Hematuria: A-to-Z Guide from Diagnosis to Treatment to Prevention

Red tinged urine in a urine test cup. Could it be Hematuria?Introduction to hematuria:

Even though blood in the urine often turns out not to be a problem, its appearance can be frightening to parents.

What is it?

Blood in the urine is called hematuria. If the blood is visible to the naked eye, it is called gross hematuria. If the blood is detected only on a urine test, it is called microscopic hematuria.

Who gets it?

Children can have hematuria for many different reasons. Children may have blood in the urine from urinary tract infections, including routine UTI’s, viral UTI’s, and tuberculosis. Those with kidney disease arising from a strep infection may have blood in the urine.

Other types of kidney disease can cause it, as can trauma or vigorous exercise. High blood pressure, bleeding disorders, and sickle cell disease are among the other classic causes.

Autoimmune diseases such as lupus can cause hematuria. Some children have blood in the urine from benign familial hematuria.

What are the symptoms?

The major symptom is blood in the urine, but it is often invisible to the naked eye. Sometimes there is swelling, high blood pressure, or another symptom of an underlying cause.

Is it contagious?

It is not contagious, although some of the underlying causes are.

How long does it last?

Hematuria from some causes disappears quickly on its own. Other types last far longer, often until the underlying cause is treated.

How is it diagnosed?

It may be diagnosed when blood is observed in the urine or discovered on a urine test. Clues to the underlying cause may be found with a careful history and physical exam and some screening lab tests. If the cause is not apparent, the diagnostic work-up continues step by step until the cause is found. Early tests might include a complete blood count, a urine culture, a 24-hour urine collection, a blood test of urine function, a C3 level (a screening test to look for kidney causes such as inflammation caused by strep or lupus), and an imaging study such as an ultrasound.

How is it treated?

Treatment is aimed at the underlying cause.

How can it be prevented?

Prevention also depends on the underlying cause.

Related concepts:

Blood in the urine, Gross Hematuria, Microscopic hematuria.

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.