Hematuria

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Associated findings presentChoose any

Associated findings absentChoose any

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Repeat testingChoose one

MicroscopyChoose any

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Microscopic hematuria
• Reviewed urine color, urinary symptoms, recent illness, exercise, trauma, menses, medications, stones, family history, and blood pressure
• No proteinuria, high blood pressure, swelling, or pain or frequency with urination
• Isolated microscopic hematuria in a well child, most often benign and transient
• Repeat UA with microscopy planned in 2-3 weeks to see whether it persists
• Follow up in 2-3 weeks to repeat the UA

Small amounts of blood seen only on the urine test are common in healthy children and usually go away within weeks, and a repeat test shows whether it persists. No change in diet or activity is needed. Return precautions given including visible blood or cola-colored urine, swelling of the face or legs, decreased urination, fever with back or side pain, headaches, pain with urination, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Title micro vs gross
Proteinuria, hypertension, edema, urinary symptoms present or absent
Isolated benign; exercise; UTI; gross; postinfectious GN
Repeat UA with microscopy; yearly checks when persistent
Microscopy confirms; culture; UPCR and calcium; creatinine, CBC, complement; ultrasound
Nephrology or urology referral with reasons
Follow-up 2-3 weeks to repeat the UA
Seek care counseling

Return precautions in the template

visible blood or cola-colored urineswelling of the face or legsdecreased urinationfever with back or side painheadachespain with urination

Sources

Pediatric Care Online: Hematuria
Pediatric Care Online: Urinalysis and Urine Culture
Pediatrics in Review: Hematuria and Proteinuria in Children
HealthyChildren.org: Blood in Urine (Hematuria)
AAP Books, Signs & Symptoms in Pediatrics: Hematuria (preview)

Few formal guidelines cover this topic, so the template also leans on expert opinion.