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Hematuria in children. A practical approach
B G Cilento1, J A Stock, G W Kaplan
1Department of Urology, Naval Medical Center, San Diego, California.
The Urologic Clinics of North America
|February 1, 1995
Summary
Evaluating pediatric hematuria requires a safe, methodical approach. Microscopic urinalysis is key, identifying causes like glomerulonephritis and guiding further diagnostic imaging for children.
Area of Science:
- Pediatric Nephrology
- Urology
- Diagnostic Medicine
Background:
- Hematuria in children necessitates careful evaluation to minimize iatrogenic risk.
- Invasive procedures like angiography and cystoscopy are generally avoided due to potential harm.
Purpose of the Study:
- To outline a safe and effective diagnostic strategy for pediatric hematuria.
- To emphasize the importance of non-invasive methods in initial evaluation.
Main Methods:
- Prioritizing a thorough patient history and physical examination.
- Utilizing microscopic examination of urinary sediment as a primary diagnostic tool.
- Employing tailored genitourinary imaging based on clinical findings.
Main Results:
- Microscopic urinalysis, particularly the presence of red blood cell casts, can strongly suggest specific diagnoses like glomerulonephritis.
- Findings from urinalysis can often obviate the need for more invasive urologic evaluations.
Conclusions:
- A systematic approach starting with history, physical exam, and urinalysis is crucial for evaluating pediatric hematuria.
- Red blood cell casts are a critical indicator for glomerulonephritis, guiding subsequent management.
- Genitourinary imaging should be selectively applied based on the clinical context and initial findings.