An organized practical approach for the pediatrician to use in evaluating a child with hematuria or proteinuria emphasizes common conditions and stepwise laboratory/radiologic investigations. Additional points of emphasis include when to refer to a pediatric nephrologist or urologist and when to consider renal biopsy. Real case statistics and salient examples from the major published studies should assist the pediatrician in counseling the patient and his or her family, especially when there is no medical indication to refer to a specialist.