Macroscopic hematuria, facing an uncommon disease: Answers

Excerpt

This 8-year-old boy presented with macroscopic hematuria and was subsequently found to have declining kidney function. The patient’s values showed acute kidney injury due to increased creatinine from his baseline of 0.44 to 2.2 mg/dl. There is no evidence to support a prerenal injury, and the absence of hydronephrosis on kidney ultrasonography rules out obstruction. Acute kidney injury present with macroscopic hematuria is seen in our patient. The presence of dysmorphic red blood cells (RBCs) and RBC casts highly specific for glomerular hematuria are findings consistent with nephritic syndrome [1]. Based on this patient’s ongoing kidney injury, the nephritic urine sediment suggests that the patient had rapidly progressive glomerulonephritis (RPGN). …