Hematuria (peds)

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

Background

Macroscopic Hematuria algorithm

• Make sure hematuria is not myoglobin or bleeding from non-urinary source
• Hematuria + pain suggests UTI or nephrolithiasis
• Hematuria + no pain suggests malignancy, hyperplasia, or vascular cause

Common Causes

• Pediatric patients
  • Glomerulonephritis
  • UTI
  • Congenital urinary tract anomaly
• Younger adults
  • UTI
  • Nephrolithiasis
• Any age
  • Schistosomiasis (most common cause worldwide)

Differential Diagnosis

Pediatric Hematuria

Macroscopic Hematuria	Transient Microhematuria	Persistent Microhematuria
Blunt abdominal trauma	Strenuous exercise	Benign familial hematuria
Urinary tract infection	Congenital anomalies	Idiopathic hypercalciuria
Nephrolithiasis	Trauma	Immunoglobulin A nephropathy
Infections	Menstruation
Poststreptococcal glomerulonephritis	Bladder catheterization	Alport syndrome
	High fever	Sickle cell trait or anemia
Immunoglobulin A nephropathy		Henoch-Schonlein purpura
Hypercalciuria		Drugs and toxins
Sickle cell disease		Lupus nephritis

Look-Alikes

• Foods or medications
  • For example beets, rifampin, multivitamins, pyridium
• Uric acid crystalluria
• Gastrointestinal bleeding (peds)
• Vaginal bleeding
  • Prepubertal vaginal bleeding
• Other causes of abnormally colored urine