Hematuria (peds)

Revision as of 18:38, 27 February 2021 by Rossdonaldson1 (talk | contribs) (Evaluation)

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

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 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

Evaluation

Management

Disposition

See Also

External Links

References