BMJ 1994;309:874-875 (1 October)

Letters

Microscopic haematuria Role of renal biopsy is undervalued

EDITOR, - Fritz H Schroder emphasises the central importance of cystoscopy in the investigation of microscopic haematuria, regarding renal biopsy as required in only a minority of patients.1 We have commented previously on the disadvantage of this approach, which is likely falsely to reassure some patients with glomerular disease, which may be progressive.2

Schroder relies on urinary red cell morphology to distinguish glomerular from non-glomerular haematuria and thus to direct the use of renal biopsy. Although both phase contrast microscopy and the alternative Coulter counter analysis of urinary red cells have been advocated enthusiastically, some authors have reported finding them unhelpful, particularly when the number of red cells is low3; the two techniques have not entered widely into British nephrological practice.4

We recently reported our experience in 165 patients with microscopic haematuria (aged 18-70) who underwent both renal biopsy and cystoscopy.5 We found evidence of glomerular disease in 73 . . . [Full text of this article]


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Relevant Article

Microscopic haematuria
Fritz H Schroder
BMJ 1994 309: 70-72. [Extract] [Full Text]

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