A Study of Ultrasonographic Findings in Children with Microscopic Hematuria in Zahedan

Abstract

Background: Microscopic hematuria in children may indicate underlying urinary tract pathology. Ultrasound is the primary imaging modality in pediatric patients because it avoids ionizing radiation. Objectives: This study aimed to evaluate the frequency and patterns of ultrasonographic findings in children with confirmed microscopic hematuria who were referred to pediatric nephrology clinics in Zahedan during 2022 - 2023 and to describe the associated clinical symptoms in this population. Methods: In this descriptive cross-sectional study, 300 children older than two months with confirmed microscopic hematuria were consecutively enrolled from nephrology clinics in Zahedan during 2022 - 2023. Microscopic hematuria was confirmed by urinalysis, including dipstick testing and urine cytology. Written informed consent was obtained from the children’s parents or guardians. Ultrasound findings were recorded using a Samsung WS80 ultrasound device. Data were analyzed using descriptive statistics. Quantitative findings are reported as mean ± standard deviation, and qualitative findings are reported as frequencies and percentages. Results: Among the 300 children, 92 (30.7%) had kidney stones, 92 (30.7%) had floating echoes and bladder debris, 56 (18.7%) had hydroureteronephrosis, 43 (14.4%) had hydronephrosis, 6 (2%) had cysts, 24 (8%) had post-void residual urine, 42 (14%) had increased bladder wall thickness, 2 (0.07%) had urinary tract masses, and 2 (0.07%) had nephrocalcinosis. Clinically, 107 (35.7%) reported pain, 103 (34.4%) had dysuria, 43 (14.3%) had urinary frequency, and 38 (12.7%) had fever. Conclusions: Floating echoes and bladder debris, as well as kidney stones, were the most common ultrasonographic findings in children with microscopic hematuria, followed by mild degrees of hydronephrosis and hydroureteronephrosis. Most children were asymptomatic, and only approximately one-third reported pain or dysuria. Ultrasound can effectively identify common urinary tract abnormalities in this population. Further studies are needed to evaluate the impact of early detection on long-term outcomes.