Can gross hematuria with clots occur in renal parenchymal disease(GN,TIN)?What renal parenchymal diseases give a combination of gross hemative and rapidly progressing renal impairment?

Can gross hematuria with clots occur in renal parenchymal disease(GN,TIN)?What renal parenchymal diseases give a combination of gross hemative and rapidly progressing renal impairment?
I have a 25 year old male patient who presented with right flank pain and gross hematuria(with clots) of a week's duration. No systemic symptoms. Urine shows RBC's and1+ proteinuria but no RBC casts. His creatinine has progressively increased from 1.6 to 4.4 mg/dl..Left kidney is small while the right is rather big(13cm) with no stones or features of obstruction. CystoUreteroscopy showed that the blood was coming out of the right ureteric orifice but the bladder and the right ureter(up until the proximal ureter ) looked normal. I have not been able to explain the rapid rise in creatinine in terms of renal hypoperfusion(with prerenal azotemia or ATN) or obstruction.He had received a contrast agent for CT and Contrast nephropathy is a possibility. The patient is clinically stable and the gross hematuria is clearing. My questions are can hematuria with clots occur in glomerular disease? Shall I just observe and see if the renal function will improve or start doing additional tests(e.g serologic tests like ANA,ANCA,etc)

Yes, gross hematuria sufficient to induce some clotting in the urine has been described rarely in glomerular disease, especially IgA nephropathy and/or in combination with a coagulopathy. Sufficient hematuria to induce clot formation can be seen with any of the crescentic GNs (ANCA, aGBM, SLE,) but is most common in IgA nephropathy. Other causes include genetic diseases like Alport’s or thin basement membrane disease. The inequality in kidney size and elevated creatinine here indicate there is bilateral renal injury, perhaps from contrast. The unilateral bleeding, and absence of proteinuria and casts would put GN low on the list of likely causes of the hematuria. It would seem more likely that something acute happened on the right – a non-opaque stone, tumor, embolus, trauma etc. With the history of recent contrast and now resolution (I assume GFR is improving as well), I do not think screening for GN is likely to be positive or alter management. I would suggest screening for coagulation disorders and obtaining optimal imaging studies of the R kidney and perhaps an angiogram to exclude any treatable entities that might represent the source of bleeding.