Hematuria means blood in urine. Significant hematuria is defined as more than 5 red blood cells/HPF of a standard urinary sediment. The site of bleeding can be from kidneys / pelvicalyceal system / ureters / urinary bladder or urethra. Rarely hematuria is due to
The colour of the urine can give clue to the site of hematuria eg. Cola coloured urine - glomerular bleeding especially with proteinuria > 2+ and puffiness of eyes. Bright red colour especially if at the end of urination is due to bleeding from urinary bladder or urethra. Every pink / red / brown coloured urine need not be due to blood in urine. Ingestion of coloured sweets, beet root, drugs, hemoglobin or myoglobin can cause red urine and history is very important before investigating further.
Intermittent hematuria in an active childAlways rule out exercise induced hematuria (after active sports or school activity, RBC's appear in urine and disappear if child is rested. IVP / Cystoscopy -are rarely required for
diagnosis of hematuria Microscopic hematuria of long standing usually does not cause anemia, hence does not need hematinics.