Management of Hematuria in Children

Area of Science:

• Pediatric Nephrology
• Urology
• Diagnostic Medicine

Background:

• Hematuria, a common finding in pediatric urology and nephrology, necessitates accurate diagnosis and management.
• Varied treatment strategies exist for hematuria, with recent guidelines offering evidence-based approaches for glomerular diseases.

Purpose of the Study:

• To provide pediatric providers with a framework for evaluating microscopic and gross hematuria.
• To update on the pathogenesis, clinical features, and treatment of kidney and urinary tract diseases presenting with hematuria.
• To facilitate appropriate and timely subspecialty referral for definitive care.

Main Methods:

• Review of diagnostic evaluation for microscopic and gross hematuria.
• Synthesis of current knowledge on pathogenesis, clinical features, and treatment strategies.
• Incorporation of recent guidelines, such as those from Kidney Diseases Improving Global Outcomes (KDIGO).

Main Results:

• Highlights heterogeneity in treatment but emphasizes KDIGO guidelines for glomerular diseases.
• Summarizes updates in treatment strategies based on advances in molecular pathogenesis and long-term outcomes for non-glomerular diseases.

Conclusions:

• Updated knowledge on hematuria epidemiology and management improves pediatric care.
• Appropriate management avoids unnecessary testing and ensures timely definitive treatment or referral.
• This review aims to enhance the primary care provider's role in managing pediatric hematuria.