Haematuria In Children

Haematuria may be microscopic or visible and can originate anywhere from the glomerulus to the urethra.

The central clinical distinction is between glomerular and nonglomerular haematuria.

• Confirm blood using urine microscopy because dipstick also detects free haemoglobin and myoglobin.

• Assess urine protein.

• Measure blood pressure.

• Check renal function.

Dysmorphic red cells and red cell casts suggest glomerular bleeding.

Consider:

• Urine calcium to creatinine ratio
• Complement
• Streptococcal serology
• Renal ultrasound
• Autoimmune investigations

depending on presentation.

Clinical toolsCalculators

BMI GCS EDD Parkland Formula

Corrected Sodium Corrected Calcium Anion Gap Creatinine Clearance Insulin Calculations qSOFA Wells PE Wells DVT CHA₂DS₂-VASc HAS-BLED CURB-65 Centor/McIsaac

Vesicoureteric Reflux

Vesicoureteric reflux is retrograde passage of urine from the bladder into the ureter and potentially the renal collecting system because of incompetence of the vesicoureteric junction.

It is graded from I to V according to severity.

The major clinical concern is recurrent febrile UTI and renal scarring.

Management depends on reflux grade, age, recurrent infection and renal damage.

Low grade reflux frequently resolves spontaneously with growth.

Key measures include:

• Prompt diagnosis and treatment of UTI
• Management of constipation and bladder dysfunction
• Selected continuous antibiotic prophylaxis in children at substantial recurrence risk
• Monitoring renal growth and blood pressure

Persistent high grade reflux, breakthrough febrile UTIs or progressive renal damage requires paediatric urology assessment for endoscopic or surgical correction.

Haematuria In Children

Overview

Clinical Features

Diagnosis

Management

Overview

Clinical Features

Diagnosis

Management