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Hematuria
1Division of Pediatric Nephrology, University of Tennessee, Memphis.
Pediatrics in Review
|March 1, 1994
Summary
Hematuria in children, characterized by red blood cells (RBCs) in urine, requires careful evaluation. Proteinuria presence guides the diagnostic and referral pathway for pediatric hematuria cases.
Area of Science:
- Pediatric Nephrology
- Clinical Diagnostics
- Urinalysis
Background:
- Hematuria affects about 1.5% of children.
- Confirming microscopic hematuria requires identifying red blood cells (RBCs) via microscopic examination, not just a positive dipstick test.
- Defining hematuria involves specific parameters like 6 cells/cc or 2 cells/high-power field.
Purpose of the Study:
- To outline the diagnostic approach for pediatric hematuria.
- To differentiate between significant and non-significant causes of hematuria.
- To guide the evaluation based on the presence or absence of proteinuria.
Main Methods:
- Review of diagnostic criteria for hematuria.
- Differential diagnosis of pediatric hematuria.
- Stratification of evaluation based on proteinuria levels.
Main Results:
- The presence or absence of proteinuria is the most critical factor in differentiating causes of hematuria.
- Children with significant proteinuria require prompt nephrology referral.
- Asymptomatic microscopic hematuria often lacks clinically significant glomerular pathology.
Conclusions:
- A systematic approach to pediatric hematuria is essential.
- Proteinuria is a key indicator for further investigation and specialist referral.
- Most cases of asymptomatic microscopic hematuria have benign prognoses.