Hematuria, Child

Hematuria is when blood is found in the urine. It may have been found during a routine exam of the urine under a microscope. You may also be able to see blood in the urine (red or brown color). Most causes of microscopic hematuria (where the blood can only be seen if the urine is examined under a microscope) are benign (not of concern). At this point, the reason for your child's hematuria is not clear.

CAUSES

Blood in the urine can come from any part of the urinary system. Blood can come from the kidneys to the tube draining the urine out of the bladder (urethra). Some of the common causes of blood in the urine are:

  • Infection of the urinary tract.

  • Irritation of the urethra or vagina.

  • Injury.

  • Kidney stones or high calcium levels in the urine.

  • Recent vigorous exercise.

  • Inherited problems.

  • Blood disease.

More serious problems are much less common or rare.

SYMPTOMS

Many children with blood in the urine have no symptoms at all. If your child has symptoms, they can vary a lot depending upon the cause. A couple of common examples are:

  • If there is a urinary infection, there may be:

  • Belly pain.

  • Frequent urination (including getting up at night to go to the bathroom).

  • Fevers.

  • Feeling sick to the stomach.

  • Painful urination.

  • If there is a problem with the immune system that affects the kidneys, there may be:

  • Joint pains.

  • Skin rashes.

  • Low energy.

  • Fevers.

DIAGNOSIS

If your child has no symptoms and the blood is only seen under the microscope, your child's caregiver may choose to repeat the urine test and repeat the exam before further testing.

If tests are ordered, they may include one or more of the following:

  • Urine culture.

  • Calcium level in the urine.

  • Blood tests that include tests of kidney function.

  • Ultrasound of the kidneys and bladder.

  • CAT scan of the kidneys.

Finding out the results of your test

If tests have been ordered, the results may not be back as yet. If your test results are not back during the visit, make an appointment with your caregiver to find out the results. Do not assume everything is normal if you have not heard from your caregiver or the medical facility. It is important for you to follow up on all of your test results.

TREATMENT

Treatment depends on the problem that causes the blood. If a child has no symptoms and the blood is only a tiny amount that can only be seen under the microscope, your caregiver may not recommend any treatment. If a problem is found in a part of the urinary tract, the treatment will vary depending on what problem is found. Your caregiver will discuss this with you.

SEEK MEDICAL CARE IF:

  • Your child has pain or frequent urination.

  • Your child has urinary accidents.

  • Your child develops a fever.

  • Your child has abdominal pain.

  • Your child has side or back pain.

  • Your child has a rash.

  • Your child develops bruising or bleeding.

  • Your child has joint pain or swelling.

  • Your child has swelling of the face, belly or legs.

  • Your child develops a headache.

  • Your child has obvious blood (red or brown color) in the urine if not seen before.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your child has uncontrolled bleeding.

  • Your child develops shortness of breath.

  • Your child has an unexplained oral temperature above 102° F (38.9° C).

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.