Urologie pro praxi 5/2002
Hematurie glomerulárního původu aneb jak může pomoci nefrolog urologovi v případě mikroskopické či makroskopické hematurie
Haematuria – does it have a glomerular aetiology and how can the nephrologist help the urologist in a case of microscopic or macroscopic haematuria Hematuria represents one of the commonest clinical symptoms encountered by urologists and by nephrologists. Even if hematuria is seldom dangerous in itself, the finding of hematuria is important, since it may be a symptom of an underlying serious condition. In the diagnosis of hematuria priority should be given to such diagnostic tools and procedures which are non-invasive and non-encumbering for the patient. From these procedures of extraordinary importance is the evaluation of urinary sediment by phase-contrast microscopy, enabling the differentiation of non-glomerular and glomerular origin of the hematuria. The exact nature of the glomerular lesion can be assessed by renal biopsy, the definitive diagnostic method, the indication of which has to be carefully weighed up in view of its invasive character. A more detailed diagnostic (and therapeutic) process in patients with hematuria of glomerular origin has always to be assessed by nephrologists. This is true in patients with isolated hematuria, and morover, in cases of hematuria associated with the presence of a more pronounced proteinuria and/or progressive renal insufficiency. It can be concluded that hematuria remains a typical clinical problem, which has to be managed in a joint interaction between urologists and nephrologists. Key words: hematuria, urinary sediment, glomerulonephritis.
