Microscopic Hematuria

Cohen, Robert A.; Brown, Robert S.

doi:10.1056/nejmcp012694

Cited by 222 publications

(87 citation statements)

References 42 publications

(28 reference statements)

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“…reported that urine microscopy was often second only to renal biopsy in making a diagnosis. Other guidelines also stress the role of urinary sediment as a discriminating diagnostic instrument in patients with hematuria29, 30, 31, 32.…”

Section: Discussionmentioning

confidence: 99%

Dysmorphic erythrocytes are superior to hematuria for indicating non‐diabetic renal disease in type 2 diabetics

Dong

Wang

Qiu

et al. 2015

J of Diabetes Invest

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Aims/IntroductionThere are sparse and limited studies on erythrocyte morphology in renal biopsy identifying nephropathic patients among type 2 diabetics. The present study sought to clarify the predictive value of dysmorphic erythrocytes in type 2 diabetics with non‐diabetic renal disease and influences on hematuria.Materials and MethodsWe examined 198 patients with type 2 diabetes who underwent kidney biopsies between 2012 and 2013. Hematuria was defined as >3 or >10 red blood cells per high‐power field (RBCs/hpf) in urine sediment. If >80% of the erythrocytes were dysmorphic, glomerular hematuria was diagnosed. Clinical findings and predictive value of dysmorphic erythrocytes were compared between patients with hematuria (n = 19) and those without (n = 61). The potential risk factors for hematuria among diabetic nephropathy patients were also screened.ResultsThere was a statistically significant difference between the diabetic nephropathy group and the non‐diabetic renal disease group (6.6 vs 16.8%; P = 0.04) when the demarcation point of hematuria was 10 RBCs/hpf. When the definition of hematuria was based on an examination of urinary erythrocyte morphology, a marked difference was seen (3.3 vs 24.8%; P < 0.001). Glomerular hematuria showed high specificity and a positive predictive value (0.97 and 0.94, respectively) in non‐diabetic renal disease. A multivariate analysis showed that nephrotic syndrome was significantly associated with hematuria (odds ratio 3.636; P = 0.034).ConclusionsDysmorphic erythrocytes were superior to hematuria for indicating non‐diabetic renal disease in type 2 diabetics. Nephrotic syndrome was an independent risk factor for hematuria.

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Section: Discussionmentioning

confidence: 99%

Dysmorphic erythrocytes are superior to hematuria for indicating non‐diabetic renal disease in type 2 diabetics

Dong

Wang

Qiu

et al. 2015

J of Diabetes Invest

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“…In gynecologic section, it was demonstrated that hematuria can be used as a screening test to detect urinary bladder mucosal infiltration of cervical cancer (Chuttiangtum et al, 2012). It has been reported that Urological cancer is found in approximately 5% of the patients presenting with microscopic hematuria, and in around 20% of the patients with gross hematuria (Khadra et al, 2000;Cohen and Brown, 2003). Therefore, screening for bladder cancer may have different performance characteristics in selected high-risk populations.…”

Section: Discussionmentioning

confidence: 99%

External Validation of a Clinical Scoring System for Hematuria

Lee

Kim

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: The aim of this study was to evaluate the accuracy of a new scoring system in Korean patients with hematuria at high risk of bladder cancer. Materials and Methods: A total of 319 consecutive patients presenting with painless hematuria without a history of bladder cancer were analyzed, from the period of August 2012 to February 2014. All patients underwent clinical examination, and 22 patients with incomplete data were excluded from the final validation data set. The scoring system included four clinical parameters: age (≥50 = 2 vs. <50 =1), gender (male = 2 vs. female = 1), history of smoking (smoker/ex-smoker = 4 vs. non-smoker = 2) and nature of the hematuria (gross = 6 vs. microscopic = 2). Results: The area under the receiver-operating characteristic curve (95% confidence interval) of the scoring system was 0.718 (0.655-0.777). The calibration plot demonstrated a slight underestimation of bladder cancer probability, but the model had reasonable calibration. Decision curve analysis revealed that the use of model was associated with net benefit gains over the treat-all strategy. The scoring system performed well across a wide range of threshold probabilities (15%-45%). Conclusions: The scoring system developed is a highly accurate predictive tool for patients with hematuria. Although further improvements are needed, utilization of this system may assist primary care physicians and other healthcare practitioners in determining a patient's risk of bladder cancer.

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“…A GP may currently have difficulty justifying a failure to refer urgently a 60-year-old male with a single prostatespecific antigen (PSA) of 6 (yet 10% of males aged 50-70 years have a raised PSA), or microscopic haematuria in a 60-year-old female (yet reported prevalence rates are up to 16.1% 8 ). The litigation bill for the NHS for delayed diagnosis of cancer is significant, and better data should help to make guidelines more robust and justifiable.…”

Section: 3mentioning

confidence: 99%

The predictive value of cancer symptoms in primary care

Barraclough

2010

Br J Gen Pract

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Microscopic Hematuria

Cited by 222 publications

References 42 publications

Dysmorphic erythrocytes are superior to hematuria for indicating non‐diabetic renal disease in type 2 diabetics

Dysmorphic erythrocytes are superior to hematuria for indicating non‐diabetic renal disease in type 2 diabetics

External Validation of a Clinical Scoring System for Hematuria

The predictive value of cancer symptoms in primary care

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