Sometimes my child's urine looks reddish in color. Is that normal?
If your child’s urine has a red, orange, or brown color, it may contain blood. When the urine specifically contains red blood cells, doctors use the medical term hematuria to descibe this condition.
Many things, including a physical injury or inflammation or infection in the urinary tract, can cause it. Hematuria also is associated with some general medical problems, such as defects of blood clotting, exposure to toxic materials, hereditary conditions, or immune system abnormalities. Sometimes there may be such small amounts of blood in the urine that you cannot see any color change, although it may be detected by a chemical test performed by the pediatrician.
In some cases the reddish color is not associated with hematuria at all, and the reddishness may be due simply to something your child has eaten or swallowed. Beets, blackberries, red food coloring, phenolphthalein (a chemical sometimes used in laxatives), or phenazopyridine (medicine used to relieve bladder pain), and the medicine rifampin may cause the urine to turn red or orange if your child ingests them.
Anytime you are not sure that one of these alternative explanations is responsible for the color change, call your pediatrician. Blood in the urine, when accompanied by protein (albumin), is usually due to inflammation of the filtering membranes of the kidney; the general term for this condition is nephritis. Your doctor may recommend further tests to distinguish among several different kinds of nephritis.
Your pediatrician will ask you about any possible injury, foods, or health symptoms that might have caused the change in urine color. He will perform a physical examination, checking particularly for any increase in blood pressure, tenderness in the kidney area, or swelling (particularly of the hands or feet or around the eyes) that might indicate kidney problems. He also will perform tests on a sample of urine and may order blood tests, imaging studies (such as an ultrasound scan or X-rays), or perform other examinations to check the functioning of your child’s kidneys, bladder, and immune system.
If none of these reveals the cause of the hematuria, and it continues to occur, your pediatrician may refer you to a children’s kidney specialist, who will perform additional tests. (Sometimes these tests include an examination of a tiny piece of kidney tissue under the microscope, a procedure known as a biopsy. This tissue may be obtained by surgically operating or by performing what’s called a needle biopsy.)
Once your pediatrician knows more about what is causing the hematuria, a decision can be made whether treatment is necessary. Often no treatment is required. Occasionally medication is used to suppress the inflammation that is the hallmarksign of nephritis.
Follow-up is important
Whatever the treatment, your child will need to return to the doctor regularly for repeat urine and blood tests and blood pressure checks. This is necessary to make sure that she isn’t developing chronic kidney disease, which can lead to kidney failure. Occasionally hematuria is caused by kidney stones, or, rarely, by an abnormality that will require surgery. If this is the case, your pediatrician will refer you to a pediatric urologist who can perform such procedures.