Blood in the urine

Case 1

John is a well-looking 31-year-old man who presents for an insurance medical. With the exception of dipstick urinalysis showing blood ++, his physical examination is unremarkable. He denies macroscopic haematuria, recent trauma or recent respiratory tract infection. He has no family history of kidney disease or hearing impairment.

What investigations should be performed?
The critical issue is establishing whether John has a ‘glomerular’ or ‘non-glomerular’ source of microscopic haematuria (see table 1). This will guide subsequent investigations and whether a