What are the causes of urinary sediment in a toddler?

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Last updated: February 19, 2025View editorial policy

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From the Guidelines

If a toddler's urine test shows sediment, it's essential to consult a pediatrician to determine the cause, as urinary tract infections (UTIs) are a common cause of sediment in toddler urine, affecting approximately 2% of children assigned male at birth and 8% of children assigned female at birth by 7 years of age 1. Possible causes of sediment in toddler urine include:

  • Urinary tract infections (UTIs), which can be further divided into cystitis and pyelonephritis, with cystitis typically presenting with localized symptoms of frequency, urgency, and dysuria, and pyelonephritis presenting with systemic symptoms such as high fever, malaise, vomiting, abdominal or flank pain, and tenderness 1
  • Kidney stones, which can cause severe pain and other symptoms
  • Kidney problems, such as vesicoureteral reflux (VUR), which can increase the risk of UTIs and renal scarring

To investigate the cause, the pediatrician may recommend a urinalysis, which includes a urine culture to check for infection, and possibly imaging tests such as an ultrasound 1.

In the meantime, ensure the toddler stays hydrated by drinking plenty of water. If the pediatrician suspects a UTI, they may prescribe an antibiotic such as amoxicillin or trimethoprim-sulfamethoxazole, with the specific dose and duration depending on the child's age, weight, and the severity of the infection 1.

It's crucial to follow the pediatrician's advice and complete the full course of antibiotics as prescribed, even if the symptoms improve before finishing the medication. If the sediment is caused by a kidney stone, the pediatrician may recommend increasing fluid intake and, in some cases, medication such as acetaminophen to help manage pain.

In any case, it's vital to monitor the toddler's symptoms and report any changes or concerns to the pediatrician promptly, as UTIs can have serious long-term consequences, including renal scarring and chronic renal failure 1.

From the Research

Causes of Urinary Sediment in Toddlers

The causes of urinary sediment in toddlers can be attributed to various factors, including:

  • Urinary tract infections (UTIs) 2, 3, 4
  • Kidney diseases, such as glomerulonephritis 4
  • Hematuria, which can be either glomerular or non-glomerular erythrocyturia 4
  • Proteinuria, which can be orthostatic or combined with hematuria 4
  • Infections, such as polyomavirus BK reactivation 5
  • Medications, such as indinavir, amoxycillin, and acyclovir, which can cause leukocyturia or crystalluria 5

Diagnostic Methods

To diagnose the causes of urinary sediment in toddlers, various methods can be used, including:

  • Urine microscopy 6, 4, 5
  • Dipstick tests for leukocyte esterase and nitrite 2
  • Urine culture 2, 3, 4
  • Flow cytometry for automated analysis of urine sediments 5
  • Collection methods, such as suprapubic aspiration, urethral catheterization, clean catch void, urine collection bag, and urine collection pad 3

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Urine Collection Methods in Children: Which is the Best?

The Nursing clinics of North America, 2018

Research

Urinalysis in children and adolescents.

Deutsches Arzteblatt international, 2014

Research

The clinical art and science of urine microscopy.

Current opinion in nephrology and hypertension, 2003

Research

The Importance of Urine Sediment Analysis.

Clinical laboratory, 2024

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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