If gross hematuria is predominant, what conditions should be considered?

When evaluating a patient with predominant gross hematuria, it is essential to consider conditions that are most commonly associated with the presence of blood in the urine. In this case, renal malignancy and trauma are significant considerations.

Renal malignancy, such as renal cell carcinoma, often presents with hematuria as a primary symptom, especially when the tumor has grown sufficiently to cause bleeding within the urinary tract. This can lead to the passage of blood in the urine that is visible to the patient, which is what is referred to as gross hematuria.

Trauma to the renal area or surrounding structures can also lead to hemorrhage within the urinary system, causing blood to appear in the urine. This could include injuries from accidents, falls, or sports, where the kidneys might be damaged, leading to internal bleeding.

Other conditions, such as those related to heart disease, diabetes, liver disease, hypertension, chronic kidney disease, or nephritis, are less likely to directly cause predominant gross hematuria. While these may contribute to various urinary or kidney-related symptoms, they do not typically result in the significant and visible presence of blood in urine as seen with malignancy or trauma.