From the Guidelines
Nephrolithiasis can lead to both gross hematuria and microscopic hematuria due to the direct trauma and irritation caused by kidney stones to the urinary tract lining. The most recent and highest quality study, 1, published in 2023, provides evidence that nephrolithiasis is a common cause of hematuria, particularly gross hematuria, which is often accompanied by flank pain and other symptoms. Some key points to consider:
- Gross hematuria typically occurs with larger stones or those with irregular surfaces, causing visible red or pink urine.
- Microscopic hematuria is more frequent and can occur with smaller stones, causing minimal irritation to the urinary tract.
- The mechanism involves abrasion of the urinary epithelium as stones pass through the urinary collecting system, renal pelvis, ureter, or urethra.
- Hematuria may be intermittent, depending on stone movement, and if accompanied by flank pain, painful urination, or urinary urgency, these symptoms strongly suggest nephrolithiasis as the underlying cause. It is essential to note that while the evidence from 1 is the most recent and highest quality, other studies, such as 1 and 1, also support the association between nephrolithiasis and hematuria, but may not provide the same level of detail or recency. Therefore, based on the strongest and most recent evidence, nephrolithiasis should be considered a potential cause of both gross and microscopic hematuria, and further evaluation and management should be guided by the patient's symptoms and clinical presentation.
From the Research
Nephrolithiasis and Hematuria
- Nephrolithiasis, commonly known as kidney stones, can cause hematuria, which is the presence of blood in the urine 2.
- Hematuria is present in 90% of cases of nephrolithiasis, but its absence does not rule out the condition 2.
- The presence of hematuria can be either gross or micro, depending on the amount of blood present in the urine.
- Gross hematuria refers to the visible presence of blood in the urine, while microhematuria refers to the presence of blood that can only be detected through laboratory tests.
Types of Hematuria Associated with Nephrolithiasis
- Nephrolithiasis can cause both gross and micro hematuria, although the exact type and severity of hematuria can vary depending on the individual case and the location of the kidney stone 2, 3.
- The presence of hematuria in patients with nephrolithiasis can be an indication of the severity of the condition and the need for prompt medical attention.
- In some cases, hematuria may be the only symptom of nephrolithiasis, while in other cases, it may be accompanied by other symptoms such as pain, nausea, and vomiting 4, 3.