Simplified algorithm for evaluation of asymptomatic persistent isolated proteinuria

Background - Proteinuria is a common laboratory finding among children and adolescents. It can be identified as either a transient or a persistent finding and can represent a benign condition or a serious disease.Methods – Pertinent medical literature for asymptomatic proteinuria in children and adolescents published in English was searched between January 1980 and May 2017 using PubMed, MEDLINE, EMBASE, and Google Scholar research databases.Results - Proteinuria has numerous etiologies, but nonspecific symptoms. Random spot urine protein-to creatinine (Pr/Cr) ratio is widely used to detect proteinuria. In adults and children over two years of age, spot urine Pr/Cr < than 0.3 is considered normal. In children aged six months to two years, the upper limit of normal is 0.5. Orthostatic proteinuria is defined as urine Pr/Cr> 0.3 detected during the day time activity but <0.3 on the first morning urine specimen. Urine Pr/Cr above 3.0 is found in patients with nephrotic syndrome.Orthostatic proteinuria is a frequent cause of proteinuria in asymptomatic children and adolescents, which require no specific therapy except for health maintenance follow-up. Pediatric nephrologist referral is indicated when the proteinuria is constant and persists over 6 months or is associated with hematuria, hypertension or renal dysfunction.Conclusion - we provide a simplified diagnostic algorithm for evaluation of proteinuria in children who appear well and in whom proteinuria is incidentally discovered during a routine examination

Keywords:

Adolescent , Algorithms , Adolescent , Child , Proteinuria