Microscopic Haematuria

Availability

North South North West Statewide

Pre-referral work-up

History

Who is more likely to require a Nephrologistbefore a Urologist?

  • Glomerular Haematuria: Presence of Proteinuria with Haematuria is highly suggestive of a glomerular source (particularly in absence of other explanations for proteinuria- ie: known diabetes)
  • Glomerular Haematuria with decline in Kidney Function: See Red Flags section of this page.
  • Isolated Microscopic Haematuria in patients <35-40 year old age with no risk factors for urothelial lesions (i.e.: no significant smoking history, occupational exposure or complex urological history

All referrals should comply to referral standards and include in particular:

  • Duration of haematuria
  • Associated symptoms including diabetes
  • Physical examination including blood pressure
  • Smoking history, occupational history especially exposure to chemicals
  • Past urological/renal history

Tests

  • MSU
  • Renal ultrasound
  • FBE
  • U&E eGFR

Interim/GP management

To refer a patient with this condition, please see the Nephrology (Renal) clinic page for the full referral process and templates.

Some patients will require referral from Urology to Nephrology and vice versa following initial GP referral- either, before or after, respective investigations by each service.Where possible, we would be happy to arrange these referrals between the 2 services as appropriate.

For more information please see the Tasmanian Health Pathways website.

Urgent / category 1

(Glomerular Haematuria) Presence of Proteinuria and Haematuria with associated rapid unexplained decline in kidney function (>25% decline in GFR over 6-12 weeks)

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention.  They may or may not indicate an emergency.For macroscopic haematuria see urology clinic guidelines

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6348 7382
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED – Phone: (03) 6493 6340  Fax: (03) 6464 1926
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6173 0489 OR contact Renal Advanced Trainee or Nephrologist on Service via RHH Switchboard (03) 6222 8303 to facilitate urgent review/advice

Urgent:

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Semi-urgent:

We will endeavour to see these patients within 12 weeks

Routine:

Next available appointment