Differential Diagnosis of Hematuria Anatomy- renal cyst, AVM, hydronephrosis Boulders- renal stone, hypercalciuriaCancer- Wilms tumor , adenocarcinomaDrug-related- cyclophosphamideExerciseForeign body ; Familial- Alports syndrome GlomerulonephritisHematology- hemoglobinopathy, coagulopathyInfection- viral, bacterial, fungal

Localization of HematuriaGlomerular Brown or tea-colored RBC cast, cellular castTubular cellsProteinuria >2+Dysmorphic erythrocytesErythrocyte volume

Recurrent gross hematuriaIgA nephropathyIdiopathic (benign familial) hematuriaAlport syndromeIdiopathic hypercalciuria

Renal biopsy- indicationHematuria of unknown causePersistant non-orthstatic proteinuriaRPGNNS resistant to steroid Suspected familial nephritisCRF of unknown causeSLE, HSPMonitor course of GN in response to Tx

Renal biopsy- complicationMacroscopic hematuria, self-limited (5%)Hematuria requiring transfusion (0.5-2%) Perineral hematoma (0.5-1.5%)AV fistula (0.5%)Puncture of viscera, vessel, infection, sepsisDeath (< 0.1%)