GuidelinesPrimary Care STG
Haematuria
Urology
R31
DESCRIPTION
- Bleeding from the urinary tract, which can be from the kidneys, collecting system, bladder, prostate and urethra.
- Glomerular disease is suggested if proteinuria, red blood cell casts and/or dysmorphic red blood cells are present on microscopy.
- Exclude schistosomiasis (bilharzia), a common cause of haematuriaa, as well as haematuria which could be the result of anticoagulant therapy.
- When haematuria is accompanied by colicky pain, a kidney stone should be excluded.
Note:
The presence of blood on the urine test strips does not indicate infection and should be investigated as above.
MEDICINE TREATMENT
- If evidence of schistosomiasis, treat as in Schistosomiasis (bilharzia).
- If symptoms of UTI; leucocytes and/or nitrite test positive in urine, treat as UTI.
- If haematuria does not resolve rapidly after treatment, refer for formal investigation, i.e. next 48 hours.
REFERRAL
- All cases not associated with schistosomiasis or UTI.
- All cases not responding to specific medicine treatment.
- When glomerular disease is suspected.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-2024_Version 1.0_17 October 2024
Chapter 8: Kidney and Urological Disorders_8.6 Haematuria