Disease Index Homeopathy Papers Renal Diseases

Haematuria and Homoeopathy

An outline of the various types of haematuria with indicated remedies.

Definition of Haematuria
Haematuria is the passage of blood in the urine.

abrot. Aconite alco. aloe alumn. am-c. ambr. amyg-p. ant-c. Ant-t. antip. APIS ARG-N. ARN. ARS. ars-h. ars-s-f. asc-t. aspar. Aurum aur-ar. aur-s. Belladonna bell-p. benz-ac. Berberis borx. BOTH. bufo CACT. cadm-met. cadm-s. CALC. Camph. CANN-S. CANTH. Caps. Carb-ac. Carb-v. carbn-s. carc. Causticum chel. Chim. chin. Chinin-ar. chinin-s. chir-fl. cimic. cina COC-C. coch. Colchicum coli. coloc. Conium Copaiva crot-c. CROT-H. cub. cupr. cupr-s. cyn-d. dig. diosm. diph-t-tpt. dulc. epig. equis-h. Erig. eucal. euph. fab. ferr. Ferr-ar. ferr-m. ferr-p. fic-r. fuma-ac. gaert. gal-ac. ger. graph. guat. HAM. Helleborus hep. hydrang. Hypericum IP. jatr-c. Kali-ar. kali-bi. Kali-chl. kali-i. kali-m. kali-n. kalm. Kreosotum Lachesis lat-m. led. loxo-lae. loxo-recl. Lycopodium Mangi. Mercurius MERC-C. Mez. MILL. moni. murx. Natrum mur. nat-n. nitricum acidum Nux-v. oci. ol-sant. Opium opun-v. ox-ac. oxyurn-sc. pall. pareir. petr. Ph-ac. PHOS. pic-ac. Plb. psor. PULS. rhod. Rhus-a. Rhus-t. sabad. Sabin. sal-ac. santin. Sarsaparilla scarl. SEC. Senec. Sepia ser-ang. Solid. SQUIL. stigm. Sul-ac. Sulph. tab. tann-ac. tarent. TER. terebe. thal-xyz. Thlas. thuj. tril-p. tub. uva vac. vanad. vesp. vip. Zincum met. zinc-p.

Types of Haematuria

Frank haematuria

It is the presence of blood on macroscopic examination.

Alumn. apis ars. bell. Cact. canth. Chim. coc-c. colch. Ip. kreos. Lycopodium mela. Millefolium Ph-ac. Platina puls.

Microscopic haematuria

It indicates that RBCs are only seen on microscopy.

Aconite ant-t. apis ARN. ars. Ars-h. Berberis CACT. cadm-s. calc. cann-s. CANTH. caps. Carb-ac. Carb-v. cham. CHIM. chin. chinin-ar. chinin-s. colch. coloc. con. crot-h. Dulcamara ferr-p. Hamamelis hell. hep. ip. kali-bi. Kali-chl. lyc. merc. mez. nat-n. nitricum acidum pareir. PH-AC. phos. pic-ac. PULS. santin. sec. SEP. sul-ac. sulph. Ter. uva Zincum met.

Haemoglobinuria

It is defined as the presence of free Hb in the urine.

acon. act-sp. agar. all-c. alum. Am-c. am-caust. ant-c. ant-t. apis arg-n. ARN. ARS. ARUND. Aspar. aur-m. bapt. bell. Benz-ac. Berberis bry. Cact. Camph. Carb-v. Causticum chel. Chim. chin. chinin-ar. Chinin-s. Cimic. cob. coc-c. colch. Coloc. con. Copaiva DIG. Elaps get. Gloninum grat. hedeo. Hyoscyamus Ip. Kali-c. kali-n. Lachesis Ledum LOB. LYC. Meph. MERC-C. Mez. Natrum mur. Nat-s. nit-ac. nux-m. Nux-v. Oci. Opium ox-ac. pall. PAREIR. Petroleum PHOS. pic-ac. PLAN. Psorinum puls. pyrog. rumx. SEL. SENEC. SEP. Silicea sumb. TARENT. ter. thuj. valer. zinc. zinc-p.

Initial haematuria

When blood comes on commencing urination. It suggests a urethral cause.

con.

Terminal haematuria

When blood comes after passing urine. It suggests a bladder base or prostatic cause.

HEP. mez. puls. sars. sulph. Thuja

Key Points for Haematuria

  • Haematuria always requires investigation to exclude an underlying cause.
  • Initial haematuria suggests a urethral cause.
  • Terminal haematuria suggests a bladder base or prostatic cause.
  • Ribbon clots suggest a pelvi-ureteric cause.
  • Renal bleeding can mimic colic due to clots passing down the ureter.

Causes of Haematuria

Important Diagnostic Features of Haematuria

Kidney

Trauma: mild to moderate trauma commonly causes renal bleeding; severe injuries may not bleed (avulsed kidney- complete disruption).

acon. Arnica bell. verat-v.

Tumours: may be profuse or intermittent.

Anil.

Renal cell carcinoma: associated mass, loin pain, clot colic or fever, occasional polycythaemia, hypercalcaemia and hypertension.

calc. chim. form. sars. solid.

Transitional cell carcinoma (TCC): characteristically painless, intermittent haematuria.

agath-a. Aloe Am-c. Ant-c. Ant-t. CALC. Cann-s. cic. Conium Helleborus heroin. hyos. Kreosotum laur. Lycopodium mosch. olnd. Opium Ph-ac. positr. psil. sacch. Secale stram. Sulph. syph. tung-m.

Calculus: severe loin/groin pain, gross or microscopic, associated infection.

act-sp. alum. am-c. am-m. ambr. Ant-c. apoc. Arg-n. arn. baros. bell. bell-p. BENZ-AC. Berberis cact. cal-ren. CALC. Cann-xyz. Cantharis cham. chin. chinin-s. Chlf. cimic. coc-c. coli. coloc. Dioscorea epig. equis-h. erig. ery-a. eup-pur. fab. frag. gali. guat. hed. hedeo. hep. hydrang. ipom-p. kali-bi. kali-c. kali-i. lach. lipp. LITH-C. Lith-f. Lith-met. Lith-p. LYC. mag-p. med. mill. morg-g. nat-m. nitricum acidum nux-m. nux-v. oci. onis. op. oxyd. PAREIR. Petroleum Phosphorus pipe. polyg-h. rub-t. Ruta saroth. SARS. Sepia Silicea solid. Stigm. sulfa. sulph. Tabacum ter. thlas. thuj. urt-u. uva vesi. Zincum met.

Glomerulonephritis: usually microscopic, associated systemic disease (e.g. systemic lupus erythematosus (SLE)).

APIS eberth. streptoc.

Pyelonephritis: rare.

apis bals-p. benz-ac. berb. bry. coc-c. coli. ferr-m. kali-sula. lyc. morg-g. naphtin. nux-v. podo. puls. sars. syc. ter.

Renal tuberculosis (rare): sterile pyuria, weight loss, anorexia, Pyrexia of unknown origin (PUO), increased frequency of micturition day and night.

ARS. BELL. calc. Carcinocin chin-ars. Coli. HEP. kreos. Lachesis led. LYC. Natrum mur. NIT-AC. ox-ac. PHOS. psor. PULS. SENEC. SEP. SULPH. Tuberculinum Vac. vanad. Zincum met.

Polycystic disease (rare): palpable kidneys, hypertension, chronic renal failure.

kres.

Renal arteriovenous malformation or simple cyst (very rare): painless, no other symptoms.

Renal infarction (very rare): may be caused by an arterial embolus, painful tender kidney.

bacls-7. LAT-M. mand. prot.

Ureter

Calculus: severe loin/groin pain, gross or microscopic, associated infection.

apis Belladonna Berberis canth. carb-an. hydrang. Lycopodium oci. par. polyg-h. SARS. sep. ter. verat.

TCC: characteristically painless, intermittent haematuria, history of work in rubber or dye industries.

agath-a. Aloe Am-c. Ant-c. Ant-t. CALC. Cann-s. cic. Conium Helleborus heroin. hyos. Kreosotum laur. Lycopodium mosch. olnd. Opium Ph-ac. positr. psil. sacch. Secale stram. Sulph. syph. tung-m.

Bladder

Calculus: sudden cessation of micturition, pain in perineum and tip of penis.

all-s. Ambr. ant-c. ant-t. apoc. arg-n. ars. aspar. bell. BENZ-AC. BERB. bry. cact. cal-ren. CALC. Cann-s. CANTH. carb-v. card-m. China Coc-c. Coch. coff-t. colch. coloc. cupr. dig. epig. equis-h. Eup-per. graph. hydrang. kali-c. Kalm. kreos. Lachesis lipp. Lith-c. Lith-m. Lith-p. Lith-s. LYC. Meny. merc. Merc-c. mez. Millefolium naja nat-m. nat-s. nitricum acidum Nux-m. Nux-v. oxyd. pall. Pareir. Petroleum Phosphorus Pulsatilla Raph. rhod. Ruta SARS. SEP. Silicea sul-ac. sulph. tarent. thuj. zinc.

TCC: characteristically painless, intermittent haematuria, history of work in rubber or dye industries.

Anil. arg-n. ars. blatta-o. chim. clem. con. congo-r. crot-h. equis-h. gamb. hydr. mal-ac. sabal sars. staph. tarax. TER. thuj. tor.

Acute cystitis: suprapubic pain, dysuria, frequency and bacteriuria.

acon. ant-t. apis ars. aspar. Belladonna benz-ac. berb. Camph. camph-ac. Cann-s. Cantharis caps. chim. con. Copaiva Cub. dig. Dulcamara elat. Equis-h. erig. Eucal. Eup-pur. fab. ferr-act. Ferr-p. Gelsemium hell. hydrang. hyos. lach. Merc-c. methyl. mez. nit-ac. nux-v. Ol-sant. Pareir. petros. pip-m. Pop. prun. Pulsatilla sabal Sabin. sars. Saur. sep. Stigm. sulph. Ter. tritic. uva vesi.

Interstitial cystitis (rare): may be autoimmune, drug or radiation induced, frequency and dysuria common.

Medorrhinum

Schistosomiasis (very rare): history of foreign travel, especially North Africa.

ant-t. ars. chin. ip.

Prostate

BPH: painless haematuria, associated obstructive symptoms, recurrent UTI.

PROSTATE GLAND – SWELLING – old people; in

aloe BAR-C. Benz-ac. Conium DIG. ferr-pic. Iodium nux-v. prost. Sabal SEL. Staphysagria sulph.

Carcinoma: rare.

bar-ox-suc. carc. chim. CON. Copaiva crot-h. Iodium kali-cy. Lycopodium naphthoq. plb. Psorinum SABAL Scir. Selenium senec. Silicea staph. sulfonam. Sulph. THUJ. thymol.

Urethra

Trauma: blood at meatus, history of direct blow to perineum, acute retention.

ARN. bell-p. cham. CON. dulc. euphr. ham. hyper. lach. Nat-c. nat-m. phos. Pulsatilla Rhus-t. samb. Sul-ac. sulph. Symphytum

Calculus: rare.

coc-c.

Urethritis: rare.

Aconite agar. agn. anemps. apis ARG-N. Arsenicum Aurum aur-ar. bell. bov. Cact. calc-f. camph. cann-i. CANN-S. CANTH. caps. carb-ac. caust. Chim. Clem. Copaiva Cub. cycl. dig. dor. dulc. ferr-p. Gelsemium gonotox. gran. Hepar hydr. kali-bi. kali-f. Kali-i. kola lith-c. lyc. lyss. mag-f. med. Mercurius Merc-c. napht. nat-c. nit-ac. Nux-v. oci-sa. pareir. Petroleum Petros. phys. pip-m. psor. puls. rham-f. Sabin. sars. staph. Sulph. sumb. syc. tab. TER. teucr. Thuja yohim.

KEY INVESTIGATIONS for Haematuria

Full Blood Count (FBC): infection, chronic blood loss. ‘Rouleaux’ suggest glomerulonephritis.

Clotting: exclude underlying bleeding cause.

Creatinine, Urea and electrolytes (U+E): renal function.

Microscopic study of urine, microbe culture and sensitivity (MSU MC + S): infection, parasites.

Renal cause: Intravenous pyelography (IVU), CT scan or Renal ultrasound (U/S) Renal Angiography for Arterio-Venous Malformation (AVM)

Bladder cause: Cystoscopy, Renal U/S

Glomerulonephritis: Autoimmune screen, Renal Biopsy (Bx)
References

Although hematuria is absent in 5% to 10% of patients with genitourinary trauma,98
Principles of Critical Care > Chapter 95. Torso Trauma > Specific Abdominal Injuries—Diagnosis and Management Principles > Genitourinary Injuries

Atraumatic Hematuria
CURRENT Diagnosis & Treatment: Emergency Medicine > Chapter 37. Genitourinary Emergencies > Immediate Management of Serious & Life-Threatening Conditions

Blood (Hematuria)
Clinician’s Pocket Reference > Chapter 6. Laboratory Diagnosis: Urine Studies > Differential Diagnosis for Routine Urinalysis

Bloody Urine
Smith’s General Urology > Chapter 3. Symptoms of Disorders of the Genitourinary Tract > Symptoms Related to the Act of Urination

Carcinoma of the Renal Pelvis and Ureter
Harrison’s Online > Chapter 90. Bladder and Renal Cell Carcinomas

Colorless urine of low concentration from excessive fluid…
DeGowin’s Diagnostic Examination > Chapter 10. The Urinary System > Urinary System Signs > Key Sign Discolored Urine > DISCOLORED URINE—CLINICAL OCCURRENCE

Diseases of glomeruli (glomerulonephritis or vasculitis) and the renal microvasculature (hemolytic…
Harrison’s Online > Chapter 45. Azotemia and Urinary Abnormalities > Azotemia > Approach to the Patient: Azotemia > Intrinsic Renal Disease

Dysuria Associated with Hematuria in Either Sex
CURRENT Diagnosis & Treatment: Emergency Medicine > Chapter 37. Genitourinary Emergencies > Immediate Management of Serious & Life-Threatening Conditions > Dysuria > Clinical Findings

Erythrocytes
Smith’s General Urology > Chapter 5. Urologic Laboratory Examination > Examination of Urine > Interpretation

About the author

Rajneesh Kumar Sharma

Rajneesh Kumar Sharma

Dr. Rajneesh Kumar Sharma, M.D. (Hom) practices in Uttaranchal, India. He is CMD of the Homoeo Cure & Research Institute since 1994. He is also the founder of Hindi Vikas Kalyan Samiti, Kashipur JCs, Homoeo Cure & Research Institute. Dr. Sharma's articles and cases have been published in newsletters and online journals. He has been honored with the Bhartiya Chikitsak Ratna Award 2007, Mother India Award for Udyog Pratibha 2007, Kashipur Gaurav Award 2005, Best International Feature Award 2003 etc. etc. Presently he is practicing at HCRC Pvt. Ltd., Kashipur- Uttaranchal (INDIA).

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