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|Quick reference medical handouts used
by Pediatric offices
Proteinuria in Children
Proteinuria is the medical term to describe a condition in which the
urine contains abnormal amounts of protein
is the medical term to describe a condition in which the urine contains protein. Proteins play an important role in children
and adults: they are the building blocks for body parts, they protect
from the body from infection, they assist in blood clotting and help
regulate the amount of fluid.
Healthy kidneys filter the blood,
removing waste products and retaining essential nutrients, like
proteins. Therefore, protein should not normally appear in the
urine in detectable amounts. When the kidneys
are damaged, protein molecules slip through the kidney's filtering
system and appear in the urine. Diseases and
inflammation that affect the filtering units themselves are the most
common cause of large amounts of protein in the urine, often referred to
is a common laboratory finding in children. It can be
identified as either a transient or a persistent finding
and can represent a benign condition or a serious disease.
Protein is detected in the urine by
dipping a special strip of paper into the urine sample. Finding a large
amount of protein in the urine is usually important, requiring further
evaluation. Sometimes low levels of proteinuria are an early sign of
kidney disease, but when only a little protein is found in the urine, a
child probably has a harmless condition such as orthostatic proteinuria.
Other examples of finding protein in the urine that is not important is
when protein appears in the urine only after strenuous exercise, or it
only occurs when the child has a fever.
proteinuria, which accounts for up to 60 percent of all cases of asymptomatic
proteinuria in children, has an excellent prognosis.
Orthostatic proteinuria is the cause of
proteinuria in many youngsters. Children with this condition have no
kidney damage or disease, but for some unknown reason, lose protein in
the urine during the day when they are active and standing up (hence the
name "orthostatic," which means "upright.") The diagnosis
of this harmless condition is made by testing two urine samples, one
first thing in the morning after the child gets up, and the second test
taken during the day. If the child has "orthostatic
proteinuria" the morning sample will be free of protein while the
sample collected during the day will test positive for protein. No
treatment is needed for children with orthostatic proteinuria. Most
physicians, however, will want to check your child's urine a few times a
year, just to be on the safe side.
Most children with proteinuria have no
signs or symptoms and the condition might have gone undetected if the
urine had not been checked. Therefore, the urinalysis is an
important test in monitoring your youngster's health and well-being. If
there is a large amount of protein in your child's urine, then the
youngster's doctor might refer him or her to a kidney specialist
("nephrologist") for further tests and evaluation. Once the
specialist finds out what is causing the protein in your child's urine,
the doctor can find the best way to treat the problem.
In general, the finding of proteinuria
during a routine examination in a child's urinalysis should not cause
parents to become too alarmed nor does it mean an automatic referral to
a specialist for more extensive tests. Only if there are multiple
positive urine tests on different occasions should a more thorough
evaluation take place. This might include collecting a 24-hour
urinalysis and/or evaluation by a specialist.
common medical causes
of Proteinuria in Children
|Nephrotic Syndrome: is
a medical condition in which the kidneys leak protein into the urine.
The "basement membrane" of the kidney's filtering system, the
glomeruli, becomes leaky to proteins and these spill out into the
urine. The resultant low blood protein levels cause water to build up in
the tissues and the child becomes quite puffy. This disease often
follows a routine viral respiratory illness; the cause is not known but
is assumed to be an auto-immune phenomenon. In the majority of
cases the illness is self-limited. Steroids often produce rapid
improvement. Sometimes nephrosis is part of a larger problem of
inflammation of the kidney, and then favorable prognosis is more
|Acute postinfectious glomerulonephritis
is an inflammation
of the kidney (glomeruli) following a streptococcal infection such as strep
throat. Symptoms of acute poststreptococcal glomerulonephrists
- fluid accumulation and tissue swelling
initially in the face and around the eyes, later in the legs
- low urine output (oliguria)
- blood in the urine (hematuria)
- protein in the urine (proteinuria)
- high blood pressure
- joint pain
Most children (up to 95 percent) fully recover in a
matter of weeks or months.
|posted 09-10-03 on
As a reminder, this information should not be relied on as
medical advice and is not intended to replace the advice of your childs pediatrician.
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