Hematuria and proteinuria in children

Based on some research evidence as well as consensus, hematuria or proteinuria that persists on repeated testing warrants additional evaluation, and, depending on history along with initial evaluation in the primary care office, may warrant referral to a pediatric nephrologist for further management. (12)(15)(35)(48) • Based on some research evidence and expert opinion, microscopic hematuria that is associated with macroscopic hematuria and/or proteinuria warrants more urgent referral to a pediatric nephrologist because these signs can be associated with worsened renal outcome. (11)(12) • Based on some research evidence as well as consensus, the urine protein/creatinine ratio has been shown to be a fairly reliable surrogate for a 24-hour urine collection, especially when tested in the first morning urine specimen. (35)(36)(37) • Based on observational studies, the long-term prognosis of orthostatic proteinuria is generally benign. (42)(43)(68) • Based on some research evidence as well as consensus, persistent proteinuria is an indicator of renal damage and is also recognized as a perpetrator of ongoing renal damage.