Hematuria medical therapy: Difference between revisions
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* Determine the underlying cause of hematuria (same for gross hematuria/ microscopic hematuria/ asymptomatic hematuria).<ref name="Pan20062">{{cite journal|last1=Pan|first1=Cynthia G.|title=Evaluation of Gross Hematuria|journal=Pediatric Clinics of North America|volume=53|issue=3|year=2006|pages=401–412|issn=00313955|doi=10.1016/j.pcl.2006.03.002}}</ref> | * Determine the underlying cause of hematuria (same for gross hematuria/ microscopic hematuria/ asymptomatic hematuria).<ref name="Pan20062">{{cite journal|last1=Pan|first1=Cynthia G.|title=Evaluation of Gross Hematuria|journal=Pediatric Clinics of North America|volume=53|issue=3|year=2006|pages=401–412|issn=00313955|doi=10.1016/j.pcl.2006.03.002}}</ref> | ||
* Ensure urinary drainage. | * Ensure urinary drainage. | ||
Treatment depends on the cause of | Treatment depends on the underlying cause of hematuria, and severity of symptoms. Controlling [[hypertension]] is usually the most important part of treatment. | ||
Medicines that may be prescribed include: | Medicines that may be prescribed include: | ||
* Blood pressure medications to control | * Blood pressure medications to control [[hypertension]], most commonly [[ACE inhibitor|angiotensin-converting enzyme inhibitor]]<nowiki/>s and [[angiotensin receptor blocker]]<nowiki/>s | ||
* | * [[Corticosteroid]]<nowiki/>s | ||
* Medications that suppress the immune system | * Medications that suppress the immune system | ||
A procedure called [[plasmapheresis]] may sometimes be used for [[glomerulonephritis]] caused by immune problems. The fluid part of the blood that contains antibodies is removed and replaced with intravenous fluids or donated plasma (that does not contain antibodies). Removing antibodies may reduce inflammation in the kidney tissues. | A procedure called [[plasmapheresis]] may sometimes be used for [[glomerulonephritis]] caused by immune problems. The fluid part of the blood that contains antibodies is removed and replaced with intravenous fluids or donated plasma (that does not contain antibodies). Removing antibodies may reduce inflammation in the kidney tissues. | ||
Revision as of 14:25, 26 June 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Steven C. Campbell, M.D., Ph.D.Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]
Overview
The treatment of hematuria is driven by the underlying pathophysiology and is in large part conservative.
Medical Therapy
The initial evaluation of patients presenting with gross hematuria is 3-fold:[1]
- Assess hemodynamic stability
- Determine the underlying cause of hematuria (same for gross hematuria/ microscopic hematuria/ asymptomatic hematuria).[2]
- Ensure urinary drainage.
Treatment depends on the underlying cause of hematuria, and severity of symptoms. Controlling hypertension is usually the most important part of treatment.
Medicines that may be prescribed include:
- Blood pressure medications to control hypertension, most commonly angiotensin-converting enzyme inhibitors and angiotensin receptor blockers
- Corticosteroids
- Medications that suppress the immune system
A procedure called plasmapheresis may sometimes be used for glomerulonephritis caused by immune problems. The fluid part of the blood that contains antibodies is removed and replaced with intravenous fluids or donated plasma (that does not contain antibodies). Removing antibodies may reduce inflammation in the kidney tissues.
References
- ↑ Avellino GJ, Bose S, Wang DS (2016). "Diagnosis and Management of Hematuria". Surg Clin North Am. 96 (3): 503–15. doi:10.1016/j.suc.2016.02.007. PMID 27261791.
- ↑ Pan, Cynthia G. (2006). "Evaluation of Gross Hematuria". Pediatric Clinics of North America. 53 (3): 401–412. doi:10.1016/j.pcl.2006.03.002. ISSN 0031-3955.