Haematuria

Pre-referral guidelines for primary care providers

Haematuria can be either macroscopic or microscopic. Haematuria, often in conjunction with proteinuria, is a common incidental finding as part of non-specific febrile illnesses along, and is not necessarily pathological.

For the diagnosis and management of haematuria, both acute and chronic, please refer to the Royal Children’s Hospital clinical practice guidelines.

Practice points

  • Haematuria is often seen in non-specific febrile illnesses and does not necessarily represent a major concern.
  • Excluding UTI and ensuring the child is not acutely unwell remain important steps.
  • For the presentation of haematuria as part of nephritic or nephrotic syndrome, please see the proteinuria pre-referral guideline.

Management

For the diagnosis and management of haematuria, both acute and chronic, please refer to the Royal Children’s Hospital clinical practice guidelines.

Referral pathways

  • Paediatrician
    • Referral to paediatric outpatient services is not appropriate in the management of unwell children with haematuria, or new onset or acute nephritic/nephrotic syndrome.
    • Most cases of transient microscopic haematuria in otherwise well children can be adequately managed in the general practice setting.
    • Referral to paediatric outpatient services should be undertaken for macroscopic haematuria or persistent microscopic haematuria.
  • Nephrologist
    • Referral for nephrology opinion can be considered after review by paediatric services.