Patient education: Blood in the urine (hematuria) in children (The Basics)

Should I be worried if there is blood in my child's urine? — It can be scary to see blood in your child's urine. But try to stay calm. Blood in the urine is not usually serious. Still, bring your child to see a doctor or nurse. The medical term for blood in the urine is "hematuria."

Blood in the urine can come from the kidneys (where urine is made) or anywhere in the urinary tract. The urinary tract includes all of the organs that deal with urine (figure 1).

What causes blood in the urine? — Blood in the urine can be caused by lots of problems. In children, these include:

●Urinary tract or bladder infection, which can also cause burning or pain when urinating

●Kidney infection, which can also cause back pain and fever

●Kidney stones, which usually also cause belly or back pain

●Irritation of the urethra

●Certain kidney diseases

●Intense exercise

●Injury (for example, if your child falls off of a bike and bruises a kidney)

Sometimes, urine can look like it is bloody even though it isn't. This can happen if your child eats a lot of beets or food dyes, or takes certain medicines.

Should my child see a doctor or nurse? — Yes. See a doctor or nurse if you see blood in your child's urine, or if your child's urine is pink, red, brownish-red, or the color of tea.

Sometimes, doctors find blood in the urine when they do a routine urine test. That can happen even if the urine looks normal. It means that there are microscopic (trace) amounts of blood in the urine.

Sometimes, your child might need to see a doctor who specializes in treating kidney problems in children.

Will my child need tests? — Yes. Your doctor or nurse will test your child's urine. Other tests might be needed, but this depends on your child's symptoms. Not all children need additional tests.

Tests might include:

●Urine tests – These can show what kind of cells are in the urine. This can help the doctor find out what might be happening. The test might also measure the amount of protein in your child's urine. Too much protein can be a sign of a kidney problem.

If your child has trace amounts of blood in their urine and it doesn't go away over time, they might have something called "familial hematuria." This condition often affects family members. Your child's doctor might suggest that other people in your family get urine tests, too. In most families, familial hematuria does not cause any other symptoms.

●Blood tests – These can show whether the kidneys are working normally, or if the child has other health problems.

●Kidney ultrasound – This is a type of imaging test that doctors use to create a picture of the kidneys. It can show if your child has kidney stones or other problems.

●CT scan – This is a special kind of X-ray. It creates a picture of the kidneys and urinary tract.

If your child has blood in their urine after an injury, their doctor will probably do a CT scan or ultrasound to check their urinary tract for problems.

●Blood pressure – Your child's blood pressure will probably be measured. That's because high blood pressure can be a sign of certain kidney problems.

Will my child need treatment? — That depends on what seems to have caused the blood in your child's urine. If your child had blood in their urine because of a bruise to the kidney, they might not need any treatment. But if your child has blood in their urine because of a bladder or kidney infection, they will probably need antibiotics.

What problems should I watch for? — Call the doctor or nurse for advice if your child:

●Has signs of an infection – These include a fever of 100.4°F (38°C) or higher and chills, or pain when urinating.

●Has very bad pain in their back or side

●Can't urinate at all, or only a small amount of urine comes out

●Has blood clots in their urine

●Has symptoms that are not getting better after a few days or are getting worse

More on this topic

Patient education: Urinary tract infections in children (The Basics)
Patient education: Kidney stones in children (The Basics)
Patient education: Blood in the urine (hematuria) in adults (The Basics)

Patient education: Blood in the urine (hematuria) in children (Beyond the Basics)