The Efficacy of Diagnostic Studies about Etiologies of Asymptomatic Microscopic Hematuria in Children

Moon, Hong Sang; Choi, Hong Yong; Park, Hae Young

Abstract

PURPOSE: A microscopic hematuria is a common finding on urine examination, with a prevalence rate of between 0.5 and 1.6% in urine samples from children. Although there are many causes of an asymptomatic microscopic hematuria, the vast majority of causes are diagnosed as idiopathic or benign, which are not indicative of significant renal disease. This study was performed to determine the value of standard laboratory and radiological evaluations of asymptomatic microscopic hematuria in children.
MATERIALS AND METHODS
Between January 2001 and December 2003, a retrospective study of 150 children with an asymptomatic microscopic hematuria, who visited the Hanyang University Guri Hospital, was conducted. The mean age was 10.2 years old, with a male to female ratio of 83:67. The diagnostic studies reviewed included; blood urea nitrogen, serum creatinine, complete blood count, liver function test, serum electrolyte, serum coagulation test, serum complement concentration, serum immunoglobulin, antinuclear antibody, ultrasonography, intravenous urogram and renal biopsy.
RESULTS
5 diseases (3.3%), 2 nephrologic and 3 urologic, were diagnosed in 150 cases. For the nephrologic diseases, two children were diagnosed with thin basement membrane disease, and for the urologic diseases, one child was diagnosed with a renal stone, with a further two diagnosed with renal cysts.
CONCLUSIONS
In this study, a microscopic hematuria was a benign finding in the vast majority of children. Because of the high false positive rate for a hematuria in the urinary mass screening, this does not seem to be an appropriate exclusive method for evaluating the etiology of a microscopic hematuria. We recommend that basic diagnostic studies, including urinalysis with dysmorphic RBC and ultrasonography, for the evaluation of children with an asymptomatic microscopic hematuria. If no abnormality was found in children using the basic diagnostic study, and in those with no family history of renal disease, proteinuria, and hypertension, it may be rational that doctors periodically follow up with routine urinalysis.