Hematuria
Douglas S. Fitzwater MD
Robert J. Wyatt MD1
1 Professor or Pediatrics, Division of Pediatric Nephrology, University of Tennessee Memphis and the Le Bonheur Children's Medical Center, Memphis, TN.
Hematunia occurs in approximately 1.5% of children. It is important in evaluating the patient who has hematuna to make sure that a positive dipstick test is accompanied by RBCs on the microscopic examination. Hematunia is defined by several parameters, the most common of which are 6 cells/cc of urine in a counting chamber or 2 cells per high-power field in a urinary sediment. Although the differential diagnosis for hematuria is extensive, the most important differentiating feature is the presence or absence of proteinuria. Those who have significant proteinunia deserve a rapid evaluation and early referral to a nephrologist. Those who do not have proteinunia should be followed and a step-wise evaluation performed. Finally, most patients who have asymptomatic microscopic hematunia do not have clinically significant glomenular pathology.
