Blood in Urine (Hematuria)

Sometimes my child's urine looks reddish in color. Is that normal?

If your child’s urine has a red, orange, or brown color, it may contain blood. The medical term for this is hematuria.

Causes

Many things, including a physical injury or inflammation or infection in the urinary tract, can cause it. Hematuria also is associated with some general medical problems, such as defects of blood clotting, exposure to toxic materials, hereditary conditions, or abnormalities of the immune system. Sometimes there may be such small amounts of blood in the urine that you cannot see any color change, although it may be detected by a chemical test performed by the pediatrician.

In some cases the reddish color may be due simply to something your child has eaten or swallowed. Beets, blackberries, red food coloring, phenolphthalein (a chemical sometimes used in laxatives), Pyridium (a medicine used to relieve bladder pain), and the medicine rifampin may cause the urine to turn red or orange if your child ingests them. Anytime you are not sure that one of these has caused the color change, or if the color change persists for more than twenty-four hours without explanation, call your pediatrician.

Treatment

The pediatrician will ask you about any possible injury or foods that might have caused the change in urine color. He will perform a physical examination, checking particularly for any increase in blood pressure, tenderness in the kidney area, or swelling (particularly of the hands or feet or around the eyes) that might indicate kidney problems. The doctor also will perform tests on a sample of urine and may order blood tests, X rays, or other examinations to check the functioning of your child’s kidneys, bladder, and immune system.

If none of these reveals the cause of the hematuria, and it continues to occur, your pediatrician may refer you to a children’s kidney specialist, who will perform additional tests. (Sometimes these tests include an examination of a tiny piece of kidney tissue under the microscope. This tissue may be obtained by surgically operating or by performing what’s called a needle biopsy.)

Once your pediatrician knows more about what is causing the hematuria, a decision can be made whether treatment is necessary and, if so, how it should be administered. Often no treatment is required. Occasionally medication is used to suppress the immune system temporarily.

Follow-up is important

Whatever the treatment, your child will need to return to the doctor regularly for repeat urine and blood tests and blood pressure checks. This is necessary to make sure that she isn’t developing chronic kidney disease, which can lead to kidney failure. Occasionally hematuria is caused by kidney stones, or rarely by an abnormality that will require surgery. If this is the case, your pediatrician will refer you to a pediatric urologist who can perform such procedures.

 

Published online: 6/07

Source: Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2004 American Academy of Pediatrics, Updated 5/05)
To order a copy of this book visit the AAP Bookstore.
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