Microscopic Hematuria: What You Need to Know

What is microscopic hematuria?

Microscopic hematuria is a condition in which there is blood in your child’s urine, but the blood is only noticeable through a urine dipstick test. Doctors can then examine the same urine sample under a microscope and may see small amounts of blood in the urine. This is different from gross hematuria (when you can clearly see blood in urine without a dipstick or microscope). Microscopic hematuria can be a sign of many different medical conditions, such as kidney infections, a urinary tract infection (UTI) or kidney or bladder stones.

What causes microscopic hematuria?

The most common cause of microscopic hematuria in children is infection. If the infection is treated properly, symptoms usually get better on their own.

Other causes of microscopic hematuria include:

• Hypercalciuria (high levels of calcium in the urine)
• Kidney stones (which may or may not be caused by hypercalciuria)
• Certain intrinsic kidney diseases

In these cases, microscopic hematuria typically is not the only symptom.

How do doctors treat microscopic hematuria?

Treatment for microscopic hematuria depends on the cause. In many cases, microscopic hematuria goes away on its own without treatment. If there is an infection or other kidney condition, your child’s care team will talk with you about different treatment options.

Does my child need to be referred to a nephrologist?

If your child has only microscopic hematuria with no other symptoms, their pediatrician can help decide on treatment without a referral.

The pediatrician might refer your child to a pediatric nephrologist (kidney doctor) if your child has a family history of kidney disorders or has symptoms such as high blood pressure, protein in the urine, or kidney injury.

What is the outcome for children who have microscopic hematuria?

Typically, children with microscopic hematuria have a good outcome. Children with persistent or recurring microscopic hematuria (when the condition is ever present or comes back frequently) have a slightly higher chance of developing kidney disease or proteinuria (protein in the urine) at some point and may need nephrology follow-up.

Rev. 12/2020. Mass General for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.