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November 21, 1990

The Evaluation of Hematuria in Adults

JAMA. 1990;264(19):2505. doi:10.1001/jama.1990.03450190034023

To the Editor.—  We have read the excellent review by Sutton,1 and we would like to comment on an important aspect that has not yet been sufficiently evaluated. Sutton proposes an interesting and probably appropriate algorithm for the initial evaluation of hematuria, including history, physical examination and urinalysis, and a full battery of screening tests. Despite an extensive initial diagnostic workup, with which we agree, he considers that a test of 24-hour urinary calcium excretion should be performed only if it is mandated by clues from the history and physical examination, and then only in children.However, the determination of urinary excretion of calcium and uric acid should be performed routinely in every patient with microscopic or gross hematuria and no evidence of a clear origin, as has recently been indicated by Andrés et al.2 In the study by Andrés and colleagues, among 121 patients prospectively evaluated,