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Hematuria

Hematuria. Evaluation of the child with hematuria Causes of hematuria in children. Evaluation Step 1: all patients. CBC U/C Serum creatinine level 24-hr urine collection for Cr Protein Ca Serum C3 level Ultrasonography or IVP. Evaluation Step 2: selected patients.

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Hematuria

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  1. Hematuria Evaluation of the child with hematuria Causes of hematuria in children

  2. Evaluation Step 1: all patients • CBC • U/C • Serum creatinine level • 24-hr urine collection for • Cr • Protein • Ca • Serum C3 level • Ultrasonography or IVP

  3. Evaluation Step 2: selected patients • DNase titer or Streptozyme test if hematuria is of <6mo duration • Skin or throat cultures • ANA titer • Urine erythrocyte morphology • Coagulation studies/platelet count • Sickle cell screen in all black patients • VCUG when infection or when a lower tract lesion is suspected

  4. Evaluation Step 3: invasive procedures • Renal biopsy indicated for • Persistent high-grade microscopic hematuria • Microscopic hematuria + any of the following • Diminished renal function • Proteinuria>150mg/24hr(0.15g/24hr) • Hypertension • 2nd episode of hematuria • Cystoscopy indicated for • Pink or red hematuria, dysuria, and sterile U/C

  5. Causes (1) • Glomerular Diseases • Recurrent gross hematuria syndrome • IgA nephropathy • Idiopathic(benign familial) hematuria • Albort syndrome • Acute PSGN • Membranous glomerulopathy • SLE • MPGN • Nephritis of chronic infection • RPGN • Goodpasture disease • Anaphylactoid purpura • Hemolytic-uremic syndrome

  6. Causes (2) • Infection • Bacterial • Tuberculosis • Viral • Hematologic • Coagulopathies • Thrombocytopenia • Sickle cell disease • Renal vein thrombosis

  7. Causes (3) • Stones and Hypercalciuria • Anatomic Abnormalities • Congenital anomalies • Trauma • Polycystic kidneys • Vascular abnormalities • Tumors • Exercise • Drugs

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