Blood in Urine (Hematuria) in Children
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If you notice blood in your child’s urine, you’re likely to panic and rush to a doctor. But you must know that it is a common occurrence in children. The presence of blood in the urine is known as hematuria. Most of the time, it is not a serious issue and goes away on its own. But obviously, you should not wait for the worst to happen. At times, it can be a symptom of a serious condition. As a parent, what you can do, is stay informed and protect your child. In this article, learn about hematuria, its signs and symptoms, and treatment.
What Is Hematuria?
The kidneys remove all the waste and fluids from the blood, turning it into the urine, which then travels through the ureters, the tubes connecting the kidneys to the bladder, where it is stored and then removed from the body in the form of urination. If blood leaks into the urine at any point in this process, it results in hematuria.
Types of Hematuria
There are two kinds of Hematuria:
- Microscopic Hematuria: This type of Hematuria is invisible to the human eye. As the colour of the urine doesn’t change, the only way to know if it is present is through a urine test. Microscopic hematuria does not cause any problems in the body and often goes away without the person realising they ever had it.
- Gross Hematuria: Here there are enough red blood cells present in the blood to give it a noticeable red hue. Gross Hematuria also clears up on its own without causing any problems. However, there are chances that it could be a sign of a more serious problem.
What Causes Hematuria in Kids?
There are many different causes for hematuria in kids, some of which include trauma, vigorous exercise, menstruation and viral illness like hepatitis. Even eating a lot of pigmented food, like beetroots and foods rich in red food dye can give the urine a reddish colour in young children and can look like blood in the urine of 3-year-old toddler.
- Blocked or Cystic Kidneys: Kidneys that are blocked or that have fluid-filled sacs called “cysts” can cause hematuria. A way of determining whether or not this is the case is to have an ultrasound done.
- Genetic Diseases: Some genetic diseases running through family lines can also be a cause. Some of these diseases include polycystic kidney disease, inherited nephritis, Alport’s syndrome, and sickle cell disease.
- Too Much Calcium: Hematuria can also be caused by high levels of calcium in the urine. Children with this problem are at a higher risk of developing kidney stones.
- Glomerulonephritis: This is a serious illness that could possibly inhibit the proper functioning of the kidneys. In some cases, blood tests can detect the glomerulonephritis, whereas, in others, a kidney biopsy may be needed.
- Idiopathic Hematuria: There are some cases where tests have ruled out all known possible causes for hematuria and there is no family history of kidney problems, yet it occurs.
Signs and Symptoms of Hematuria in Children
Hematuria very rarely causes any symptoms on its own, except for if there is too much blood in the urine. Here blood clots can form and block the flow of urine, resulting in pain in the lower pelvic region. Hematuria itself is usually a symptom of other problems.
- Glomerulonephritis: Swelling in the lower abdomen, reduced urination and high blood pressure are a few other symptoms that can occur if hematuria is caused by glomerulonephritis.
- Kidney or Bladder Infection: Depending on where the infection is, symptoms could include pain on one side of the mid-back, shaky chills, fever, nausea and vomiting, pain above the groin or bladder region, pain or discomfort during urination, more frequent and foul-smelling urine.
- Bleeding Disorders: These cause abnormal bleeding throughout the body, including the urine.
- Trauma: Other signs of physical trauma like cuts and bruises will be present.
How Is Hematuria Diagnosed in Children?
Children with microscopic hematuria who do not have any problems with the functioning of the kidneys and who have normal blood pressure should have their urine tested over several months. If the blood in the urine still occurs, then it is advised to check the urine for protein, calcium, and creatinine. A kidney ultrasound should be done.
Children who have high blood pressure, high levels of protein in their urine, a family history of kidney problems and bad blood test results may need to have a kidney biopsy.
Complications of Hematuria
One of the biggest complications of hematuria is that does not have any specific treatments for it. Hematuria itself is considered to be a symptom and not a disease. This means that treatment in each individual case is different as it could be caused by a number of things.
As a result, children may have to undergo many tedious tests in order to find out the root cause of the bleeding. In some cases, it has been able to help diagnose and treat ailments like bleeding disorders and urinary tract infections, but a lot of the time the results do not show any problems, and the child recovers normally, and without medical assistance.
How to Treat Your Child for Hematuria
As there is no specific treatment for this condition, the doctor will diagnose the cause of it and treat it. Some of the underlying causes of hematuria are given below along with the treatment measures followed for them.
- Urinary Tract Infection: For this, symptoms usually subside after the medication is started. Antibiotics are the usual treatment for urinary tract infection.
- Kidney Stones: If the condition is not too serious, drinking large amounts of water and staying active can usually help pass the stones out of the system. However, if the condition is severe, then your doctor will most likely try the extracorporeal shock wave lithotripsy (where shock waves are used to break the stone into small pieces). Sometimes surgery may also be performed.
- Kidney Disease: Kidney problems can be very serious and require treatment. Relieving inflammation and preventing further damage to the kidneys is vital no matter what may cause it.
- Inherited Diseases: The treatment of different inherited diseases in the kidneys varies greatly. For example, familial hematuria does not require treatment whereas Alport syndrome will require intensive treatment and care.
When to Consult a Specialist
If a child has blood and protein in the urine, he should be taken to a nephrologist (kidney care specialist). In the case of microscopic hematuria in a child, a doctor should be consulted if the condition persists for a few months or if it comes with high blood pressure and other symptoms.
If the cause of hematuria in children is kidney stones, urinary tract infection, exercise, or medication, then the chances of complete recovery are high. For children, hematuria resulting from glomerulonephritis that develops after a strep infection or if it is mild, complete recovery is possible. Those with more serious cases will require more intensive medical care.
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