January 1980

Hematuria of Tubular Origin-Reply

Author Affiliations

San Francisco

Arch Intern Med. 1980;140(1):134-135. doi:10.1001/archinte.1980.00330130136038

We agree with Drs Nyström and Wahlin that it is reasonable to consider the possibility that hematuria frequently observed in endemic benign nephropathy (EBN) is of tubular origin. This possibility is suggested by the observed normal glomerular histology in conjunction with acute interstitial inflammatory changes. However, we would be cautious in attributing hematuria to renal interstitial origin in a disease in which the prevalence of hematuria is reported to be as high as 75%1 in the absence of RBC casts, inasmuch as the presence of RBCs in the tubular lumen would presumably result in RBC cast formation, as postulated in our report. The lack of reported occurrence of RBC cast formation in a large series of urinary sediment examinations in patients with EBN2 suggests the additional possibility that hematuria in EBN may be of nonrenal origin. In the absence of RBC casts and in the absence of

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