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Hematuria
1Division of Pediatric Nephrology, University of Tennessee, Memphis.
Hematuria occurs in approximately 1.5% of children. It is important in evaluating the patient who has hematuria to make sure that a positive dipstick test is accompanied by RBCs on the microscopic examination. Hematuria is defined by several parameters, the most common of which are 6 cells/cc of urine in a counting chamber or 2 cells per high-power field in a urinary sediment. Although the differential diagnosis for hematuria is extensive, the most important differentiating feature is the presence or absence of proteinuria. Those who have significant proteinuria deserve a rapid evaluation and early referral to a nephrologist. Those who do not have proteinuria should be followed and a step-wise evaluation performed. Finally, most patients who have asymptomatic microscopic hematuria do not have clinically significant glomerular pathology.
Hematuria occurs in approximately 1.5% of children. It is important in evaluating the patient who has hematuria to make sure that a positive dipstick test is accompanied by RBCs on the microscopic examination. Hematuria is defined by several parameters, the most common of which are 6 cells/cc of urine in a counting chamber or 2 cells per high-power field in a urinary sediment. Although the differential diagnosis for hematuria is extensive, the most important differentiating feature is the presence or absence of proteinuria. Those who have significant proteinuria deserve a rapid evaluation and early referral to a nephrologist. Those who do not have proteinuria should be followed and a step-wise evaluation performed. Finally, most patients who have asymptomatic microscopic hematuria do not have clinically significant glomerular pathology.