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Proteinuria in ChildrenAka: Pediatric Proteinuria

See Also
1. Proteinuria in Adults
Epidemiology: Proteinuria Incidence
1. School aged children: 5-6%
2. Adolescent peak: 11%
Causes
1. Transient Proteinuria (75%)
  1. Fever
  2. Exercise
  3. Dehydration
  4. Congestive Heart Failure
  5. Abdominal Surgery
  6. Extreme Cold
2. Orthostatic Proteinuria (60%)
3. Persistant Proteinuria
  1. Benign Proteinuria
  2. Acute Glomerulonephritis
  3. Interstitial Nephritis
  4. Structural Abnormalities
    1. Reflux nephropathy
    2. Renal Hypoplasia or dysplasia
    3. Polycystic Kidney Disease
    4. Hydronephrosis
Labs
1. Urinalysis (first morning void)
  1. See Urine Protein
2. Urine Protein to Creatinine Ratio (random urine)
3. Urine Protein 24 Hour collection
4. Consider ambulatory and recumbent Urinalysis
5. Serum Chemistry
  1. Electrolytes
  2. Renal Function
    1. Blood Urea Nitrogen
    2. Creatinine
  3. Cholesterol
  4. Serum Protein
  5. Serum Albumin
6. Complement level (C3)
7. Anti-streptolysin O titer (ASO Titer)
8. Antinuclear Antibody (ANA)
Referral Indications
1. Systemic signs
  1. Fever
  2. Edema
  3. Joint pain
2. Elevated Renal Function tests
3. Proteinuria with Hematuria
4. Persistent, non-Orthostatic Proteinuria
5. Family History
  1. Glomerulonephritis
  2. Renal Failure
  3. Renal transplant
6. Parental anxiety

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This page was written by Scott Moses, MD, and was last revised 1/13/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 5.0.