Blood In Urine - Know Types Of It In Kids!

The kidneys are the main excretory organs and remove all toxins and wastes from the body in a liquid medium, the urine. The urine is normally straw coloured as there are filters which do not allow blood to enter the kidneys. However, due to various reasons, when there is a disease in the urinary tract, red blood cells can escape into the urine. The urine then assumes a pinkish tinge; the exact colour would depend on the amount of blood leaked. While the thought of pinkish urine is scary, it becomes a bigger concern when seen in children. Read on to know a little more about the types, causes, and ways to manage this condition. 

Types: 

1. Microscopic: When there is blood visible only through a microscope. This is quite common in children, and unless there is no accompanying kidney disease, it does not pose a problem when found, occasionally. 
2. Gross: It is when the color of the urine changes to a pinkish tinge. This is of concern and requires immediate attention. 

Causes:

There are various reasons and some of them are listed below 

1. Inherited causes: Conditions like sickle cell disease, polycystic kidney disease, Kidney stones and inherited nephritis. 
2. Structural causes: Cysts in the kidneys can cause hematuria 
3. Trauma: An injury (to the abdominal area) during sports should be ruled out, which could have damaged the problem 
4. Infections: Infections along the entire urinary tract right from glomerulonephritis to kidneys to bladder can cause blood in the urine 5.    Imbalances in minerals: High levels of serum calcium, which puts them at a higher risk of developing kidney stones later. Dietary calcium should be reduced. These children also could have a history of stones in the family. 
5. Idiopathic: When the cause of the hematuria is not known, it is termed idiopathic. 

Associated issues/Diagnosis: 

Hematuria is an indication or a symptom of an underlying medical condition (be it infection or trauma) and the underlying cause always needs complete evaluation. Accompanying symptoms can help narrow down the diagnosis. If any inherited cause is suspected, the presence of hematuria should always be assessed in parents and grandparents. 

1. Check for history of trauma 
2. Known prior kidney disease 

Symptoms of infection 

1. Family medical history 
2. Urine tests to analyse its composition 
3. Urine culture, MRI, CT scanning, or biopsy may be required in more serious cases. 

When to worry? 

1. Associated proteinuria 
2. Microscopic hematuria which is persistent 
3. Kids with high blood pressure 
4. Kids with other existing kidney diseases 

Management: 

In most cases, no specific treatment for hematuria is required as the condition subsides after the underlying problem is addressed. For instance, once the infection clears, the hematuria also clears. Follow-up urine tests may be required to confirm that it is cleared. Blood in urine must always be evaluated by pediatric nephrologist as its causes range from very mild disease to rapidly evolving kidney failure, which may occur over days to weeks.