Macroscopic haematuria usually occurs extrarenal manifestation. Isolated hematuria without concomitant proteinuria is also primarily a urological problem as urinary tract infections, kidney stones and tumors must be ruled out as the cause.
Microscopy can provide an important indication of whether haematuria originating from renal or extrarenal disease. By glomerular hematuria will erythrocytes on their way through nephrons be exposed to osmotic and mechanical forces that may affect erythrocyte appearance. Homogeneous haematuria where all erythrocytes are round and equal gear should give suspected extrarenal manifestation. Normal protein excretion and absence of cylinders in the sediment will also lead to the investigation of extrarenal causes. On the other hand by dysmorf haematuria (erythrocytes of abnormal shape and large size variation) accompanied by sylinderuri there exists a nefrittsediment where glomerular inflammation should be suspected. Finds erytrocyttsylindre know with certainty that it concerns a glomerulonephritis.
Nefritisk syndrome using one of a condition that presents itself with a nefrittsediment with hypertension and falling GFR.
The various glomerulonephritis tends clinically presenting itself either nephrotic or nephritic, which helps to substantiate the diagnosis before biopsy answer finally exists.