Abstract

Haematuria is not a factor for progressive loss of kidney function but it could be a symptom of severe renal disease. The aim of the study was to discover the aetiology of haematuria among paediatric inpatients and define those prone to progressive kidney damage.

In the paediatric department of the new Tokuda Hospital, Sofia (February 2007–February 2008) 19 children (7 boys, 12 girls) aged 3–16 years with haematuria have been examined. Four patients have isolated haematuria and 15 have haematuria associated with proteinuria or hypertension. The follow-up period was 4 months–9 years.

11/19 patients have been diagnosed as having glomerular haematuria (GH). Eight of them underwent kidney biopsy with the following results: three with IgA glomerular nephritis (GN), two with mesangial proliferative GN, two with Alport syndrome, one with minimal change disease. One patient has Henoch–Schonlein GN. Five patients with GH have a positive family history for progressive GN. Among 8/19 patients with non-GH two have urinary tract infection, one tubulointerstitial nephritis and uveitis, one tubulointerstitial nephritis, one kidney stone and one hypercalciuria. In one patient bleeding from the left kidney has been confirmed. All patients have normal renal function. One patient with IgA GN and nephrosclerosis achieved remission after treatment with ciclosporin and endoxan. A patient with GH and proteinuria required treatment with ciclosporin alone or with angiotensin-converting enzyme inhibitors and omega 3. In six patients with GN gross haematuria and proteinuria disappeared. Non-GH has been treated according to the underling disease.

Haematuria is rare and is associated with deteriorated kidney function but careful follow-up is required.