Hematuria in Children

When there are red blood cells in urine, it is referred to as hematuria. Typically, the kidney filters out any blood, preventing it from coming in contact with urine. However, hematuria in children happens when for some reason red blood cells are able to enter via the filters or other areas of the urinary tract. Often times in adolescents, the condition resolves itself. It can still be very stressful for a child and parents as they worry something serious may be the cause.

Types of Hematuria in Children

There are two types of hematuria with children:

  • Gross Hematuria

The condition is considered gross hematuria when you can see the blood in your child's urine with the naked eye. The urine will turn tea-colored, red or pink if it has blood in it. If this happens, you should call your pediatrician.

  • Microscopic Hematuria

Hematuria is considered microscopic when your child's urine appears normal, but a microscope reveals red blood cells. If a urine sample is taken for another diagnostic test, a dipstick will reveal that it may contain blood. If this happens, it will be examined and looked at via a microscope to confirm.

Causes of Hematuria in Children

Hematuria is quite common in children and is caused by over 100 different reasons, including:

  • Abnormal urinary tract
  • Urine mineral imbalances
  • Kidney disease
  • Genetic diseases
  • Sometimes, cause not found

1. Abnormal Structural Hematuria Causes

Sometimes a kidney can have a cyst or is blocked by an abnormal structure, causing hematuria. This condition can be diagnosed by ultrasound to determine if it is the reason for blood in your child's urine.

2. Mineral Imbalances

Sometimes children may have high levels of calcium in their urine, especially if their family has a history of kidney stones. The elevated level can lead to hematuria, which may cause kidney pain, painful urination or no symptoms at all. Unless a child actually develops a kidney stone, no treatment is needed. Do not reduce your child's calcium intake unless directed by a doctor.  Calcium is still needed for healthy bone development.

3. Kidney Diseases

There are different kinds of kidney diseases, ranging from very mild to quite severe. It is very common for one of these conditions to cause hematuria in children. Sometimes the condition will go away on its own, but there are times when more aggressive treatment is needed. Diagnostic tests could be as simple as a few blood tests, but can be as invasive as a biopsy of the kidney.

4. Inherited Hematuria Causes

There are several genetic diseases that can cause hematuria. These diseases include Alport's syndrome, polycystic kidney disease, sickle cell disease in African-Americans and inherited nephritis.

5. No Specific Cause

Sometimes it is hard to pinpoint the exact cause of hematuria and an underlying condition causing blood in the urine may never be found. Sometimes it will resolve on its own and sometimes it will be a lifetime condition. Either way, no treatment is given in these cases.

When to Take Your Child to the Doctor

If your child has visible blood in his urine, you should take him to see a specialist. If blood is discovered in his urine through a lab test, a doctor should be consulted as well.

Look out for urine that is brown, red or orange, as theses colors indicate the possibility of blood. However, seek your pediatrician's guidance as the change in color can also be attributed to something your child ate. For example, blackberries, beets, red food coloring and certain medications can affect urine color.

Other times, red blood cells and protein can be elevated in urine due to an infection of the kidneys' filtering membranes. Your child's doctor will order tests to determine the cause of the issue.

How Is It Treated?

Hematuria in children usually does not require any treatment, especially if it is an isolated incident. However, if the condition becomes chronic, tests will need to be done to find the cause so a treatment plan can be developed. Sometimes when an underlying condition is treated, the hematuria will resolve on its own.

Treatment options can include medication, diet changes and even surgery. No matter the course of action, follow-up testing will be needed to make sure it was successful. If blood continues to be present in your child's urine, testing will need to be repeated periodically to make sure something else is not causing it or there is not an infection. If there aren't any other symptoms, the tests will continue for a couple of years to make sure it has not escalated.

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