The clinical significance of asymptomatic gross and microscopic hematuria in children

Jerry Bergstein, Jeffrey Leiser, Sharon Andreoli

Research output: Contribution to journalArticle

42 Scopus citations

Abstract

Background: The development of asymptomatic gross or microscopic hematuria is relatively common in children. Objective: To evaluate the clinical importance of hematuria in children and the necessity for such an evaluation using a defined diagnostic protocol. Design: The protocol included a personal and family history, physical examination and blood pressure determination, and a set of comprehensive laboratory and radiological examinations. Results: Of 342 children with microscopic hematuria, no cause was uncovered in 274 patients. The most common cause discovered was hypercalciuria (16%), followed by post-streptococcal glomerulonephritis (1%). Of 228 children with gross hematuria, no cause was uncovered in 86 patients. The most common cause discovered was hypercalciuria (22%). Ten patients had clinically important structural abnormalities. Fifty-three patients qualified for renal biopsy; 36 had IgA nephropathy. Conclusions: Our results suggest that diagnostic evaluation for potential causes of asymptomatic microscopic hematuria in children may not be necessary. Because microscopic hematuria can, rarely, be the first sign of occult renal disease, long-term follow-up is mandatory. As clinically important abnormalities of the urinary tract are commonly discovered in children with asymptomatic gross hematuria, a thorough diagnostic evaluation is warranted.

Original languageEnglish (US)
Pages (from-to)353-355
Number of pages3
JournalArchives of Pediatrics and Adolescent Medicine
Volume159
Issue number4
DOIs
StatePublished - Apr 1 2005

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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