Haematuria and proteinuria in childhood

Haematuria and proteinuria are common findings on urinalysis in childhood. They typically occur in three situations; firstly in patients with specific symptoms e.g. macroscopic haematuria or nephrotic syndrome, secondly in patients who have non-specific symptoms (usually when looking to exclude urinary tract infection) and thirdly in asymptomatic children. For the majority of children in the latter two groups the finding is temporary and not associated with long term renal disease. If the finding is persistent or patients have specific clinical features then renal abnormalities are more likely and appropriate investigation is required. This review provides a rationale for an approach that allows reassurance to be given to children and their families in whom the finding is transient and benign, whilst identifying those in whom renal abnormalities are present and treatment required. It describes algorithms for macroscopic haematuria (MaH), asymptomatic microscopic haematuria (MiH) and proteinuria.