Microscopic hematuria in children

The occurrence of microscopic hematuria (microhematuria) in children often causes concern for parents, patients, and physicians. The condition is usually benign in nature, so unnecessary laboratory tests should be avoided. A detailed history and physical examination must be undertaken, but a complete urinalysis with a microscopic examination is usually the only laboratory test required. The differential diagnosis of microhematuria is extensive, but the most important differentiating feature is the presence or absence of proteinuria. Urologists should ensure that serious conditions are not overlooked, unnecessary tests are not performed, and parents are properly reassured. However, there is still no consensus on the standard evaluation that should be used to determine microhematuria in children. The aim of this article is to provide a brief review of microhematuria in children and suggest a stepwise approach that can be used to detect major and/or treatable problems while avoiding unnecessary tests.