LIMITED EVALUATION OF MICROSCOPIC HEMATURIA IN PEDIATRICS

Objective. The purpose was to determine the value of the standard labo ratory and radiologic evaluation of microscopic hematuria in children, and to determine the prevalence of idiopathic hypercalciuria in those children referred for evaluation of unexplained microscopic hematuria . Methods. This was a retrospective study of 325 children referred fro m 1985 to 1994 for the evaluation of asymptomatic microscopic hematuri a. The diagnostic.. studies reviewed included serum creatinine, blood urea nitrogen, serum electrolyte studies, serum complement concentrati on, antinuclear antibody, urinalysis, urine calcium to creatinine rati os, urinary protein to creatinine ratio and/or 24-hour urinary protein excretion, renal ultrasounds, intravenous pyelograms, voiding cystour ethrograms, and historical information. Results. All creatinine and el ectrolyte values were normal for age, and none of the biochemical test s obtained in the children with hypercalciuria was abnormal. Of the 32 5 patients with idiopathic microscopic hematuria, only 18 had abnormal renal ultrasound examinations and 9 voiding cystourethrograms showed low-grade reflux. Hypercalciuria was found in 29 patients. The family history was positive for urolithiasis in 16% of patients without hyper calciuria compared with 14% of patients with hypercalciuria. A positiv e family history of hematuria was reported in 25% of patients; 62 pati ents did not have hypercalciuria and 4 of the patients had hypercalciu ria. Microscopic hematuria in children is a benign finding in the vast majority of children. Conclusions. Our data demonstrate that a renal ultrasound, voiding cystourethrogram, cystoscopy, and renal biopsy are not indicated in the work-up of microscopic hematuria, and microhemat uria in the otherwise healthy child is a minimal health threat, rarely indicative of serious illness. URL: p://www.pediatrics.org/cgi/conten t/full/102/4/e42.