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Approach to the Child with Hematuria
Denver D Brown1, Kimberly J Reidy1
1Pediatric Nephrology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, 3415 Bainbridge Avenue, Bronx, NY 10467, USA.
Pediatric Clinics of North America
|November 21, 2018
Summary
Hematuria, or blood in urine, can stem from infections or irritation. While some cases require further investigation for kidney disease, many microscopic hematuria cases have no clear cause.
Area of Science:
- Nephrology
- Urology
- Pediatrics
Background:
- Hematuria, characterized by blood in urine, can be macroscopic or microscopic.
- Causes often overlap, including urinary tract infections and urethral/bladder irritation.
- Hypertension and proteinuria warrant investigation for glomerular disease.
Purpose of the Study:
- To summarize the common causes and diagnostic considerations for hematuria.
- To highlight specific conditions like postinfectious glomerulonephritis in children.
- To discuss the workup for persistent microscopic hematuria.
Main Methods:
- Review of existing medical literature on hematuria.
- Analysis of overlapping causes for macroscopic and microscopic presentations.
- Identification of common etiologies based on clinical presentation.
Main Results:
- Urinary tract infections and irritation are frequent causes of both hematuria types.
- Postinfectious glomerulonephritis is the most common glomerulonephritis in children.
- Many cases of isolated microscopic hematuria lack a clear underlying cause upon diagnosis.
Conclusions:
- Diagnostic workup for hematuria depends on associated symptoms like hypertension and proteinuria.
- Thin basement membrane nephropathy, IgA nephropathy, and idiopathic hypercalciuria are common causes of persistent microscopic hematuria.
- Prognosis and treatment are disease-specific.
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