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Evaluation of gross hematuria in children

Olivia Gillion Boyer, MD, PhD
Section Editors
Patrick Niaudet, MD
Laurence S Baskin, MD, FAAP
Deputy Editor
Melanie S Kim, MD


Gross hematuria is defined by the presence of an increased number of red blood cells (RBCs) in the urine that is visible to the naked eye. Although an uncommon occurrence in children, nevertheless it is a disturbing finding for both the affected child and his/her family.

The causes and evaluation of gross hematuria in children will be reviewed here. The evaluation of children with microscopic hematuria is discussed separately. (See "Evaluation of microscopic hematuria in children".)


Gross hematuria is suspected when red or brown urine is present. However, red or brown urine can be due to causes other than blood including the following (table 1):

Pigments from drugs (eg, phenazopyridine, rifampicin) or foods (eg, beets)

Metabolites associated with other clinical conditions (eg, porphyria)

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Literature review current through: Nov 2017. | This topic last updated: Aug 19, 2016.
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