Pediatric glomerular hematuria: a clinicopathological study.

Area of Science:

• Pediatric Nephrology
• Glomerular Diseases
• Genetics

Background:

• Hematuria is a frequent pediatric concern requiring extensive investigation.
• Identifying the cause of hematuria is crucial for appropriate management and counseling.

Purpose of the Study:

• To determine the primary causes of glomerular hematuria in Egyptian children.
• To establish a reference range for glomerular basement membrane thickness (GBMT).
• To identify predictors of poor outcomes in pediatric hematuria.

Main Methods:

• Retrospective review of clinical and pathological findings in 95 children with hematuria (2013-2019).
• Exclusion of non-glomerular causes of hematuria.
• Assessment of kidney biopsies from 20 children with steroid-resistant nephrotic syndrome to establish normal GBMT.

Main Results:

• Alport syndrome (AS) was the most common diagnosis (66.3%), followed by thin basement membrane disease (TBMD) (29.5%).
• Males with AS showed a higher risk of renal failure and dialysis compared to females.
• Persistent proteinuria and lower glomerular filtration rate (GFR) at diagnosis were significant predictors of poor outcomes.

Conclusions:

• Alport syndrome is the leading cause of glomerular hematuria in Egyptian children.
• Proteinuria and reduced GFR at presentation are key indicators of adverse outcomes.
• Establishing local reference ranges for GBMT is essential for accurate diagnosis.