I’m a 66yo female with hematuria discovered in my urine 1 1/2yrs ago. Referred to urologist and have had pretty much all testing to determine the cause to no avail. Saw my urologist for my 6 month checkup and said “no more Cat-Scans” to which she agreed as nothing has showed up and after 7, I felt I didn’t want more unnecessary radiation. She wanted to do one more test which if it came back normal I wouldn’t see her again for another year. The test was a hematuria study to determine if the blood was coming from the upper of lower tract. Let me also say it’s only a very small amount of blood showing up and only on a dipstick or urinalysis. Not visable in my urine. Hematuria study came back that the blood is coming from my kidneys with the dx: “Dysmorphic erythrocytes indicating severe glomerular and/or renal tubular bleeding”. Now I just finished a 24hr urine collection test along with blood work to check for protein and a few other things. I haven’t got the results of this yet. My mother died of kidney cancer at age 66, her mother of some type of leukemia at age 68 and I had thyroid cancer at age 27. If this is kidney damage, should I be seeing a nephrologist and would the likely next step be a kidney biopsy. I feel like this might have been caused by high blood pressure I ignored for several years, only starting on medication a few months ago. To say I’m more then a little stressed out waiting for the results is an understatement, but have the feeling all I’m going to hear is “let’s do another test or procedure” so still will have no answers. Any insight would be appreciated.

Yes, the evaluation of isolated hematuria (blood in the urine) is first to see a urologist and make sure it is not coming from the lower urinary tract.  If nothing is found, then the next decision whether the red blood cells are coming from the kidney and then whether a kidney biopsy is warranted to determine the cause of the blood.  Referral to a nephrologist would be appropriate to decide whether there is sufficient evidence of kidney disease to warrant a kidney biopsy.

I’m not sure why seven computerized tomograms (CAT-scans) were necessary.

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