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Background: Hematuria is an important and common sign of urinary system diseases in children. Careful assessment is needed for definitive diagnosis and appropriate management. In this study we aimed to investigate the demographic and clinical characteristics of patients who were admitted to our pediatric nephrology clinic with hematuria and to determine the features that will guide the diagnosis. Methods: Medical charts of 370 patients who were referred to our clinic in a period of four years with gross or microscopic hematuria were evaluated retrospectively. Demographical data, clinical and laboratory findings, imaging modalities and diagnosis of the patients were investigated. Findings: Of the patients 195 (52.7 %) were boys and 175 (47.3%) were girls and the majority of the patients were in the age group of 6-10 years. Major presenting feature was red colored urine (64.1 %). Non-glomerular causes were found to be significantly higher among patients with macroscopic hematuria (p=0.002). Acute poststreptococcal glomerulonephritis formed the majority of glomerular hematuria and urinary system infections formed the majority of non-glomerular hematuria causes respectively. Conclusions: This study suggests that a careful history, detailed physical examination and clinical evaluation may elucidate the etiology in the majority of the patients with hematuria. Advanced imaging modalities and renal biopsy are indicated only in selected cases.
Purpose: Hematuria is an important discovery of diseases of the urinary system in children. It requires a careful assessment and a good clinical approach to the distinctive diagnosis as it may be a sign of underlying serious diseases. This study was aimed at examining and determining the demographic and clinical characteristics of patients who apply to our pediatric nefrology clinic with the cause of hematurium. Patients and Method: This study was carried out by retrospective assessment of the files of 370 patients who were monitored in our clinic due to macroscopic and/or microscopic hematures. The demographic data of patients, abortion results and clinical findings, screening tests and final diagnoses were studied. Results: 195 of the patients (52.7%) are male, 175 (47%) are male. 7) was angry and most of them were in the 6-10-year-old group. 234 patients (63.2 percent) were applied to macroscopic hematuria, while 44 (15.3 percent) were diagnosed with glomerular hematuria. In the macroscopic hematury group, non-glomerular causes were found significantly high. Among the causes of glomerular hematuria, acute poststreptoccal glomerulonefritis (APSGN), which is still widely detected in our country, was not-glomerular causes of urinary system infections. Discussions: This study shows that with a careful history, detailed physical examination and clinical assessment, the majority of patients who apply to hematuria can illuminate the ethology. Advanced screening and renal biopsy are indicated only in selected cases.
Amaç: Hematüri çocuklarda üriner sistem hastalıklarının önemli bir bulgusudur. Altta yatan ciddi hastalıkların belirtisi olabileceğinden ayırıcı tanı için dikkatli bir değerlendirme ve iyi bir klinik yaklaşım gerektirmektedir. Bu çalışmada pediatrik nefroloji kliniğimize hematüri nedeni ile başvuran hastaların demografik ve klinik özelliklerinin incelenmesi ve tanıya yol gösterecek özelliklerin belirlenmesi amaçlandı. Hastalar ve Yöntem: Bu çalışma, kliniğimizde makroskopik ve/veya mikroskopik hematüri nedeniyle izlenmiş olan 370 hastanın dosyası retrospektif olarak değerlendirilerek gerçekleştirildi. Hastaların demografik verileri,l aboratuar sonuçları ve klinik bulguları, görüntüleme tetkikleri ve nihai tanıları araştırıldı. Bulgular: Hastaların 195’i (%52.7) erkek, 175 (%47.7)’si kızdı ve çoğunluğu 6-10 yaş grubunda yer almaktaydı. Hastaların 234 ‘ü (%63.2) makroskopik hematüri ile başvururken , 44’ünde (%15.3) glomerüler hematüri saptandı. Makroskopik hematüri grubunda non-glomerular nedenler anlamlı olarak yüksek bulundu. Glomerüler hematüri nedenleri arasında ülkemizde halen yaygın olarak saptanan akut poststreptokokkal glomerülonefrit (APSGN), non glomerüler nedenlerden de üriner sistem enfeksiyonu en yüksek oranda görülen hastalıkları oluşturmaktaydı. Tartışma: Bu çalışma dikkatli bir öykü, ayrıntılı fizik muayene ve klinik değerlendirme ile hematüri ile başvuran hastaların büyük çoğunluğunda etiyolojinin aydınlatılabileceğini göstermektedir. İleri görüntüleme tetkikleri ve renal biyopsi sadece seçilmiş vakalarda endikedir.
Field : Sağlık Bilimleri
Journal Type : Uluslararası
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