[Asymptomatic isolated hematuria in the adult: proposal of a diagnostic algorithm]

Isolated asymptomatic hematuria in the adult, i.e. hematuria and no evidence of renal or systemic disease, is a perplexing clinical problem. It is usually difficult to decide to what extent to pursue a diagnosis, especially whether to perform renal angiography or renal biopsy. An algorithm is provided to optimize detection of structural defects and intrinsic renal diseases, in an effort to avoid subjecting the patient to unnecessary invasive tests. Since the age-related recommendations of the algorithm are controversial, a discussion of renal cell carcinoma and intrinsic glomerular diseases is proffered.