Prevalence of microhematuria in renal colic and urolithiasis: a systematic review and meta-analysis

Abstract

Background: This systematic review and meta-analysis aims to investigate the prevalence of microhematuria in patients presenting with suspected acute renal colic and/or confirmed urolithiasis at the emergency department. Methods: A comprehensive literature search was conducted to find relevant data on prevalence of microhematuria in patients with suspected acute renal colic and/or confirmed urolithiasis. Data from each study regarding study design, patient characteristics and prevalence of microhematuria were retrieved. A random effect-model was used for the pooled analyses. Results: Forty-nine articles including 15′860 patients were selected through the literature search. The pooled microhematuria prevalence was 77% (95%CI: 73-80%) and 84% (95%CI: 80-87%) for suspected acute renal colic and confirmed urolithiasis, respectively. This proportion was much higher when the dipstick was used as diagnostic test (80 and 90% for acute renal colic and urolithiasis, respectively) compared to the microscopic urinalysis (74 and 78% for acute renal colic and urolithiasis, respectively). Conclusions: This meta-analysis revealed a high prevalence of microhematuria in patients with acute renal colic (77%), including those with confirmed urolithiasis (84%). Intending this prevalence as sensitivity, we reached moderate values, which make microhematuria alone a poor diagnostic test for acute renal colic or urolithiasis. Microhematuria could possibly still important to assess the risk in patients with renal colic.

The Use of Visual Analogue Scale Score as a Predicting Tool in Differentiating Renal Colic From Lumbar Back Pain

“…In our study, we also evaluated these parameters. Hematuria, a parameter that can be considered as stone-specific, shows a very high prevalence in patients with renal colic [ 24 ]. In our study, although there was a significant difference between groups in paired comparisons, we observed that 10 patients with LBP had microscopic hematuria without significant findings on CT or US, and this hematuria disappeared after symptomatic treatment.…”

“…In our study, although there was a significant difference between groups in paired comparisons, we observed that 10 patients with LBP had microscopic hematuria without significant findings on CT or US, and this hematuria disappeared after symptomatic treatment. In their meta-analysis, Minotti et al also emphasized that microhematuria was not sufficient to be a stone-specific symptom [ 24 ]. Again, it is remarkable that nausea-vomiting, which is thought to develop secondary to tension in the kidney capsule and hydronephrosis, was not observed in most of our patients, but was seen in a small number of patients with LBP.…”

Haematuria in adults

“…They are commonly accompanied by NVH, but VH may be seen. It is worth noting that up to 10–30% of stones (number varies by report) are not associated with haematuria, despite confirmed radiological evidence of stone disease (Minotti et al., 2020).…”

“…They are commonly accompanied by NVH, but VH may be seen. It is worth noting that up to 10-30% of stones (number varies by report) are not associated with haematuria, despite confirmed radiological evidence of stone disease (Minotti et al, 2020). The management of stone disease is complex, with several factors determining management (either on an emergency, or urgent outpatient basis).…”

Metabolic evaluation: is there really a future?

“…This can result from a prerenal cause, such as dehydration (in case of vomiting), or from a postrenal cause, such as unilateral or bilateral obstruction. Unilateral obstruction in patients with solitary kidney and bilateral obstruction are responsible for higher creatinine levels [12,13]. Another important analysis is the serum calcium.…”