Evaluation and Management of Hematuria in Children

Purpose of review: This paper will review the common causes of hematuria (both microscopic and gross) in the pediatric population and propose diagnostic evaluation algorithms. We will discuss the clinical features, presentations, and treatment plans for several kidney diseases presenting with hematuria. The goal is to provide practicing pediatricians and primary care providers with a simplified approach for the evaluation of pediatric patients with hematuria. Recent findings: Recent studies and understanding of pathogenesis of hematuria have shed light on the significance of hematuria in children, as it can be evidence of active kidney process in diseases such as glomerulonephritis, vasculitis, and Alport syndrome. The ongoing clinical trials demonstrate that the outcomes of such diseases can be significantly improved with early management. This proposes the need to evaluate and manage children with hematuria properly to ensure they are provided time-appropriate therapy. Summary: Hematuria, both gross and microscopic, is common in children, and while it usually has a good outcome, it can be evidence of a more serious cause. Having an updated knowledge of its epidemiology and a systematic approach for its evaluation and management can improve the care of children.