Hematuria medical therapy
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Steven C. Campbell, M.D., Ph.D.
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 cause of the disorder, and the type and severity of symptoms. Controlling high blood pressure is usually the most important part of treatment.
Medicines that may be prescribed include:
- Blood pressure medications to control high blood pressure, 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.