Hematuria (peds)

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

Background

Macroscopic Hematuria algorithm

Make sure hematuria is not myoglobin (e.g. 2/2 rhabdomyolysis) or bleeding from non-urinary source

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

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

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

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