Microhematuria

Few Cases of Minor Hematuria Need Workup
By Nancy Walsh, Staff Writer, MedPage Today
Published: January 11, 2013
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

"Action Points

• Older age and a recent history of gross hematuria were the strongest predictors of urinary tract malignancy in patients with asymptomatic microscopic hematuria.
• Point out that the results of this study suggest that microscopic hematuria is an unreliable predictor of malignancies of the urinary tract.

Factors other than age and a history of gross hematuria in the validation cohort that were associated with cancer included:

• Male sex, OR 2.93 (95% CI 1.41 to 6.09)
• History of smoking, OR 1.88 (95% CI 1.01 to 3.53)
• Urinalysis finding of 25 or more red blood cells per high power field, OR 2.29 (95% CI 1.12 to 4.71)

But the odds ratios for these three extra factors were much smaller than what was seen for age and gross hematuria, so in calculating the risk index, age and gross hematuria were each assigned four points and these three lower-odds factors were assigned one point each. A score on this index of 0 to 4 was considered low, 5 to 8 was moderate, and 9 to 11 was high."

Primary source: Mayo Clinic Proceedings
Source reference:Loo R, et al "Stratifying risk of urinary tract malignant tumors in patients with asymptomatic microscopic hematuria" Mayo Clin Proc 2013; DOI: 10.1016/j.mayocp.2012.10.004.

 

http://www.medpagetoday.com/Urology/Urology/36797