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November 21, 1990

The Evaluation of Hematuria in Adults-Reply

Author Affiliations

Arnett Clinic Lafayette, Ind

Arnett Clinic Lafayette, Ind

JAMA. 1990;264(19):2505. doi:10.1001/jama.1990.03450190034024

In Reply.—  Regarding Dr Bosniak's comments on the algorithm for the evaluation of hematuria, my treatment of the workup of a renal mass was incomplete. This was because there were several recent reviews devoted specifically to this subject.1,2 In the accompanying text I supplemented the algorithm by stating, "If a renal mass has been detected by the IVP, the subsequent evaluation has been delineated." For this statement I referenced Clayman et al,1 who proposed an algorithm on the evaluation of a renal mass that incorporated the renal computed tomographic scan as an integral component, as emphasized by Dr Bosniak. Elsewhere in the article I referenced a more recent review that also dealt in detail with this subject.2I agree with Dr White that the performance of an intravenous pyelogram and computed tomography of the kidneys with the same dose of contrast reagent is a reasonable approach to