ABSTRACT
Patients with a new diagnosis of hypertension should have a baseline biochemistry and urinalysis to exclude renal disease. Dipstick proteinuria originates either from post-renal inflammatory causes such as stones, malignancy, infection, and obstruction, or from intrinsic renal causes. The majority of renal proteinuria is due to glomerular diseases such as diabetes, hypertension or glomerulonephritis. The proteinuria leads to further renal damage from inflammation and fibrosis. Analysis of the urine can give clues to the origin of renal disease. Bladder outflow obstruction is a common cause of renal dysfunction, particularly in men. In patients with visible haematuria, especially those with urinary symptoms, an urgent urology referral is warranted unless the haematuria resolves with successful treatment of an underlying urinary tract infection. Persistent leucocyturia with low-grade proteinuria despite antibiotic treatment may indicate tubulointerstitial disease and a renal referral should be considered, particularly in the presence of abnormal renal function.
