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April 2005

Asymptomatic Microscopic Hematuria: Time to Look the Other Way?

Arch Pediatr Adolesc Med. 2005;159(4):398-399. doi:10.1001/archpedi.159.4.398

Hematuria has been a concern of physicians since antiquity because a number of genitourinary tract diseases and conditions, as well as systemicconditions with renal involvement, produce blood in the urine. Examination of the urine has been a time-honored tool to assist in the investigation of renal and urinary tract disorders, especially when cellular casts, protein, bacteria, and glucose also are present. In this issue of the ARCHIVES, Bergstein et al1 report a large, uniformly studied group of children referred to a nephrology center with either microscopic or macroscopic hematuria. Their findings challenge the conventional recommendations for pursuing a diagnostic evaluation for persistent asymptomatic microscopic hematuria in otherwise healthy children. Perhaps it is time to step back and ask, “Should we evaluate hematuria?” rather than “How should we evaluate hematuria?”

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