Asymptomatic hematuria and proteinuria in children: differentiating the causes

In dealing with asymptomatic hematuria or proteinuria in the pediatric population, the physician should begin with an organized, logical sequence of diagnostic steps, including careful review of the history, physical findings, and laboratory data. If serious glomerular disease is suspected (eg, presentation atypical of acute poststreptococcal glomerulonephritis, nephrotic syndrome beyond the usual age for idiopathic nephrotic syndrome of childhood, renal insufficiency, severe hypertension), biopsy is probably inevitable, and early referral to a nephrologist is urged.