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Proteinuria in ChildrenAka: Pediatric Proteinuria

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  1. See Also
    1. Proteinuria in Adults
  2. Epidemiology: Proteinuria Incidence
    1. School aged children: 5-6%
    2. Adolescent peak: 11%
  3. 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
  4. 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)
  5. 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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