About this symptom
A child’s urine may look pink, red or dark, or red blood cells may be found only on testing. This is called haematuria. Its cause cannot be determined from colour or a single dipstick result alone.
What matters most
Visible blood can occur with a urinary infection, kidney or urinary-tract condition and other causes. Sometimes food or medicines alter urine colour without bleeding. A clinician considers the history rather than assuming every red sample represents the same disease.
Symptoms and situations to watch
Mention pain or burning when passing urine, fever, lower back or abdominal pain, swelling, a change in the amount of urine, recent illness or injury. A child may otherwise feel well despite an abnormal urine test.
Important distinctions
Microscopic haematuria is different from visible bleeding. It can be transient or persistent, and isolated findings differ from blood accompanied by proteinuria, raised blood pressure or impaired kidney function. Those combinations may need a paediatric nephrologist.
How clinicians assess the problem
The doctor may recommend a properly collected repeat urinalysis, urine microscopy, a culture when infection is suspected and targeted blood or imaging tests. Blood pressure and associated symptoms guide the next steps; a single abnormal strip does not establish a diagnosis.
Care and limitations
Treatment is directed at the cause. Avoid starting an antibiotic or other medicine solely because urine looks different. Even when there are no acute symptoms, arrange follow-up for repeated or persistent haematuria.
When emergency help is needed
Visible blood with severe flank pain, high fever, inability to urinate, marked weakness or rapid deterioration requires urgent face-to-face care. Call 103 or 112 for collapse, impaired consciousness or another severe emergency.
Related information
Protein in a child’s urine; Urinary tract infections in children; Pyelonephritis in children; Glomerulonephritis in children.
Signs and symptoms
Mention pain or burning when passing urine, fever, lower back or abdominal pain, swelling, a change in the amount of urine, recent illness or injury. A child may otherwise feel well despite an abnormal urine test.
Diagnosis and tests
The doctor may recommend a properly collected repeat urinalysis, urine microscopy, a culture when infection is suspected and targeted blood or imaging tests. Blood pressure and associated symptoms guide the next steps; a single abnormal strip does not establish a diagnosis.
Care and treatment approaches
Treatment is directed at the cause. Avoid starting an antibiotic or other medicine solely because urine looks different. Even when there are no acute symptoms, arrange follow-up for repeated or persistent haematuria.
When to seek urgent care
Visible blood with severe flank pain, high fever, inability to urinate, marked weakness or rapid deterioration requires urgent face-to-face care. Call 103 or 112 for collapse, impaired consciousness or another severe emergency.
Frequently asked questions
Can urine contain blood without changing colour?
Yes. Microscopic haematuria may only be detected on urinalysis and can need confirmation and follow-up.
Does a well-looking child need review?
Yes, especially when the finding persists or recurs or is accompanied by protein in urine or high blood pressure.
Is a single test enough to diagnose kidney disease?
No. The result is interpreted with symptoms, repeat testing when indicated and further assessment tailored to the child.
Important information
A medical consultation is needed for diagnosis and treatment recommendations.
Self-treatment can be harmful to your health.
