Proteinuria In Children

Proteinuria can be transient, orthostatic or persistent.

Persistent proteinuria can indicate significant glomerular or tubular disease.

Transient proteinuria commonly accompanies fever, exercise, dehydration or acute illness.

Proteinuria itself is often asymptomatic.

Heavy protein loss may cause:

• Oedema
• Ascites
• Weight gain
• Frothy urine

Confirm dipstick protein with a quantitative spot urine protein to creatinine ratio, preferably from a first morning specimen.

First morning testing also helps identify orthostatic proteinuria.

Assess:

• Blood pressure
• Serum albumin
• Creatinine
• Urinalysis for haematuria
• Complement where glomerular disease is suspected

Transient proteinuria requires repeat testing after recovery from the precipitating illness.

Orthostatic proteinuria is generally benign.

Persistent proteinuria, nephrotic range proteinuria, associated haematuria, hypertension or reduced renal function requires nephrology assessment.