Clinical significance of gross hematuria and its evaluation in patients receiving anticoagulant and aspirin treatment

Avidor, Yoav; Nadu, Andrei; Matzkin, Haim

doi:10.1016/s0090-4295(99)00388-x

Cited by 56 publications

(31 citation statements)

References 11 publications

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“…203,204 A retrospective analysis of all patients presenting with gross hematuria over a 9-year period while taking anticoagulant or aspirin therapy found that 25% (six of 25) of those patients presenting with hematuria were found to have a tumor. 205 Several studies addressed the question of GI bleeding. A retrospective series of 166 patients presenting with lower GI bleeding, with 100 of the patients taking an antiplatelet or anticoagulant and 66 not, found that nine of 88 (10.2%) patients taking anticoagulants had colon cancer compared with two of 62 (3.2%) not taking anticoagulants.…”

Section: Investigating Anticoagulant-associated Bleedingmentioning

confidence: 99%

Evidence-Based Management of Anticoagulant Therapy

Holbrook

Schulman

Witt

et al. 2012

Chest

1,066

348

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Section: Investigating Anticoagulant-associated Bleedingmentioning

confidence: 99%

Evidence-Based Management of Anticoagulant Therapy

Holbrook

Schulman

Witt

et al. 2012

Chest

1,066

348

View full text Add to dashboard Cite

“…In these studies, genitourinary tract pathology including carcinoma, calculi, renal infarction, and/or infection was noted in 30-60% of patients taking warfarin and presenting with hematuria, with considerable variance between studies. 9,13, 14 The strengths of the present study are the relatively large sample size, and the inclusion of a propensity score-matched control group of patients who were not taking warfarin. This study emphasizes the importance of complete evaluation of hematuria in patients receiving anticoagulation therapy.…”

Section: Clinical Significance Of Hematuria In Oat Patientsmentioning

confidence: 99%

“…9,11,13, 14 Furthermore, in some forms of malignancy such as stomach or colorectal cancer, anticoagulantrelated gastrointestinal bleeding was found to facilitate early detection of malignant gastrointestinal lesions. 15, 16 Thorough evaluation of anticoagulant-related bleeding is critical to detect malignancy during the potential window of curability, 17 but, although hematuria is not an uncommon complication in patients with OAT, there are limited data on the impact of anticoagulation on evaluation and management.…”

mentioning

confidence: 99%

Clinical Significance of Hematuria in Atrial Fibrillation With Oral Anticoagulation Therapy

Kim

Uhm

et al. 2017

Circ J

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Background: Hematuria is a common and important complication in atrial fibrillation (AF) patients on oral anticoagulation therapy (OAT). This study evaluated the clinical significance of hematuria and its relationship with genitourinary disease in AF patients receiving OAT. Methods and Results:Among 20,456 consecutive AF patients who visited a tertiary hospital from January 2005 to April 2015, 5,833 had hematuria. Of these 5,833 patients, 3,798 were on OAT (OAT(+) group) and 2,035 were not (OAT(-) group). A total of 1,785 patients from each group were then matched on propensity score analysis. The prevalence of cancer and other diseases in the genitourinary tract was evaluated. While there was no difference in the prevalence of genitourinary stones or urinary tract infection, genitourinary cancer was significantly more common in the OAT(+) group than in the OAT(-) group (1.6% vs. 0.7%, P=0.011). Bladder cancer was the most common genitourinary malignancy, and it was significantly more common in the OAT(+) group (1.2% vs. 0.5%, P=0.019). Subjects on warfarin were more likely to have bladder cancers of lower pathologic grade (63.6% vs. 33.3%, P=0.124). Conclusions:OAT was associated with a higher prevalence and early detection of genitourinary cancer in AF patients with hematuria. Meticulous evaluation of the cause of hematuria is necessary in AF patients with hematuria receiving OAT.

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“…However, an underlying malignancy was found in 24% and 7% of patients in two separate series and thorough urological evaluation should not be foregone in patients receiving anticoagulants [16, 17]. …”

Section: Investigation Of Haematuriamentioning

confidence: 99%

Haematuria: An Imaging Guide

Moloney

Murphy

Twomey

et al. 2014

Advances in Urology

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This paper discusses the current status of imaging in the investigation of patients with haematuria. The physician must rationalize imaging so that serious causes such as malignancy are promptly diagnosed while at the same time not exposing patients to unnecessary investigations. There is currently no universal agreement about the optimal imaging work up of haematuria. The choice of modality to image the urinary tract will depend on individual patient factors such as age, the presence of risk factors for malignancy, renal function, a history of calculus disease and pregnancy, and other factors, such as local policy and practice, cost effectiveness and availability of resources. The role of all modalities, including conventional radiography, intravenous urography/excretory urography, ultrasonography, retrograde pyelography, multidetector computed tomography urography (MDCTU), and magnetic resonance urography, is discussed. This paper highlights the pivotal role of MDCTU in the imaging of the patient with haematuria and discusses issues specific to this modality including protocol design, imaging of the urothelium, and radiation dose. Examination protocols should be tailored to the patient while all the while optimizing radiation dose.

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Clinical significance of gross hematuria and its evaluation in patients receiving anticoagulant and aspirin treatment

Cited by 56 publications

References 11 publications

Evidence-Based Management of Anticoagulant Therapy

Evidence-Based Management of Anticoagulant Therapy

Clinical Significance of Hematuria in Atrial Fibrillation With Oral Anticoagulation Therapy

Haematuria: An Imaging Guide

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