Children with hematuria, especially microscopic hematuria (i.e., urine with normal color, but red blood cells can be seen under the microscope) often have no obvious abnormal clinical symptoms and have an insidious onset. The disease is mostly detected by physical examination or by chance, but the cause of hematuria is complex and can be caused by injury anywhere in the urinary system, such as the kidney, ureter, bladder, urethra, etc. It may also originate from systemic diseases, and the prognosis varies in severity, so it should be given sufficient attention and treated in a timely manner. Question 1: Does red urine necessarily mean hematuria? Case: On the morning of the second day of anti-tuberculosis medication for a child with tuberculosis, the parents were alarmed to find that the child’s urine was red, but the urine routine was normal before treatment. Answer: Red urine is not necessarily hematuria, and there is a difference between real and fake hematuria. Only after excluding pseudohematuria can we confirm the diagnosis of true hematuria. The difference between the two is that there are no red blood cells in the urine of children with pseudohematuria under the microscope. Common pseudohematuria includes red urine due to drug metabolism after oral administration of rifampin (an anti-tuberculosis drug), sodium phenytoin and rhubarb; red urine can also occur after children take large amounts of food containing artificial colors; and red urine in children with hemoglobinuria and myoglobinuria. Bright red urine is considered to be caused by anti-tuberculosis drugs, so drink more water and do not be nervous. Tip: If you encounter red urine, parents should take your child to the doctor and tell him/her about the recent diet and medication, as this will facilitate the diagnosis and treatment of the disease. Question 2: What if the urine is positive for occult blood? Case: Lingling was found to have ++ occult blood in urine during the routine urine examination at school, but the microscopic examination of red blood cells was 0. Urine pH and urine specific gravity were normal, and the child’s next of kin did not have kidney disease. Does the positive occult blood mean that Ling Ling is suffering from nephritis? Answer: There are usually two methods of urine red blood cell detection, one is the manual method, using a microscope to directly watch the count, which is the traditional and accurate method, but relatively time-consuming; the other method is the use of machine testing, through the chemical test paper to detect urine occult blood, the method is very sensitive, but easily disturbed by many external factors, such as urine stored for a long time or high temperature storage, bacteriological urine, a large amount of vitamin C, etc., can lead to false positive urine occult blood results (i.e., there are no red blood cells in the urine, but the urine is positive for occult blood). Doctors mainly diagnose the presence of hematuria based on the number of red blood cells in the urine microscopy, and the urine occult blood is for reference only. Thus, Lingling’s positive urine occult blood is not suffering from nephritis, but a false positive result, caused by external disturbing factors, and the diagnosis of hematuria is not valid, and the urine routine can be rechecked if necessary. Tip: If the child has a strong positive urine occult blood (++++), accompanied by changes in urine color such as pink, or accompanied by fever and other discomfort, you should promptly seek medical advice and cooperate with the doctor to improve relevant tests to exclude other diseases. Question 3: Do children with hematuria have a good prognosis? Answer: The prognosis of hematuria depends mainly on the cause. If the child has no clinical discomfort, no family history, no other abnormal laboratory tests, and only microscopic hematuria, the prognosis is often good and has no effect on normal life. However, if it is accompanied by some other serious symptoms, such as abnormal vision and hearing, swelling, severe pain in the lower back, and bleeding from the skin and mucous membranes, active treatment is needed to prevent the condition from deteriorating. Therefore, clarifying the cause of hematuria is essential for the prognostic assessment. Question 4: What are the common precautions for children with hematuria? Answer: Whether it is microscopic hematuria or carnal hematuria, you should seek medical attention in a timely manner and make appropriate medical interventions under the guidance of a physician, do not take drugs indiscriminately, and regular outpatient follow-up is advisable. When urinating, pay attention to the color of urine, the volume of urine, whether there are small bubbles that should not dissipate, and whether there is a combination of other special discomfort, etc. If abnormal, promptly seek medical attention. If you go to the doctor for respiratory infections or other diseases, you should take the initiative to inform the doctor of your history of hematuria so that you can be treated and avoid the use of nephrotoxic drugs. Exercise in moderation, protect yourself from cold and heat, eat healthily, take care of your rest, and develop good habits.