Referrals
Hematuria referral checklist
Baseline evaluation, red flags, and referral note elements for hematuria.
Last reviewed 2026-01-05|urology | urinary | workup
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Minimum pre-referral workup
- Repeat urinalysis with microscopy to confirm hematuria.
- Urine culture if infection suspected.
- Serum creatinine and eGFR.
- Blood pressure and proteinuria assessment.
- Renal ultrasound for persistent or unexplained hematuria.
Urgency tier
- Gross hematuria with clots or urinary retention.
- Flank pain with fever or suspected obstruction.
- Rapidly rising creatinine or significant proteinuria.
- Unintentional weight loss or systemic symptoms.
- High-risk features (older age, smoking history).
Referral packet checklist
- Gross versus microscopic hematuria and duration.
- Associated symptoms (pain, dysuria) and infection history.
- Risk factors (smoking, occupational exposure).
- Lab results and imaging reports.
- Relevant medications (anticoagulants) and comorbidities.
Pre-referral optimization tasks
- Treat confirmed infection and repeat urinalysis post-treatment when appropriate.
- Review anticoagulant and antiplatelet plan if bleeding risk increases.
- Reinforce return precautions for clot retention, fever, severe pain, or urinary obstruction.