What does microscopic blood and protein in the urine signify?

Patient

Q: My sons urine sample came back with 1+protien,1+blood and 1+ bilirubin. The urgent care did not want to tell me what this maybe until we meet and run more test. However we are going on vacation in two days and will begone for ten days, I need to have some idea what we are talking about before we go. Can you help? please Thank you.

Doctor

A:   The result of your son’s urine dipstick examination has revealed that there is microscopic haematuria (blood in the urine) and proteinuria (protein in the urine). Haematuria can either be visible to the naked eye (gross) or apparent only upon urinalysis (microscopic). Urinary abnormalities are common in children but are rarely persistent. Persistent haematuria (whether microscopic or gross) or persistent proteinuria are uncommon and warrant further investigation as they are indicators of potentially significant underlying kidney disease. It is difficult to say at present why the urine dipstick is abnormal other than it could be a sign of kidney disease or damage. Further investigations required include measurement of serum creatinine (a measure of kidney function) and quantification of proteinuria either by a 24-hour urine collection or determination of the urine protein-to-creatinine ratio on a first morning urine sample. The results of these investigations will aid in determining the underlying cause.

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