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What is hematuria?
Hematuria means that red blood cells are in the urine. Urine does not normally contain red blood cells because the filters in the kidney prevent blood from entering the urine. In hematuria, the filters or other parts of the urinary tract allow blood to leak into the urine. Microscopic hematuria means that the blood is detected only with a microscope, while Macroscopic hematuria means the urine appears red or the color of tea or cola. Microscopic hematuria in an otherwise healthy child does not usually need to be investigated unless it is present in at least three urine tests over several months. However, if the child has high blood pressure, chronic kidney disease or protein in the urine, then hematuria should be investigated promptly

What causes hematuria?
Hematuria is a common finding in children and has more than 100 different causes. These causes may include:

  • abnormal structures in the urinary tract
  • inherited diseases
  • mineral imbalances in the urine
  • glomerulonephritis
  • in some cases, no cause of hematuria may be found.

How is hematuria evaluated?
Children who have microscopic hematuria with normal blood pressure and kidney function should have their urine checked over several months. If blood in the urine continues:

  • A kidney ultrasound may be performed
  • Urine should be checked for protein and may be checked for calcium and creatinine.
  • Blood test to determine kidney function and other tests may be performed.
  • If all tests are negative and blood remains in the urine, yearly checkups should be done.

Children who have microscopic hematuria with high blood pressure, abnormal blood tests, a family history of kidney disease or high levels of protein in the urine may need to have a kidney biopsy.

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