Approach to the Child with Hematuria

Pediatr Clin North Am. 2019 Feb;66(1):15-30. doi: 10.1016/j.pcl.2018.08.003.

Abstract

The causes of macroscopic and microscopic hematuria overlap; both are often caused by urinary tract infections or urethral/bladder irritation. Coexistent hypertension and proteinuria should prompt investigation for glomerular disease. The most common glomerulonephritis in children is postinfectious glomerulonephritis. In most patients, and especially with isolated microscopic hematuria, the diagnostic workup reveals no clear underlying cause. In those cases whereby a diagnosis is made, the most common causes of persistent microscopic hematuria are thin basement membrane nephropathy, immunoglobulin A nephropathy, or idiopathic hypercalciuria. Treatment and long-term prognosis varies with the underlying disease.

Keywords: Glomerulonephritis; Gross hematuria; Hematuria; Hypercalciuria; Macroscopic; Microscopic hematuria; Red blood cells; Thin basement membrane nephropathy.

Publication types

  • Review

MeSH terms

  • Child
  • Diagnosis, Differential
  • Glomerulonephritis, IGA / complications
  • Hematuria / diagnosis*
  • Hematuria / etiology*
  • Humans
  • Hypercalciuria / complications
  • Hypertension / complications
  • Kidney Diseases / complications
  • Proteinuria / complications
  • Urinary Tract Infections / complications