Children's Hospital of Orange County

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Hematuria

What is hematuria?

Hematuria is the presence of red blood cells (RBCs) in the urine. There are two types of hematuria, microscopic and gross (or macroscopic). Microscopic hematuria is only visible under a microscope. Gross hematuria is visible to the naked eye and the urine will appear red or “cola” colored. Only one milliliter of blood (less than a tenth of an ounce) can make the urine appear red.

What causes hematuria?

There are many causes of hematuria in children, but not all of these causes are related to the urinary tract and may be caused by things such as strenuous exercise or menstrual bleeding. Most of the causes (of both types) are not serious and will self resolve with observation only.

Some causes by the urinary tract can be from:

How is it hematuria diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures may include:

  • Urinalysis, a laboratory examination of urine for various cells and chemicals, such as RBCs, white blood cells, casts or excessive protein
  • Blood tests to look at creatinine levels
  • Ultrasound

What treatments are available for hematuria?

Specific treatment will be determined by your physician based on:

  • The child’s age, overall health and medical history
  • Extent of the hematuria
  • Underlying cause of the hematuria
  • The child’s tolerance for specific medications, procedures or therapies
  • Expectations for the course of the hematuria
  • The family’s opinion or preference

Blood in urine that lasts more than one day should be reported to the child’s health care provider, especially if is coupled with unexplained weight loss, flank pain, discomfort with urination, frequent urination or urgent urination.

Treatment will vary depending on the cause. If caused by kidney stones, general treatment is stone removal. If caused by urinary tract infections, treatment is antibiotic therapy. Other treatments are determined based on the diagnosis. Many children will need no treatment beyond observation.