Introduction

See the Clinical Practice Guideline for haematuria: Clinical Practice Guidelines: Haematuria

The majority of children have isolated asymptomatic microscopic haematuria and do not need immediate investigation, but do require follow up with repeat urinalysis.

When to refer

• Patients <18 years old
• Microscopic haematuria:
  • Persistent over at least 6mth with at least 3 separate urine tests confirming haematuria.
  • Single test showing haematuria, but associated with any of the following:
    • Hypertension
    • Proteinuria on measured urine Prot:Cr >50mg/mmol
    • Elevated serum creatinine
    • Abnormal renal US
• Macroscopic haematuria
  • Refer to Urology if associated pain, blood clots, dysuria or renal calculi. Other cases, refer to Nephrology.
  • Call Nephrology department urgently on 9345-5054 during business hours, or refer to emergency after hours if there is associated hypertension, proteinuria or elevated creatinine.
    • Ensure results of the following are included with the referral:
      • FBE, UEC, LFT, ESR, C3/C4, ASOT, ANA, ANCA, Coags
      • Urine M/C/S, Prot:Cr, Ca:Cr.
      • Renal US

Wait time for appointments

Specialist Clinics wait times

(Please note, non-urgent referrals for patients over the age of 16 may be declined if it is likely they will not be seen before their 18^th birthday.)

Services available closer to home

Alternative paediatric services available in Victoria:

• Monash Children's Hospital

Referral criteria/required information

Starred items (*) are mandatory.

• *Details of clinical concern requiring nephrologist input, including duration of symptoms and details of all treatments offered or tried.
• *Current height and weight
• *Observations including BP
• *Investigations completed (Blood tests, urine tests, renal ultrasound), but must include:
  • Urine tests at times when child was well:
    • 3 separate urine microscopy reports
    • At least one early morning urine Prot:Cr.
  • Renal US
• *Screening urine microscopy for both biological parents in the setting of persistent microscopic haematuria.

How to refer

Specialist Clinics referral

Please complete the above and submit via:

• Facsimile (03) 9345 5034 or
• Email screferrals@rch.org.au
• Emergencies only call ED or Nephrologist on-call (03) 9345 5522

Information for families

Your child’s referral will be triaged based on the information received in the referral. Your referrer will continue to monitor and manage your child’s care prior to and after your consultation. If there is a change in the clinical situation, a new referral explaining the need for re-triage of the referral is required.

If you are seen elsewhere, please cancel your appointment with our service so that we can provide service to another child on our wait list.

Resources and links

• RCH Clinical Practice Guideline
• infoKID Haematuria

Acknowledgements

The development of this guideline was coordinated by the Department of Nephrology. Guideline reviewed in March 2026.