Hematuria in children: A practical approach

The investigation of hematuria in children should never be allowed to pose a greater risk to the child's health than does the problem itself. For this reason, angiography and cystoscopy are rarely employed in the evaluation. The evaluation of the child should proceed methodically and rest firmly on a well-taken history and results of physical examination. The microscopic examination of the urinary sediment is the cornerstone of the evaluation process and can itself suggest the origin of the hematuria. Red cell casts, if present, indicate glomerulonephritis and obviate further urologic evaluation. Genitourinary imaging should be tailored to each clinical situation.