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[Recurrent hematuria in children: study of 250 cases]
Insights
Investigating recurrent hematuria in children effectively determines the cause in over 80% of cases. This study analyzed 250 children, identifying various kidney conditions and metabolic disorders as common etiologies.
Area of Science:
- Pediatric Nephrology
- Clinical Diagnostics
- Urology
Context:
- Recurrent hematuria in children presents a diagnostic challenge.
- A comprehensive diagnostic protocol is essential for accurate etiological determination.
- Understanding the causes of hematuria is crucial for appropriate management.
Purpose:
- To analyze the etiology of recurrent hematuria in a pediatric cohort.
- To evaluate the effectiveness of a standardized diagnostic protocol.
- To establish the frequency of different causes of hematuria in children.
Summary:
- A study of 250 children (6 months to 17 years) with recurrent hematuria utilized urine analysis, blood tests, and imaging.
- Key findings included hypercalciuria (67 cases), other glomerulopathies (45 cases), and Alport syndrome (19 cases).
- The diagnostic protocol successfully identified the cause in over 80% of cases, with 43 receiving no specific diagnosis.
Impact:
- Highlights the importance of a systematic approach to diagnosing pediatric hematuria.
- Provides etiological data that can inform clinical practice and research.
- Emphasizes that a significant majority of recurrent hematuria cases in children are diagnosable.
Abstract:
In order to analyse the etiology of recurrent hematuria in childhood, we studied 250 children, referred to our Service (age: 6 mo-17 ys; 102 female and 148 male). They were submitted to the following protocol: urine analyses, uroculture, serum total and fraction complement, electrophoresis of hemoglobin, serum creatinine, BUN, 24h urinary calcium, uric acid and protein, oral calcium load test in children with hypercalciuria (UCa greater than 4mg/kg/day). Radiological evaluation and renal percutaneous biopsy was performed when necessary. The following diagnostic distribution was obtained: Alport syndrome, 19; Berger disease, 15; other glomerulopathies, 45; hypercalciuria, 67; uric acid hyperexcretion, 10; nephrolithiasis, 27; urinary tract infection, 14; renal malformation, 8; no diagnosis, 43. Based in these results, we conclude that appropriate investigation on recurrent hematuria, leads to determination of etiology in over 80% of cases.