Genitourinary System
5-A. Hematuria
Pseudohematuria (Dyes and Pigments)
Beets
Food dyes
Phenytoin
Rifampin
Pyridium
Urates
Porphyrins
Myoglobin
Free hemoglobin (intravascular hemolysis)
Renal Parenchymal Causes
Primary glomerulopathy
Postinfectious glomerulonephritis
Thin basement membrane disease
Immunoglobulin A (IgA) nephropathy (Berger disease)
Membranoproliferative glomerulonephritis
Focal glomerulosclerosis
Crescentic glomerulonephritis
Multisystem and hereditary diseases
Diabetes mellitus
Lupus erythematosus
Goodpasture syndrome
Polyarteritis nodosa, other vasculitides
Endocarditis, shunt nephritis
Hemolytic-uremic syndrome, thrombotic thrombocytopenic purpura
Henoch-Schönlein purpura
Malignant hypertension
Polycystic kidney disease
Hereditary nephritis (Alport syndrome)
Fabry disease
Nail-patella syndrome
Other
Exercise
Pyelonephritis, acute
Nephrolithiasis
Renal cyst
Renal trauma
Renal neoplasm
Coagulopathy, thrombocytopenia
Interstitial nephritis, acute
Analgesic nephropathy
Sickle cell trait or disease
Medullary sponge kidney
Lymphomatous or leukemic infiltration
Hydronephrosis
Oxaluria
Vascular anomalies, intrarenal arteriovenous fistula
Acute febrile illnesses (e.g., malaria)
Papillary necrosis
Renal infarction (acute renal artery occlusion, renal vein thrombosis)
Hematuria loin pain syndrome
Renal transplant rejection
Lower Urinary Tract Causes
Congenital anomalies (e.g., ureterocele)
Neoplasms (bladder, ureter, prostate, urethral), benign or malignant
Cystitis, prostatitis, urethritis
Calculi
Trauma
Foreign body
Coagulopathy
Varices (renal pelvis, ureter, bladder)
Radiation cystitis
Drugs (especially cyclophosphamide, anticoagulants)
Schistosomiasis
Genitourinary tuberculosis
Non-Urinary Tract Causes
Neoplasm of adjacent organs
Diverticulitis
Pelvic inflammatory disease
Appendicitis
References
1. Cohen RA, Brown RS. Microscopic hematuria. N Engl J Med. 2003;348:2330-2338.
2. Koenig KG, Bolton WK. Clinical evaluation and management of hematuria and proteinuria, p. 815. See Bibliography, 6.
5-B. Polyuria
Central diabetes insipidus (see 3-U)
Renal disease
Nephrogenic diabetes insipidus, congenital
Chronic renal insufficiency (especially tubulointerstitial disease)
Diuretic phase of acute renal failure
Postobstructive diuresis, partial or intermittent obstruction
Hypercalcemia
Hypokalemia
Sickle cell trait or disease
Multiple myeloma
Amyloidosis
Sarcoidosis
Sjögren syndrome
Decreased protein intake
Osmotic diuresis
Diabetes mellitus, poorly controlled
Mannitol or urea administration
Iodinated contrast dye
Hyperalimentation
Tube feedings
Drugs
Alcohol
Diuretics
Lithium
Demeclocycline
Methicillin
Gentamicin
Amphotericin B
Phenothiazines
Sulfonylureas
Phenytoin
Propoxyphene
Methoxyflurane
Colchicine
Vinblastine
Foscarnet
Clonidine
Norepinephrine
Narcotic antagonists
Water load
Psychogenic polydipsia
Intravenous fluid therapy
Deliberate water consumption (e.g., marathon preparation)
Drug-induced polydipsia (e.g., phenothiazines, anticholinergics)
Reference
1. Berl T, Schrier RW. Disorders of water metabolism, p. 1. See Bibliography, 1.
5-C. Proteinuria
Benign/Physiologic
Fever
Exercise
Orthostatic
Contrast dye
Usually Nonnephrotic (<3 g/day)
Chronic pyelonephritis
Arteriolar nephrosclerosis
Malignant hypertension
Interstitial nephritis, acute or chronic
Acute tubular necrosis
Urinary tract obstruction
Nephrolithiasis
Renal neoplasm
Renal trauma
Polycystic kidney disease
Hereditary nephritis (Alport syndrome)
Glomerular disease, especially:
IgA nephropathy (Berger disease)
Crescentic glomerulonephritis
Hemolytic-uremic syndrome
Systemic sclerosis
Genitourinary tuberculosis
Often Nephrotic
Primary renal disease, especially:
Minimal change disease
Membranous glomerulopathy
Membranoproliferative glomerulonephritis
Focal segmental glomerulosclerosis
Systemic disease, especially:
Diabetes mellitus
Lupus erythematosus
Polyarteritis nodosa
Wegener granulomatosis
Henoch-Schönlein purpura
Mixed cryoglobulinemia
Amyloidosis (primary or secondary)
Neoplasm
Solid tumors (especially lung, colon, stomach, breast)
Hodgkin disease, other lymphomas
Multiple myeloma
Sarcoidosis
Myxedema
Graves disease
Sickle cell disease
Toxins, drugs
Gold
Mercury
Heroin
Nonsteroidal anti-inflammatory drugs
Penicillamine
Captopril
Trimethadione and other anticonvulsants
Allergens
Infection, especially:
Bacterial (e.g., streptococcal, staphylococcal)
Hepatitis B and C
Cytomegalovirus (CMV)
Epstein-Barr virus (infectious mononucleosis)
Human immunodeficiency virus (HIV)
Syphilis
Malaria
Helminthic (e.g., schistosomiasis)
Leprosy
Miscellaneous
Congestive heart failure
Tricuspid insufficiency
Constrictive pericarditis
Pre-eclampsia
Renal vein thrombosis, inferior vena cava obstruction
Massive obesity
Hereditary diseases, especially:
Congenital nephrotic syndrome
Fabry disease
Nail-patella syndrome
References
1. Glassock RJ. The glomerulopathies, p. 623. See Bibliography, 1.
2. See Bibliography, 2.
5-D. Glomerulopathy
Primary Renal Disease
Minimal change disease
Membranous glomerulopathy
Membranoproliferative glomerulonephritis
Focal segmental glomerulosclerosis
Crescentic glomerulonephritis
Mesangial proliferative glomerulonephritis (e.g., IgA nephropathy)
Infection
Bacterial, especially:
Streptococcal
Endocarditis
Shunt infection
Septicemia, especially pneumococcal or staphylococcal
Meningitis
Viral, especially:
Hepatitis B and C
Mononucleosis
Rubella
Varicella
Mumps
CMV
HIV
Syphilis
Parasitic infestation (especially malaria)
Tuberculosis
Systemic Disease
Diabetes mellitus
Lupus erythematosus
Scleroderma
Rheumatoid arthritis
Mixed connective tissue disease
Polyarteritis nodosa
Wegener granulomatosis
Hemolytic-uremic syndrome
Thrombotic thrombocytopenic purpura
Henoch-Schönlein purpura
Mixed cryoglobulinemia
Goodpasture syndrome
Waldenström macroglobulinemia
Amyloidosis
Fibrillary/immunotactoid glomerulopathies
Neoplasm
Solid tumors (especially lung, stomach, colon, breast)
Hodgkin disease, other lymphoma
Multiple myeloma, light-chain nephropathy
Sarcoidosis
Pre-eclampsia
Postpartum renal failure
Sickle cell disease
Hepatic cirrhosis
Other
Radiation
Hereditary nephritis (Alport syndrome)
Fabry disease
Nail-patella syndrome
Congenital nephrotic syndrome
Renal transplant rejection
References
1. Glassock RJ. The glomerulopathies, p. 623. See Bibliography, 1.
2. See Bibliography, 2.
5-E. Interstitial Nephropathy
Infection, especially:
Bacterial (pyelonephritis, acute or chronic)
Mycoplasmal
Toxoplasmosis
Leptospirosis
Hantavirus
Brucellosis
Mononucleosis
Legionnaires disease
Urinary tract obstruction, vesicoureteral reflux
Papillary necrosis
Drugs
Analgesics (especially aspirin, phenacetin)
Methicillin and penicillin analogs
Sulfonamides
Cephalosporins
Tetracycline
Rifampin
Amphotericin B
Acyclovir
Furosemide
Thiazides
Nonsteroidal anti-inflammatory drugs
Allopurinol
Phenytoin
Azathioprine
Lithium
Cimetidine
Warfarin
Polymyxins
Chinese herbs (aristolochic acid)
Heavy metals
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