Etiological Profile and Clinical Outcomes of Pediatric Hematuria at BMU

Abstract

Background: Hematuria in children is a common clinical finding with a wide spectrum of urological etiologies, ranging from benign conditions to significant structural abnormalities. Limited prospective data exist on urological causes of pediatric hematuria in low- and middle-income settings, including Bangladesh. Objective: To determine the urological etiological profile and clinical outcomes of pediatric hematuria. Methods: This prospective cohort study was conducted at Bangladesh Medical University (BMU), Dhaka, Bangladesh, from January 2019 to December 2024. A total of 197 children aged 1 month to 18 years with gross or microscopic hematuria were enrolled through purposive sampling. Data were analyzed using SPSS version 23.0. Results: The mean age was 7.8±4.1 years; 111 (56.3%) were male. Urinary tract infection (UTI) was the most common cause (98 children, 49.7%), followed by hypercalciuria (54, 27.4%) and urolithiasis (32, 16.2%). Vesicoureteral reflux was diagnosed in 9 (4.6%), and post-traumatic hematuria in 4 (2.0%). No urological etiology was determined in 6 children (3.0%). At six-month follow-up, complete resolution occurred in 179 children (90.9%), persistent asymptomatic hematuria in 15 (7.6%), and progression to chronic kidney disease (CKD) in 3 (1.5%). All CKD cases were associated with obstructive uropathy from large renal stones. Conclusion: Urinary tract infection, hypercalciuria, and urolithiasis are the leading urological causes of pediatric hematuria in Bangladesh. Most cases resolve favorably, but children with obstructive stone disease require close follow-up to prevent CKD progression.

Journal of Paediatric Surgeons of Bangladesh (2026) Vol. 17 (1): 30-36