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Blood in Urine
October 2001

Q. My son consistantly has blood in his urine since he was 3 or 4 months old (he is 2 years old now). At that time, we were referred to a urologist, who ran several types of tests including an ultrasound on his abdomen, and everything appeared regular. However, tests continued to show varying amounts of blood in his urine. They suggested that we just follow him to see what happens.

I didn't hear anything about it for quite some time. When my son went back for his well-child check this past week, they noticed that, while in the past he had always been small (in the 20th percentile), he now had completely fallen off the chart. When I mentioned the past hematuria, the doctor had completely forgotten about it, and ordered a test on his urine. They used a catheter to take some urine, and did a dip test to get immediate results. The doctor said there was a significant amount of blood in his urine, and she was going to send it out for a culture. I received those test results from her nurse today, who simply told me he did not have a urinary tract infection. The doctor has referred him back to the urologist.

I have read on the internet that there are a wide variety of causes for this type of hematuria, and sometimes the cause is never determined. But from what I am reading, this type of situation usually resolves itself, whereas my son's hematuria has been going on for nearly two years. Any thoughts or suggestions as to what the cause could be?

A. The key to medical treatment is to establish a diagnosis and then proceed with current recommendations for treatment. At this point in time, your child has two abnormalities, hematuria and delayed growth, but the diagnosis has not been established. The two conditions may well be related. It is likely that a pediatric nephrologist (kidney specialist) can help you in this regard so that treatment options can be considered.

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