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Guide to Pediatric Urology and Surgery in Clinical Practice ( PDFDrive ).pdf
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Chapter 14

Hematuria and Proteinuria

Alan R. Watson

Key Points

››Macroscopic hematuria is a rare symptom in childhood and should be referred for evaluation to the pediatric department.

››Commonest cause for macroscopic and microscopic hematuria (on dipstick) is urinary tract infection and the major causes in adults of stones and cancer are rare in childhood.

››Dipsticks are very sensitive for blood and urinalysis should be repeated before referral. If persistent dipstick hematuria test family members as benign familial hematuria is not uncommon.

››Heavy proteinuria on dipstick (+++ or more) needs prompt referral but lesser degrees need confirmation with repeat testing. Orthostatic (postural) proteinuria is common in older children and can be deduced from testing early morning and late afternoon urines.

››A combination of hematuria with proteinuria are more likely to be significant than isolated microscopic hematuria and low level proteinuria alone.1

P.P. Godbole et al. (eds.), Guide to Pediatric Urology and

147

Surgery in Clinical Practice, DOI: 10.1007/978-1-84996-366-4_14,

© Springer-Verlag London Limited 2011