Blood in a Child's Urine

When you see blood in your child’s pee, you may think the worst. But it’s a common urinary system (urinary tract) symptom.  And it’s important to understand that many things can cause this. Common causes of bleeding in a child’s urine are:

• Urinary tract infection (UTI).
• Kidney infection (pyelonephritis).
• Bladder infection (cystitis).
• Kidney, bladder and ureteral stones.
• Vigorous exercise.

Some more serious conditions that can cause bloody urine are kidney (renal) disease and sickle cell disease. Bladder or kidney cancer are possible causes of blood in the urine but are also rare causes in children.

Visible blood in your child’s pee is called gross hematuria. Sometimes, your child may still have blood in their pee, but you can’t see it. That’s known as microhematuria — and the blood (red blood cells) is only visible under a microscope.

If you see blood in your child’s pee, or they have pain or other symptoms like fever, nausea, vomiting or chills, you’ll want to find out what’s going on.

What to expect at your child’s first visit

You’ll want to be prepared to answer a lot of questions when you meet with your child’s provider. They’ll want to know all about what’s going on and may ask things like:

• When did you first notice the blood in your child’s pee?
• Is your child having any pain or discomfort when they pee?
• What other kinds of symptoms has your child had?
• Has your child had any recent injuries or accidents?
• Does your child take any medications or supplements?
• Does your child have a history of urinary tract infections or kidney problems?
• Does anyone in your family have a history of kidney or bladder problems?
• Do you know if your child has been exposed to any chemicals or toxins?
• Does your child have any other medical conditions or allergies?
• How much does your child drink each day?

During the visit, your child’s provider will do a physical exam and order tests to help confirm a diagnosis.

Testing for blood in a child’s urine

Even if you can see blood in your child’s pee, their provider will want to do tests to find out what’s causing it. Your child may have:

• Urinalysis.
• Urine culture.
• Urine cytology.
• Cystoscopy.
• Imaging tests like MRIs, CT scans or ultrasounds.

Meet Our Pediatric Hematuria Team

Cleveland Clinic Children’s believes in team-based care that brings together the experience of providers from different specialties to diagnose and treat blood in a child’s urine. No two diagnoses are the same, so your child will have a care team focused on their specific needs with providers like:

• Pediatric urologists.
• Pediatric nephrologists.
• Pediatric radiologists.
• Pediatricians.
• Pediatric nurse practitioners.
• Child life specialists.

Your child’s treatment plan will depend on what’s causing blood in their urine. Medications are often a first-line therapy for blood in a child’s urine. Your child’s providers may prescribe antibiotics to treat infections and pain relievers to make your child more comfortable.

For more serious conditions like sickle cell disease, cancer or kidney disease, your child may take medications specific to those diagnoses, like chemotherapy or diuretics. Severe kidney disease may require dialysis or even a kidney transplant.

Taking the Next Step

Many conditions can cause blood in a child’s urine. And when you see it, you’ll want to find out what’s causing it and get treatment quickly. The experts at Cleveland Clinic Children’s are here to help find out what’s going on with your child. Our caring team will guide you both through what to expect so you can feel more at ease about diagnosis, treatment and recovery.