Evaluation of hematuria and microscopic examination of urine sediment are commonly used tools by nephrologists in their assessment of glomerular diseases. Certain morphological aspects of urine red blood cells (RBCs) seen by microscopy may help in identifying the source of hematuria as glomerular or not. Recognized signs of glomerular injury are RBC casts or dysmorphic RBCs, in particular acanthocytes (ring-shaped RBCs with protruding blebs). Despite being a highly operator-dependent test, urine sediment examination revealing these signs of glomerular hematuria has demonstrated specificities and positive predictive values ranging between 90%-100% for diagnosing glomerular disease, although sensitivity can be quite variable. Hematuria is a commonly used tool for diagnosing patients with proliferative glomerulonephritis such as IgA nephropathy, antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, and lupus nephritis, sometimes even as a surrogate for kidney involvement. Studies examining the role for hematuria in monitoring and predicting adverse outcomes in these diseases have shown inconsistent results, possibly due to inconsistent definitions that often fail to consider specific markers of glomerular hematuria such as dysmorphic RBCs, acanthocytes, or RBC casts. A consensus definition of what constitutes glomerular hematuria would help standardize use in future studies and likely improve the diagnostic and prognostic value of hematuria as a marker of glomerulonephritis.

血尿评估和尿沉渣显微镜检查是肾病学家评估肾小球疾病时常用的工具。通过显微镜观察到的尿液红细胞 (RBC) 的某些形态学方面可能有助于确定血尿的来源是否是肾小球性的。公认的肾小球损伤迹象是红细胞管型或畸形红细胞，尤其是棘红细胞（具有突出泡的环形红细胞）。尽管是一项高度依赖于操作者的测试，尿液沉渣检查揭示了肾小球血尿的这些迹象，但其诊断肾小球疾病的特异性和阳性预测值范围在 90%-100% 之间，尽管敏感性可能存在很大差异。血尿是诊断增生性肾小球肾炎（如 IgA 肾病、抗中性粒细胞胞质抗体 (ANCA) 相关血管炎和狼疮性肾炎，有时甚至可以作为肾脏受累的替代指标。检查血尿在监测和预测这些疾病的不良后果中的作用的研究显示出不一致的结果，这可能是由于不一致的定义常常没有考虑肾小球血尿的特定标志物，如畸形红细胞、棘细胞或红细胞管型。关于肾小球性血尿的构成的共识定义将有助于在未来的研究中标准化使用，并可能提高血尿作为肾小球肾炎标志物的诊断和预后价值。检查血尿在监测和预测这些疾病的不良后果中的作用的研究显示出不一致的结果，这可能是由于不一致的定义常常没有考虑肾小球血尿的特定标志物，如畸形红细胞、棘细胞或红细胞管型。关于肾小球性血尿的构成的共识定义将有助于在未来的研究中标准化使用，并可能提高血尿作为肾小球肾炎标志物的诊断和预后价值。检查血尿在监测和预测这些疾病的不良后果中的作用的研究显示出不一致的结果，这可能是由于不一致的定义常常没有考虑肾小球血尿的特定标志物，如畸形红细胞、棘细胞或红细胞管型。关于肾小球性血尿的构成的共识定义将有助于在未来的研究中标准化使用，并可能提高血尿作为肾小球肾炎标志物的诊断和预后价值。