Differentials
Nephrolithiasis
SIGNS / SYMPTOMS
Patients usually have severe pain in addition to haematuria. The site and radiation of pain depend on the position of the stone.
INVESTIGATIONS
Urinalysis shows haematuria, but no dysmorphic red blood cells (RBCs) or casts. CT KUB (kidney, ureter, bladder) or renal ultrasound reveals the stone.
Bladder cancer
SIGNS / SYMPTOMS
Important cause of painless haematuria. Patients are older and mostly have a history of smoking.
INVESTIGATIONS
Urinalysis shows haematuria, but no dysmorphic RBCs or casts. Diagnosis is made by cystoscopy and biopsy of the lesion.
Renal cancer
SIGNS / SYMPTOMS
A triad of flank pain, fever, and haematuria can be seen. Many cases are detected incidentally when a CT is done for other purposes.
INVESTIGATIONS
Urinalysis shows haematuria, but no dysmorphic RBCs or casts. Imaging by CT would reveal a renal mass.
Pre or post acute kidney injury
SIGNS / SYMPTOMS
Patients present with vague generalised symptoms (fatigue, loss of appetite, and nausea) besides those of the underlying aetiology.
INVESTIGATIONS
Urinalysis does not reveal dysmorphic RBCs or casts. Fractional excretion of sodium is <1% in pre-renal causes.
Renal imaging (ultrasound or CT) shows obstructive uropathy.
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