Background Haematuria is a common paediatric problem leading to extensive work-up and anxiety in parents. Traditionally, detection of haematuria has prompted extensive evaluation of the patients; however, this historic wisdom is now questioned.

Materials and Methods We conducted a retrospective chart review over a 10-year period from October 1998 to March 2007.

Results Of 102 children’s medical record reviewed, 51 were males and females, respectively, the majority were Saudi nationals, 83 (81%). Mean age was 7.38 ± 3.21 years for males and 7.5 ± 2.8 years for females. Family history of renal disease was present in 17% of the cases and only 12% had history of haematuria in other members of the family. Approximately two-thirds (66) of patients had microscopic haematuria and one third (36) had gross haematuria. 54% of patients presenting with microscopic haematuria were undiagnosed, whereas 22% were undiagnosed in the gross haematuria group. The common diagnoses were acute post-streptococcal glomerulonephritis (APSGN) 14%, adenoviral cystitis 36% in each group, respectively. Haematuria resolved in 49% of children during the follow-up period of 20.06 ± 15.51 months. The yield of various laboratory tests in approaching a diagnosis in asymptomatic children was rather poor, similarly the yield of radiological tests, primarily renal sonogram, was only 6.2% from 80 studies.

Conclusions Our study has indicated that the aetiology of haematuria in children in Saudi Arabia is quite similar to western data, with APSGN, adenoviral cystitis and hypercalciuria being the common causes. In addition, we support the practice of careful long-term follow-up in patients with asymptomatic microscopic haematuria without extensive work-up.