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Management of Hematuria in Kids

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Hematuria is a condition that causes an abnormal appearance of red blood cells (RBC) in the urine. To learn more, read the article.

Published At January 18, 2023
Reviewed AtJune 19, 2023

What Is Hematuria in Kids?

Hematuria in children is quite a common condition where blood is found in the urine. Even though the condition seems to be abnormal often, it is harmless. Normally the filters in the kidneys help to prevent the flow of red blood cells into the urine. Still, in the condition called hematuria, the filters of the kidney and the other parts of the urinary tract allow blood to flow into the urine. The cause of hematuria varies from child to child. The most common causes are kidney infections, trauma to the urinary tract, kidney infections, and kidney stones.

What Are the Types of Hematuria?

There are two types of hematuria. Most of the time, both types of hematuria are harmless and may not require any treatment. The following are the two types of hematuria in children.

1. Microscopic Hematuria:

It is a type of hematuria where the red blood cells are visible only through the microscope. It is not a dangerous condition that comes and goes away; it may not even be identified until the urine test is done.

2. Macroscopic or Gross Hematuria:

Macroscopic or gross hematuria is a condition where blood is seen in the urine without any microscope, which can change the urine into red, dark yellow, or brown in color. However, suppose the child has chronic conditions such as increased blood pressure, kidney infections, or increased protein in the urine. In that case, the proper action has to be taken, consult the doctor as early as possible.

How Does Blood Enter Urine?

Blood enters urine through the urinary tract or the filters of the kidney. This may happen anywhere in the kidney, such as:

  • In ureters, the tubes carry urine from the kidneys to the bladder.

  • In the bladder, it stores urine.

  • The urethra leaves urine out of the body.

Blood in the urine can sometimes be an indication of serious life-threatening conditions such as kidney cancer, bladder cancer, or bleeding disorders.

What Are the Most Common Causes of Hematuria in Children?

There are various causes of hematuria in children. Among them, the following are the most common causes that cause hematuria in children.

  • Bladder or kidney problems in kids.

  • Inherited or genetic disorders.

  • Renal calculi or kidney stones.

  • Mineral imbalances in the kidneys.

  • High levels of calcium or any other minerals in the urine.

  • Any trauma or injury to the kidneys or urinary tract.

  • Few medications may also result in hematuria in kids.

  • Vigorous exercise may also result in hematuria.

  • Hematuria is most often seen in athletes and runners.

What Are Conditions That Appear as Hematuria?

The conditions that appear similar to hematuria are:

  • Few foods like beet and blueberries cause color changes in urine in children, which may confuse with actual pathological hematuria.

  • Menstrual bleeding.

  • Some prescription medications may also cause discoloration of urine in kids.

What Are the Signs and Symptoms of Hematuria in Kids?

The microscopic hematuria will not exhibit any signs or symptoms. It is usually harmless and goes away without treatment. But in macroscopic hematuria, there will be a color change of blood from dark brown to yellow in color, which may exhibit very few symptoms such as fever, pain in the lower abdomen, and pain while passing urine. The only symptom is tea-colored urine. But this may vary if the cause of hematuria is any underlying conditions such as blood pressure or chronic kidney infections.

How to Diagnose Hematuria in Children?

The doctor may examine the child thoroughly; both the physical and the clinical examination are done in order to evaluate the condition. The following diagnostic tests are performed to confirm the disease.

  • Blood tests determine the function of the kidney and know the other functions of different parts of the urinary tract.

  • Urine test.

  • Ultrasound of the kidneys.

  • MRI (magnetic resonance imaging).

  • CT scan (computerized Tomography).

  • Urine creatinine and urine protein ratios are performed.

  • The complete blood count is done.

If all the tests are normal and there is still blood in the urine, regular investigations must be done yearly to avoid further complications. The child may need a consultation with a nephrologist (a specialist in treating diseases related to kidneys).

How Is Hematuria Treated in Children?

If hematuria happens only once, no treatment is required. But if the cause of hematuria is any underlying chronic or long-term conditions, it is very important to treat the underlying condition. The doctor may prescribe analgesics if the child has any pain or fever. Unless a kidney stone has formed, most children with microscopic hematuria do not require treatment. It is critical not to restrict calcium intake in children who have high calcium levels in their urine. Kidney stones later in life are less likely to occur in growing youngsters. However, there is a risk of insufficient calcium being deposited in the skeleton. Once the child's doctor determines the cause, he or she will receive treatment to manage the cause, which will eventually eliminate the blood in the urine and any symptoms the child may be experiencing. If the child has a urinary tract infection, for example, the doctor may prescribe antibiotics. The parents or caregivers must ensure that the child takes all of the antibiotics. Often, the doctor will also recommend that the child have a follow-up examination or urine test to ensure that the infection has been eradicated.


Red blood cells can be found in the urine, which is known as hematuria. Red blood cells are not normally found in urine because the kidney's filters prevent blood from entering the urine. In hematuria, the urinary tract's filters or other parts allow blood to leak into the urine. Microscopic hematuria occurs when blood can only be seen through a microscope, whereas gross hematuria occurs when the urine appears red or the color of tea or cola. If a kid with microscopic hematuria is generally healthy, additional testing is typically not necessary unless at least three urine tests over a period of many months reveal the presence of the condition. If the child has high blood pressure, chronic renal disease, or has protein in the urine, hematuria should be looked into very away.

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Dr. Samer Sameer Juma Ali Altawil
Dr. Samer Sameer Juma Ali Altawil



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