Hematuria in childhood [Article in Croatian]

Abstract

This article reviewed up to date knowledge on hematurias in children, including the definitions of the following terms: macrohematuria, microhematuria with clinical symptoms, asymptomatic microhematuria with proteinuria, and asymptomatic (isolated) microhematuria. The glomerular and nonglomerular hematurias, as well as discolorated urine have been additionally defined. Signs and symptoms, usually connected with hematuria were described. Although the hematuria is mostly transient, with no mayor influence on child’s health, this article warned that hematuria can be the sign of serious renal disease, no matter if it goes with or without signs of illness. The diagnostic methods used in a diagnostic process of hematuria were discussed, with special attention on algorithms which are currently used in both primary and secondary health care level. This paper was done in order to stress the signs which lead towards diagnosis, and to indicate the necessity of knowledge refreshment in primary care doctors. Moreover, it indicates that they have to decrease the pressure on the sub specialists by using a logic approach to hematurias, with help of previously well prepared diagnostic algorithms. By coordinating diagnostic procedure with the algorithms, the primary care doctor will recognize the time when the patient should be referred to nephrologist, and than will be fully incorporated in the diagnostic process of hematurias in children, having the good interaction with patient and sub specialist. The result of such good cooperation will improve confidence of patient and their parents in their primary care doctor as well as health care system.