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Conditions

Hematuria initial risk assessment

Primary care hematuria framework emphasizing malignant, obstructive, and infectious red-flag exclusion.

Last reviewed 2026-02-07|hematuria | urology | risk stratification

Assessment priorities

  • Confirm gross versus microscopic hematuria and associated symptoms.
  • Review anticoagulation status, trauma, infection signs, and renal risk factors.
  • Assess for flank pain, clot retention, or systemic instability.

Red flags

  • Gross hematuria with clots causing retention or hemodynamic compromise.
  • Hematuria with severe flank pain, fever, or acute kidney injury concern.
  • Persistent unexplained hematuria in high-risk populations.

Initial management

  • Stabilize and stratify urgency based on bleeding severity and associated findings.
  • Start targeted workup and document risk factors clearly.
  • Define immediate versus expedited referral threshold.

Follow-up and escalation

  • Ensure timely reassessment and trend review.
  • Escalate for worsening bleeding, obstruction, infection, or renal decline.
  • Coordinate urology pathway for persistent unexplained cases.