Causes of Hematuria:

Remember the mnemonic “SHIIITTS”:

•Stones

•Hemolysis - (schistocytes on peripheral smear)/Hematologic - (ex. Anticoagulation, hemophilia, sickle cell disease)

•Immunologic - Glomerulonephritis, Berger’s, Alport synd, Lupus

•Infection

•Instrumentation

•Trauma

•Tumor - renal, bladder or prostate - Risks: >50yo, male, smoking, +FMH, occupational exposures (dyes, amines etc)

•Schistosomiasis - underdeveloped countries

Recommended work up in the ED:

•CBC

•BMP

•UA +/- urine culture

•Imaging: renal and bladder US vs non-contrast CT

Then outpatient Urology follow up within 2 weeks

Reference:

Askew, K. “Urinary Tract Infections and Hematuria". Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8eEds. Judith E. Tintinalli, et al. New York, NY: McGraw-Hill, 2016, pg 594-6.