Differential Diagonosis of Day (3D) – Glomerular Causes of Hematuria

Today is a quick review of glomerular causes of hematuria without proteinuria, renal insufficiency, or RBC cast.

• IgA Nephropathy
• Thin Basement Membrane Nephropathy
• Hereditary Nephritis (Alport’s)

• Histologically normal glomeruli

Nonetheless, the role of renal biopsy in the evaluation of asymptomatic hematuria in patients without proteinuria, hypertension, or kidney insufficiency is unclear. But it appears that biopsy in these patients is very unlikely to change management. According to Richards et al only biopsy changed management only once out of every 36 patients 3% vs 86% in patients with nephrotic range proteinuria and 731 in patients with unexplained AKI (PMID: 7816285).

Source: Brenner and Rector’s The Kidney | PMID: 7816285