diagnostic value of hematuria in young patients with kidney stones.
Pediatric nephrolithiasis has been steadily increasing worldwide, and hematuria—blood in the urine—has traditionally been considered one of the most common and reliable markers for detecting stones. However, the precise relationship between hematuria and stone characteristics in children remains largely uncertain. This study set out to evaluate this association and determine whether hematuria could be used as a reliable indicator of stone disease in the pediatric population.
The researchers conducted an observational analysis of children aged one month to 18 years who were diagnosed with nephrolithiasis or nephrocalcinosis. To ensure accurate interpretation, the study excluded children with systemic illnesses, active urinary tract infections, congenital urinary tract abnormalities, familial hematuria, recent trauma, fever, urinary tract tumors, or recent renal colic episodes. Detailed information, including demographics, stone features, metabolic findings, and urinalysis reports, was collected and analyzed using standard statistical methods.
The authors concluded that hematuria should not be viewed as a standalone diagnostic marker in children suspected of having kidney stones. Instead, imaging—such as ultrasound—remains an essential component of the diagnostic pathway, particularly for children who present with symptoms but lack hematuria on urinalysis.
"The research reinforces the need for heightened clinical vigilance and supports a more comprehensive diagnostic strategy to ensure timely detection and management of kidney stones in pediatric patients," they wrote.
Pournasiri, Z., Taheri, M.M., Fatollahierad, S. et al. Hematuria as a diagnostic marker in pediatric nephrolithiasis without acute obstruction or infection. Pediatr Nephrol (2025). https://doi.org/10.1007/s00467-025-07032-5
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