1. Microscopic Haematuria

2. Transient Causes Transient –UTI –Exercise Spurious –Menstrual contamination –Sexual intercourse

3. Causes continued Urological: BPH Bladder, kidney, prostate, ureteric cancer Renal stones Prostatitis Radiation cystitis TB Renal IgA nephropathy Glomerulonephritis Vasculitis

4. When to Investigate Don’t opportunistically check urine Only if clinical indication Urine dip 1+ blood is positive If symptomatic needs investigation If asymptomatic- blood persistent on 2 out of 3 samples

5. Investigations BP UE ACR If > 40 yrs – urology assessment, imaging and cystoscopy If < 40 years and all normal- monitor If < 40 and any abnormality- renal rv

6. Monitoring Annual BP, UE and ACR Refer if visible haematuria or symptomatic to urology Refer to renal if increasing proteinuria, GFR < 30 or deteriorating GFR

7. Case 55 year old male Seen 2 weeks ago with fever, urine dip at the time, negative for infection, 1+ blood Has brought 2 further samples over the last 2 weeks, both are 1+ of blood on dipstick Fever has resolved and he is now well in his self You feel he needs referral to investigate further

8. Summary Common Diagnosed on dipstick Check BP, UE, ACR Under 40 think renal Over 40 think urological