Blood or Protein in the Urine
By Dr. Punit Chhajed
Consultant – Paediatric Nephrology, Pune
As a parent, it’s natural to worry if you notice something unusual with your child’s health. One such concern is when a doctor mentions the presence of blood (hematuria) or protein (proteinuria) in your child’s urine. It may sound alarming, but not all cases are serious. However, it’s important to understand what this means, why it happens, and when to seek medical help.
What Is Blood in the Urine?
Blood in the urine is called hematuria. It can be:
- Visible (gross hematuria) – You can clearly see that your child’s urine is red, pink, or tea-colored.
- Invisible (microscopic hematuria) – The blood is only visible under a microscope and found during a urine test generally done for some other reason.
Even a small amount of blood in the urine can look scary, but it doesn’t always mean something is seriously wrong.
What Is Protein in the Urine?
Protein in the urine is called proteinuria. Normally, kidneys filter waste and hold on to important substances like protein. If the kidney filters are not working properly and become leaky, protein can be lost in the urine.
- Temporary proteinuria can occur due to fever, dehydration, or after exercise.
- Persistent proteinuria may indicate kidney issues and needs further investigation.
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Is It Normal?
In some children, especially after a fever, cold, or heavy activity, small amounts of blood or protein may show up in the urine temporarily and go away on their own. But if these findings keep coming back, persist or worsen, it’s best to get it checked.
What Are the Causes?
Causes of Blood in Urine:
- Urinary Tract Infection (UTI): This is one of the most common reasons, especially in younger children. Other symptoms include pain while passing urine and fever.
- Kidney Stones: They can cause pain and blood in the urine. Earlier thought to be uncommon in children although the number of children with kidney stones is on the rise !
- Glomerulonephritis: A condition where the tiny filters in the kidney (glomeruli) get inflamed.
- Injury or Trauma: A fall or blow to the back or abdomen can lead to blood in the urine.
- Inherited Kidney Diseases: Such as Alport syndrome or thin basement membrane disease.
- Strenuous Exercise: Sometimes, vigorous physical activity can temporarily cause blood in urine.
Causes of Protein in Urine:
- Dehydration or Fever: These can cause a temporary increase in protein levels.
- Orthostatic Proteinuria: Common in teenagers, where protein appears in urine during the day but disappears at night.
- Nephrotic Syndrome: A kidney condition where large amounts of protein leak into urine, often accompanied by swelling (especially around the eyes).
- Chronic Kidney Disease (CKD): Persistent protein in urine can be an early sign of kidney damage.
What Are the Symptoms?
Sometimes, blood or protein in urine shows no obvious signs and is only found during a routine urine test. But in other cases, you may notice:
- Urine that is red, brown, or tea-colored
- Swelling in the face, hands, feet, or belly
- Reduced urine output
- Foamy or bubbly urine (a sign of excess protein)
- Frequent urination or burning sensation (especially with UTI)
- Fatigue or lack of appetite
How Is It Treated?
Treatment depends on the underlying cause.
For Blood in Urine:
- UTI: Treated with antibiotics.
- Kidney Stones: Managed with fluids, diet changes, or in some cases, surgical removal.
- Glomerulonephritis: Requires medication to reduce inflammation and protect kidney function.
- Injury: Most injuries heal with rest, but follow-up may be needed.
For Protein in Urine:
- Temporary causes: Often resolve on their own.
- Nephrotic Syndrome: Treated with steroids, salt restriction, and regular follow-up.
- Chronic Conditions: Managed with medications to control blood pressure and reduce protein leakage.
When Should You See a Paediatric Nephrologist?
You should consult a Paediatric Nephrologist like Dr. Punit Chhajed if:
- Blood or protein in urine is persistent or repeatedly detected.
- Your child has swelling, high blood pressure, or reduced growth.
- There is a family history of kidney disease.
- As a second opinion when the routine treatment hasn’t resolved the issue.
As a specialist in children’s kidney health, I take a holistic approach to evaluating and managing these symptoms, focusing not just on treatment but also on long-term kidney health.
What Can Parents Do?
- Don’t Panic: Many causes are minor and treatable.
- Stay Hydrated: Encourage your child to drink enough water.
- Follow Up on Tests: If your child’s pediatrician finds anything unusual in urine reports, don’t ignore it.
- Track Symptoms: Keep a record of any swelling, changes in urine color, or frequency of urination.
- Healthy Diet: Limit excess salt and processed foods to reduce strain on the kidneys.
Final Thoughts
Blood or protein in the urine may sound scary, especially when it involves your child. But remember, not every case is serious. With the right evaluation and timely treatment, most children recover well and lead a normal, healthy life.
If you have any doubts or your child has been advised to see a kidney specialist, we are here to help.
Dr. Punit Chhajed
