Definition

Hematuria means blood in the urine. Normally, urine does not contain any blood. There are two kinds of hematuria:

• Microscopic hematuria—Urine contains a very small amount of blood. It cannot be seen with the naked eye.
• Gross hematuria—Urine appears red or tea-colored.

Causes

The Urinary Tract

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Hematuria can be caused by many conditions, such as:

• Vigorous exercise
• Injury to the abdomen, pelvis, or internal organs of the urinary tract
• Conditions that affect the urinary tract (eg, infection, vesicoureteral reflux , blockage or abnormalities, tumors)
• Cancer (eg, kidney or bladder cancer)
• Kidney disease
• Kidney stones
• Bleeding disorders (eg, hemophilia )
• Certain congenital diseases (eg, polycystic kidneys )
• Certain medicines

Sometimes the exact cause is not found.

Risk Factors

Risk factors include:

• Urinary tract infection
• Recent upper respiratory tract infection
• Family history of kidney problems
• Injury or abuse
• Medicines (eg, certain antibiotics or pain medicines)
• Radiation of the pelvis (for cancer treatment)

Symptoms

Hematuria does not always cause symptoms. It may be a sign of an underlying condition which can cause symptoms. For example, if a urinary tract infection is the cause, your child may have to urinate often. She may also have a burning feeling when she urinates.

Diagnosis

The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. Tests may include:

• Urine tests—tests to confirm the presence of blood and look for protein, bacteria, or cancer cells in the urine
• Blood tests—tests to check how well the kidneys are functioning and to look for conditions that cause hematuria
• X-ray —a test that uses radiation to take a picture of structures inside the body
• Ultrasound —a test that uses sound waves to create images of the kidneys and urinary tract
• CT scan —a type of x-ray that uses a computer to create images of the kidneys and urinary tract
• MRI scan —a test that uses powerful magnets and radio waves to create images of the kidneys and urinary tract
• Cystoscopy —a thin tube inserted through the urethra and into the bladder to look at its lining
• Kidney biopsy (done in rare cases)—a small sample of kidney tissue is removed for testing

Treatment

Treatment will depend on the cause. Some causes do not require treatment. Other causes can be treated with medicine. For example, a urinary tract infection is treated with antibiotics. In some cases, like a blockage in the urinary tract, surgery may be needed.

Prevention

By treating the underlying condition, the doctor may be able to prevent your child from developing hematuria.