What is the cause of blood in the urine of children?

If a child has blood in his urine, it is a serious condition and the child should be taken to the hospital immediately to check whether there is any infection in the urinary system. Blood in the urine is likely caused by serious diseases such as glomerular hematuria and leukemia, and kidney function tests are needed. If it is caused by glomerular inflammation, it is recommended that the patient should receive medical treatment in time to alleviate the condition.

1. What causes hematuria in children?

There are many causes of hematuria in children, which can be divided into two categories according to the source of hematuria: glomerular hematuria and non-glomerular hematuria.

Glomerular hematuria

Refers to hematuria originating from the glomerulus. ① Primary glomerulonephritis: It is the most common cause of hematuria in children. Such as various acute, chronic, and protracted glomerulonephritis, rapidly progressive nephritis, nephrotic syndrome, IgA nephropathy, etc. In addition to hematuria, there are also symptoms of proteinuria, edema, hypertension and renal insufficiency. ② Secondary glomerulonephritis: Common ones include hepatitis B or hepatitis C virus-related nephritis, purpura nephritis, lupus nephritis, nodular arteritis, hemolytic uremic syndrome, infective endocarditis nephritis, etc. In addition to hematuria, it is often accompanied by clinical manifestations of the primary disease. ③ Familial hereditary glomerular diseases: common ones include hereditary nephritis (Alport syndrome) and thin basement membrane nephropathy. ④ Simple hematuria: Clinically, it only manifests as persistent or recurrent microscopic hematuria, with or without paroxysmal macroscopic hematuria, and is not accompanied by other symptoms such as edema, hypertension, and renal dysfunction. ⑤ Transient hematuria after some strenuous exercise.

Non-glomerular hematuria

It refers to hematuria originating from the renal tubules, renal interstitium or urinary tract (including collecting system, ureters, bladder and urethra) and systemic diseases. ① Urinary tract infection: such as pyelonephritis, renal tuberculosis, cystitis, etc. In addition to bacterial infection, pathogens can also be caused by viruses, mycoplasma, fungi, parasites, etc. ② Urinary stones: kidney stones, bladder stones, and urethral stones. ③ Idiopathic hypercalciuria. ④ Drugs and chemical substances: antibiotics (such as aminoglycosides, cefotaxime, penicillin, sulfonamides), acetylsalicylic acid, anticoagulants (heparin, dicoumarol), cyclophosphamide, phenazone, cold medicine, phenol, heavy metals (mercury, arsenic, lead), etc. ⑤ Vascular lesions: nutcracker phenomenon (left renal vein compression syndrome), renal vein thrombosis, and renal arteriovenous fistula. ⑥ Urinary tract malformations: polycystic kidney, horseshoe kidney, sponge kidney, bladder diverticulum, hydronephrosis, etc. ⑦ Tumors: Wilms tumor, nephroblastoma, leukemia. ⑧Trauma: such as trauma, surgery, instrument damage, urethral foreign body, etc. ⑨ Lesions of adjacent organs: such as appendicitis, pelvic inflammatory disease, etc. ⑩ Systemic diseases: thrombocytopenic purpura, hemophilia, spontaneous hemorrhage of the newborn, etc.

2. What should I do if my child has hematuria?

Bed rest

Patients should stay in bed for 2 weeks after the onset of the disease. Children with severe conditions should stay in bed for a longer period of time. Generally, they can gradually get out of bed and move around only after the visible hematuria disappears, the edema subsides, and the blood pressure returns to normal; they can return to school only after the erythrocyte sedimentation rate improves; and they can resume physical activities only after the urine routine test has returned to normal for 3 months.

Clearing the infection

The bacteria that usually cause this infection are streptococci, so penicillin, which is sensitive to streptococci, is often used, with a course of 7-10 days; those who are allergic to penicillin can use erythromycin instead.

Limit sodium intake

Consuming sodium salt before the condition has fully improved will cause the condition to worsen and become difficult to cure, so sodium salt can generally only be consumed after the edema in children has subsided.

Diuretic use

Children's lack of urine will lead to the inability to excrete harmful metabolites in the body, which will cause lesions in other body systems in the long run and is not conducive to the improvement of the disease. Choosing appropriate diuretics to help children maintain the body's water, salt and electrolyte balance will help improve the condition.

Understanding Misunderstandings

When children have hematuria, it does not necessarily mean that the color of the blood urine is bright red. Sometimes it is ash-like or meat-washed color. This is due to the different amounts of acid and alkali in the urine, resulting in different shades of color.