Idiopathic Renal Hematuria/Benign Essential Renal Hematuria

Idiopathic renal hematuria (IRH), or benign essential renal hematuria, is a rare condition of chronic severe unilateral, or less commonly bilateral, renal bleeding. This condition typically results in port-wine colored urine that is not associated with trauma, urolithiasis, neoplasia, or other obvious causes. The anatomic source of hematuria can be broadly divided into conditions arising from either the upper or lower urinary tract. Lower urinary tract disorders causing hematuria are more easily diagnosed with the advent of contemporary imaging such as ultrasound, fluoroscopy, and cystourethroscopy. Diagnosis of the IRH has traditionally been a diagnosis of exclusion in veterinary patients. Dogs or cats can present with chronic, acute, or intermittent severe hematuria. This is sometimes associated with signs of urinary tract disease including dysuria, stranguria, pollakiuria, and pyuria. Once a diagnosis of the IRH was made based on cystoscopy or ureteral catheterization, a ureteronephrectomy was recommended as the treatment of choice.