Microscopic haematuria Role of renal biopsy is undervalued

BMJ 1994;309:874-875 (1 October)

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Microscopic haematuria Role of renal biopsy is undervalued

EDITOR, - Fritz H Schroder emphasises the central importanceof cystoscopy in the investigation of microscopic haematuria,regarding renal biopsy as required in only a minority of patients.¹We have commented previously on the disadvantage of this approach,which is likely falsely to reassure some patients with glomerulardisease, which may be progressive.²

Schroder relies on urinary red cell morphology to distinguishglomerular from non-glomerular haematuria and thus to directthe use of renal biopsy. Although both phase contrast microscopyand the alternative Coulter counter analysis of urinary redcells have been advocated enthusiastically, some authors havereported finding them unhelpful, particularly when the numberof red cells is low³; the two techniques have not entered widelyinto British nephrological practice.⁴

We recently reported our experience in 165 patients with microscopichaematuria (aged 18-70) who underwent both renal biopsy andcystoscopy.⁵ We found evidence of glomerular disease in 73 . . . [Full text of this article]

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Microscopic haematuria: Fritz H Schroder
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