Hematuria and Proteinuria in Children

Introduction

Hematuria and proteinuria are common findings in primary care practice. Although the American Academy of Pediatrics eliminated routine urine screening from its preventive care guidelines a decade ago, many pediatricians continue to use screening urinalysis (UA) as part of their health supervision visits. Most pediatric patients who are diagnosed as having hematuria or proteinuria through screening UA do not have renal disease, and abnormal findings usually resolve on repeated testing. However, hematuria or proteinuria that persists on repeated testing warrants additional evaluation, and, depending on history along with initial evaluation in the primary care office, may warrant referral to a pediatric nephrologist for further management. Although guidelines put forth by the American Academy of Pediatrics do not recommend yearly evaluation of urine by dipstick analysis for children, regular routine screening of pediatric populations has been established in Japan, Taiwan, and Korea. (1)(2)(3)(4) Our practice recommends screening of certain patient populations at increased risk for renal disease over a lifetime (Table 1 …