Evaluation and Management of Gross Hematuria in Autosomal Dominant Polycystic Kidney Disease: A Point of Care Guide for Practicing Internists

Gross hematuria is common in autosomal dominant polycystic kidney disease (ADPKD). It is an alarming symptom and may be the first manifestation of ADPKD. Cyst hemorrhage is a frequent cause of hematuria in ADPKD while other differential diagnoses include cyst infection, urinary tract infection, renal stones and an underlying malignancy. Knowledge of the precipitating factors and clinical presentation of these conditions will help practicing internists in performing an appropriate evaluation and management of these entities and their complications, as well as executing timely referrals to subspecialists when indicated.