazopyridine, pyridium, phenytoin)
  • Porphyria
  • Laxatives (phenolphthalein)

Gross painless hematuria is bladder cancer until proven otherwise.

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This post was written by Omar Rifai