Asymptomatic Microscopic Hematuria in Inpatient Nonsurgical Adults

Am J Clin Pathol. 2023 Mar 13;159(3):221-224. doi: 10.1093/ajcp/aqac158.


Objectives: This study sought to determine the proportion of nonsurgical inpatients with asymptomatic microscopic hematuria (AMH) who qualified for urologic investigation according to consensus guidelines.

Methods: The study population included all patients acutely admitted to the internal medicine departments of Israeli regional hospitals between 2014 and 2017.

Results: Of 29,086 consecutive admissions, 10,116 (34.8%) underwent dipstick urinalysis and 8,389 (28.8%) underwent reflex microscopic urinalysis. After the exclusion of patients with a urethral catheter or a positive urine culture, 2,206 had 3 or more RBCs per high-power field, and as many as 2,052 (7.1% of the entire cohort and 24.4% of all patients undergoing microscopic urinalysis) met the criteria for a urologic workup.

Conclusions: We conclude that according to the consensus guidelines, an unreasonably high proportion of hospitalized nonsurgical patients would be referred for a urologic workup of uncertain clinical utility because of an incidental AMH finding.

Keywords: Asymptomatic microscopic hematuria; Consensus guidelines; Hospitalized adults; Urologic workup.

MeSH terms

  • Adult
  • Erythrocytes
  • Hematuria* / diagnosis
  • Hematuria* / epidemiology
  • Hematuria* / etiology
  • Humans
  • Inpatients*
  • Microscopy
  • Urinalysis