Assessment and management of non-visible haematuria in primary care

doi:10.1136/bmj.a3021

Published 16 January 2009, doi:10.1136/bmj.a3021
Cite this as: BMJ 2009;338:a3021

Clinical Review

Assessment and management of non-visible haematuria in primary care

John D Kelly, senior lecturer¹, Derek P Fawcett, consultant urologist², Lawrence C Goldberg, consultant nephrologist³

¹ Department of Oncology, Cambridge University, Addenbrooke’s Hospital, Cambridge CB2 0QQ, ² Harold Hopkins Department of Urology, Royal Berkshire Hospital, Reading RG1 5AN, ³ Sussex Kidney Unit, Brighton and Sussex University Hospitals NHS Trust, Royal Sussex County Hospital, Brighton BN2 5BE

Correspondence to: J D Kelly jk334@cam.ac.uk

The first 150 words of the full text of this article appear below.

The terms visible haematuria should replacemacroscopic or gross haematuria, and non-visible haematuria(both symptomatic and asymptomatic) should replace microscopichaematuria or dipstick positive haematuria

Urine testing forhaematuria should be performed for clinical reasons only—currentevidence does not support opportunistic testing

The test ofchoice for diagnosing haematuria is urine dipstick analysis—scoresof $≥$ 1+ are positive

Transient or spurious causes of haematurianeed to be excluded

All patients aged $≥$ 40 with haematuria shouldbe investigated for urological disease

All patients with noidentified urological cause should be monitored long term

Many clinicians are not sure what constitutes clinically relevanthaematuria; they are also unsure about when patients with haematuriashould be referred for specialist assessment and whether theyshould be referred to a urologist, nephrologist, or both.

In 2006 the National Institute for Health Research, Health TechnologyAssessment (NIHR HTA) commissioned a systematic review of theevidence for the . . . [Full text of this article]

Transient
Spurious
Urologicalcauses
Nephrologicalcauses

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