Hematuria: Algorithms for Diagnosis

HEMATURIA, either gross or microscopic, in any patient warrants laboratory investigation. The direction and magnitude of this evaluation is dependent to a large extent on the age and sex of the patient and the presence or absence of a urinary tract infection. For example, hematuria in an otherwise asymptomatic 70-year-old man requires a significantly different evaluation than does hematuria in a 20-year-old woman with symptoms of cystitis or in an 8-year-old child with increased blood pressure. In this two-part series, three algorithms for the evaluation of hematuria are presented. Part 1 addresses the problem of hematuria in the child, and part 2, which will appear next week, deals with hematuria in the adult and hematuria secondary to trauma. HEMATURIA IN THE CHILD In children, the laboratory investigation of hematuria begins with a urinalysis and urine culture. Further evaluation depends on the results of these tests. If the child has hematuria