The prevalence of asymptomatic hema...

The prevalence of asymptomatic hematuria is approximately 05 to 20 percent in children. When gros or persistent microscopic hematuria is existing the cause usually is determined between the sides of a thorough evaluation. The clinical significance of asymptomatic hematuria has not been determined, and the usefulness of this evaluation is unclear. Bergstein and associates assessed the clinical significance of hematuria in children and the usefulness of a defined diagnostic protocol.

The prospective close attention included children who were referr to a medical center with asymptomatic gros or microscopic hematuria. The cogitation was conducted between May 1979 and May 2002 The childrens' primary care physicians discovered microscopic hematuria in random urine samples during routine examinations. The diagnosis was confirmed by means of repeat urinalysis. Hematuria was defined as more than five r life-current cells per high power field. The evaluation included a patient and family history, physical examination, and family pressure measurement. Laboratory tests included ended blood count; urinalysis; serum creatinine and C3 levels; timed urine collection for creatinine clearance; protein and calcium excretions; and renal ultrasonography or intravenous pyelography. Specific criteria were used to determine which children required renal biopsies.

The application of mind group consisted of 342 children evaluated for asymptomatic microscopic hematuria and 228 for asymptomatic gros hematuria. In the microscopic hematuria arrange no cause was identified for 274 patients (80 percent) Hypercalciuria without stone disease was the chiefly common cause of microscopic hematuria (16 percent) Four patients in the microscopic dispose had poststreptococcal glomerulonephritis; all four replyed to normal renal function within three month Four patients in the microscopic dispose had structural abnormalities. Only pair patients in this group met the criteria for renal biopsy.

In the gros hematuria form into groups no cause was identified for 86 children (38 percent) Hypercalciuria was the chiefly common cause of gross hematuria (22 percent) Ten children in this arrange had significant structural abnormalities. Fifty-three children met the criteria for and received renal biopsy. The in the greatest degree common biopsy findings were IgA nephropathy (67 percent) and poststreptococcal glomerulonephritis (11 percent)

The authors deduce that children with asymptomatic microscopic hematuria may not ne diagnostic evaluations. Follow-up is necessary because, in rare cases, microscopic hematuria is the first sign of mysterious renal disease. They add that a diagnostic evaluation is warranted in patients with gros hematuria because of the significant number of structural abnormalities erect in this group.

Bergstein J et al. The clinical significance of asymptomatic gros and microscopic hematuria in children. Arch Pediatr Adolesc M April 2005;159:353-5

COPYRIGHT 2006 American Academy of Family Physicians

COPYRIGHT 2006 Gale Group