Hematuria (peds)

This page is for pediatric patients. For adult patients, see: hematuria

Background

  • Make sure hematuria is not myoglobin or bleeding from non-urinary source

Common Causes

Clinical Features

Types of hematuria

  • Initial hematuria
    • Blood at beginning of micturition with subsequent clearing
    • Suggests urethral disease
  • Intervoid hematuria
    • Blood between voiding only (voided urine is clear)
    • Suggests lesions at distal urethra or meatus
  • Total hematuria
    • Blood visible throughout micturition
    • Suggests disease of kidneys, ureters, or bladder
  • Terminal hematuria
    • Blood seen at end of micturition after initial voiding of clear urine
    • Suggests disease at bladder neck or prostatic urethra
  • Gross hematuria
    • Indicates lower tract cause
  • Microscopic hematuria
    • Tends to occur with kidney disease
  • Brown urine with RBC casts and proteinuria
    • Suggests glomerular source
  • Clotted blood
    • Indicates source below kidneys

Differential Diagnosis

Pediatric Hematuria

Macroscopic Hematuria Transient Microhematuria Persistent Microhematuria
Blunt abdominal traumaStrenuous exerciseBenign familial hematuria
Urinary tract infectionCongenital anomaliesIdiopathic hypercalciuria
NephrolithiasisTraumaImmunoglobulin A nephropathy
InfectionsMenstruation
Poststreptococcal glomerulonephritisBladder catheterizationAlport syndrome
High feverSickle cell trait or anemia
Immunoglobulin A nephropathyHenoch-Schonlein purpura
HypercalciuriaDrugs and toxins
Sickle cell diseaseLupus nephritis

Evaluation

Management


Disposition


See Also



References

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