Evaluation of visible hematuria

Last reviewed: 6 Apr 2025
Last updated: 25 Jun 2024

Summary

Differentials

Common

  • Benign prostatic hyperplasia (BPH)
  • Urinary tract infection (UTI)
  • Acute pyelonephritis
  • Bladder cancer
  • Prostate cancer
  • Kidney stone
  • Instrumentation of the urinary tract
  • Menstruation
Full details

Uncommon

  • Renal trauma
  • Bladder trauma
  • Urethral trauma
  • Sickle cell anemia
  • Coagulopathy
  • Cystic renal disease
  • Arteriovenous malformation
  • Renal vein thrombosis
  • Alport syndrome
  • Extrapulmonary tuberculosis
  • Benign familial hematuria (thin basement membrane nephropathy)
  • Postinfectious glomerulonephritis
  • Membranoproliferative glomerulonephritis
  • Rapidly progressive glomerulonephritis
  • IgA nephropathy
  • Systemic lupus erythematosus (SLE)
  • Renal cancer
  • Metastatic cancer
  • Urethral cancer
  • Penile cancer
  • Placenta percreta
  • Endometriosis
  • Bladder stone
  • Radiation cystitis
  • Nephrotoxic/cytotoxic medications
  • Anticoagulation
  • Exercise-induced hematuria
  • Loin pain hematuria syndrome
  • Medication
  • Food-related
Full details

Contributors

Authors

Simon Y. Kimm

Clinical Fellow and Instructor

Division of Urologic Oncology

Memorial Sloan-Kettering Cancer Center

New York

NY

Disclosures

SYK declares that he has no competing interests.

Jeffrey H. Reese

Department of Urology

Santa Clara Valley Medical Center

San Jose

Clinical Professor of Urology

Stanford University School of Medicine

Stanford

CA

Disclosures

JHR declares that he has no competing interests.

Peer reviewers

Associate Professor of Medicine

Division of Nephrology

University of California at San Francisco

CA

Disclosures

LF declares that she has no competing interests.

Assistant Professor of Medicine

University of Illinois

Chicago College of Medicine

Department of Nephrology

Chicago

IL

Disclosures

MF declares that he has no competing interests.

Consultant Urological Surgeon

Bart's and The London NHS Trust

London

UK

Disclosures

JM declares that he has no competing interests.

Consultant Urological Surgeon

Homerton University and Bartholomew's Hospitals

London

UK

Disclosures

VN declares that he has no competing interests.

References

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Key articles

Nielsen M, Qaseem A. Hematuria as a marker of occult urinary tract cancer: advice for high-value care from the American College of Physicians. Ann Intern Med. 2016 Apr 5;164(7):488-97.Full text  Abstract

Morey AF, Broghammer JA, Hollowell CMP, et al. Urotrauma guideline 2020: AUA guideline. J Urol. 2021 Jan;205(1):30-5.Full text  Abstract

European Association of Urology. EAU guidelines on urological trauma. Mar 2022 [internet publication].Full text

American College of Radiology. ACR appropriateness criteria: hematuria. 2019 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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