Evaluating a child with “RED URINE”

All cases of red urine are not due to hematuria.

Ask – History of fever, dysuria, rash, joint pain etc. If asymptomatic ask history of ingestion of beet-root, food colouring agents at a party, candies etc.                                               

Look: For rash, edema, hypertension, renal angle tenderness etc.  

Confirm: Presence of RBCs in urine with urine microscopy in a freshly voided urine specimen. Presence of >5 RBCs per HPF is significant in centrifuged specimen. 

Evaluate:                                                               

  • Urine for culture, colony count and sensitivity. If positive treat for UTI 
  • Renal function tests, albumin, spot urine protein creatinine ratio. Refer to Pediatric nephrologist if acute glomerulonephritis is suspected.    
  • Ultrasound KUB. Refer to Pediatric Nephrologist/Urologist if Nephrolithiasis. 
  • Spot urine calcium creatinine ratio, 24 hr urine calcium for hypercalciuria 

Wait and watch: If above evaluation is non-contributory and child is otherwise asymptomatic.   

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