Podcast 70: Proteinuria in Children

Dear Listeners,

An estimated 10% of school-aged children will have proteinuria. About 0.1% of them will have persistent hematuria requiring further investigation.

Transient proteinuria can be caused by stress, exercise, cold exposure, dehydration, and orthostasis.

Persistent proteinuria can be caused by Glomerular or Tubular Disease. Glomerular disease is most common with differential including infections (Strep Throat, Mono), collagen vascular diseases (HSP, SLE), glomerulopathies and malignancies. Tubular disease is usually caused by exposure to medications such as NSAIDs, or antibiotics.

A positive dipstick or urinalysis should always be verified with a morning sample to rule out orthostatic or transient proteinuria. If persistence is noted, this should be followed up with a Protein/Creatinine ratio to assess severity of the disease. A Renal ultrasound is helpful in ruling out structural causes such as malignancy and PCKD. Treatment is variable and diagnosis dependent. It will be usually be decided by a nephrologist or a paediatrician.

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Posted on 03/12/2020 by Dr. Dimitre