Is Renal Ultrasound a Viable Approach for Evaluating Microhematuria?

Recent guidelines from the American Urological Association (AUA; published in 2020 and amended in 2025) recommend renal ultrasound (RUS) rather than cross-sectional imaging (i.e., computed tomography or magnetic resonance imaging [CT/MRI]) for evaluating patients with microhematuria who are at low or intermediate risk. In this study, researchers in Texas used a large, single-institution database to assess the diagnostic efficiency of this approach in more than 5000 outpatients (mean age, 52) with microhematuria, defined as ≥3 red blood cells per high-power field. About half of patients were classified as having low or intermediate risk based on age, sex, and smoking status. Patients with prior genitourinary malignancy were excluded.