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Hematuria
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Hematuria:
Hematuria may have its origin at any point along the urinary tract. It is estimated that approximately 10% of adult hematuria is glomerular in origin. Algorithm: Evaluation of Hematuria (pediatric)
Isolated microhematuria is relatively common in children with an estimated prevalence of 4% on dipstick evaluation of a single urine sample. Most of these pediatric cases are felt to be lower tract in origin and most resolve spontaneously. Persistent isolated microhematuria is felt to have a prevalence of no more than 1%. For those children without urine infection, screening for hypercalciuria may be useful, and those who have persistence greater than 1 year should be referred to a pediatric nephrologist. Algorithm: isolated asymptomatic microhematuria
Microhematuria with proteinuria is much less commonly seen in children with a prevalence of less than 0.7%. This combination of findings is associated with a high risk of significant renal disease. Referral to a pediatric nephrologist is recommended. Algorithm: asymptomatic hematuria with proteinuria
Gross hematuria is uncommonly seen in children, and the majority have an easily recognizable and apparent cause which may be identified by careful review of the history, physical examination, and laboratory studies. Up to 36% of cases of asymptomatic gross hematuria, however, may have no detectable cause. Algorithm: gross hematuria
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