Renal: Haematuria: Free MSRA Podcast

🩸 FREE MSRA PODCAST – Haematuria🎧 A clear, high-yield breakdown of this critical red flag symptom in renal medicine – perfect for exam prep and real-life clinical scenarios.🧠 Key Learning Points📌 Definition• Haematuria is the presence of blood in the urine.• It is classified as:– Visible Haematuria (VH): red, brown, or smoky urine– Non-Visible Haematuria (NVH): detected on dipstick or microscopy• NVH further splits into:– Symptomatic NVH (SNVH): with LUTS– Asymptomatic NVH (ANVH): incidental, no symptoms📌 Causes & Risk Factors• Common causes:– UTI– Stones– Bladder tumours– BPH (in men)– Prostate cancer• Other causes:– Trauma– Glomerulonephritis– Inflammation (e.g. prostatitis)– Structural abnormalities (e.g. cysts, VUR)– Bleeding disorders or medications (e.g. anticoagulants)• Risk factors for cancer:– Age >60– Smoking– Occupational chemical exposure (e.g. dyes)– Family history of renal or bladder malignancy🧠 Mnemonic: “TUMOURS” – Trauma, UTI, Malignancy, Obstruction (stones), Unusual meds, Renal disease, Structural causes📌 Pathophysiology• Bleeding can occur anywhere along the urinary tract: kidneys, ureters, bladder, urethra.• Mechanism varies by cause: inflammation, erosion, tumour invasion, or structural lesions.📌 Symptoms• Visible haematuria or urine discolouration• Dysuria, frequency, urgency (if UTI)• Flank or abdominal pain (stones or upper tract disease)• Features of glomerular disease:– Hypertension– Proteinuria– Renal impairment🧠 Red cell casts or glomerular RBCs on microscopy suggest renal origin📌 Differential Diagnosis• True haematuria vs lookalikes:– Myoglobinuria (e.g. rhabdomyolysis)– Haemoglobinuria (e.g. haemolysis)– Drugs: rifampicin, nitrofurantoin– Foods: beetroot– Menstrual contamination– Porphyria– Bilirubinuria (dark cola-like urine)📌 Diagnosis• Urine dipstick + microscopy to confirm RBCs• Rule out UTI with urine culture• Assess renal function: U&Es, creatinine, eGFR• Screen for proteinuria: ACR/PCR• Imaging:– Ultrasound KUB (first-line)– CT Urogram (if high-risk or persistent haematuria)• Cystoscopy if:– VH– Persistent NVH in high-risk patients• Special tests:– Red cell morphology (glomerular vs non-glomerular)– Renal biopsy (if GN suspected)📌 Management• Treat underlying cause:– UTI → antibiotics– Stones → lithotripsy or surgery– Cancer → urgent referral• UK Referral Criteria:– Urgent (2WW) for unexplained VH– Persistent VH after UTI treatment– Recurrent UTIs in >60s– Persistent ANVH (2 of 3 positive dips)• Low-risk NVH (<40, normal BP/renal function/protein) → monitor in primary care• No role for general screening – only test if clinically indicated📌 Complications• Missed malignancy• Recurrent infections• Chronic kidney disease• Obstruction• Psychological distress from persistent symptoms📌 Prognosis• Depends entirely on the underlying cause• Most transient causes resolve• Malignant causes need early detection for best outcomes📚 More MSRA Resources for Haematuria📝 Revision Notes:https://www.passthemsra.com/topic/haematuria-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/haematuria-flashcards/💬 Accordion Q&A Notes:https://www.passthemsra.com/topic/haematuria-accordion-qa-notes/🚀 Rapid Quiz:https://www.passthemsra.com/topic/haematuria-rapid-quiz/🧪 Topic Quiz:https://www.passthemsra.com/quizzes/haematuria/🎓 Full Course:https://www.passthemsra.com/courses/renal-for-the-msra/📣 All resources are part of the Renal for the MSRA course athttps://www.passthemsra.com – your hub for high-yield revision, quizzes, and flashcards built around NICE guidance.Hashtags#MSRA #MSRARevisionNotes #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQANotes #MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision #MSRARevisionWebsite #Renal #Haematuria