Particles in Urine

Dear Lisa,

I have a 3 1/2 year old son who had tiny particles in his urine today. They looked like tiny dirt particles and I asked if it hurt when he went to the bathroom and he said it did not. I had never seen anything like this. I will keep an eye on it, but does this sound like something medically that you are familiar with?

“Particles in son’s urine”

Dear “Particles in son’s urine”,

Normally urine has sediment which tends to increase in a child who is dehydrated, has a fever or who has been exercising. In some cases certain types of sediment can be a sign of a disease state, such as kidney disease, lead poisoning, or a metabolic disorder. (1) Usually sediment is not seen by the naked eye and can only be seen when visualized under a microscope.

More likely, particles seen by the naked eye are the result of contamination from debris on the skin that falls into the toilet when a child urinates. Your child could have had some dirt or fibers from his clothing on his skin that ended up in the toilet bowl when he urinated. Another explanation is that sometimes the water in the toilet bowel contains residue due to hard water in the plumbing system. Residue in the toilet bowl can also be found when a person who previously used the toilet bowl had a bowel movement or diarrhea. In some cases, people use the toilet bowl to dispose waste or garbage and this too can leave a residue in the toilet bowl. So the particles that you noticed could have been from the water in the toilet bowl and not from your child’s urine.

If a child has renal calculi or kidney stones it is possible to visualize granules, small stones or sandy particles in a child’s urine after they void. This is probably not the case with your child since he told you that urinating did not hurt. Typically passing a kidney stone is painful. In addition kidney stones are not common in the pediatric population unless the child has an underlying condition. The medical conditions that predispose a child to develop kidney stones include hypercalciuria (too much calcium in the urine), recurrent urinary tract infections, metabolic disorders, hyperparathyroidism, renal tubular acidosis, Cushing syndrome or conditions that result in prolonged immobilization(such as an orthopedic injury). (2)

The signs of a kidney stone include pain with urination, blood in the urine, abdominal pain and urethral obstruction or the inability to pass urine. Although spontaneous passage of a kidney stone may occur with no previous symptoms. If there is a family history of kidney stones, metabolic disorders or Gout you should bring your son to his Pediatrician for an evaluation. Also if your son has any underlying medical conditions that would predispose him to kidney stones he should also be seen by his Pediatrician.

Otherwise it is a good idea to continue to monitor you child’s urine. If particles reoccur or if he develops other symptoms such abdominal pain, blood in the urine, fever, pain with urination or change in his urine flow you should contact your Pediatrician. If this occurs you will need to collect a urine specimen so that it can be examined at the laboratory. A fresh, clean catch urine sample collected in a sterile container is the type of specimen that should be obtained. The specimen should not be taken out of the toilet bowl.

It is important for children to have scheduled physical examinations on a regular basis in order to promote health and to monitor for any health deviations. During your son’s next scheduled physical examination a routine urinalysis should be performed.

(1) Wallace M, Sadovsky R. What Clinicians should know about urinalysis. The Clinical Advisor. 2005;April:39-48.
(2) Betz C, Hunsberger M, Wright S. Family-Centered Nursing Care of Children. W.B. 2nd ed. Philadelphia, PA:Saunders Company. 1994:1530-1531.

Lisa-ann Kelly R.N., P.N.P.,C.
Certified Pediatric Nurse Practitioner

Ask Lisa Pediatric Advice