Simplified algorithm for evaluation of proteinuria in clinical practice: How should a clinician approach?
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 adol...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2019-01-01
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| Series: | International Journal of Preventive Medicine |
| Subjects: | |
| Online Access: | http://www.ijpvmjournal.net/article.asp?issn=2008-7802;year=2019;volume=10;issue=1;spage=35;epage=35;aulast=Mazaheri |
| _version_ | 1818057852487467008 |
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| author | Mojgan Mazaheri Farahnak Assadi |
| author_facet | Mojgan Mazaheri Farahnak Assadi |
| author_sort | Mojgan Mazaheri |
| collection | DOAJ |
| description | 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. Of the 64 reviewed articles, 24 studies were eligible for inclusion. Results: Random spot urine protein-to-creatinine (PCR) ratio is widely used to reliably detect proteinuria. The normal value for the spot PCR in children aged 2 years or older is less than 0.3. In children aged below 2 years, the PCR can be as high as 0.5. Orthostatic proteinuria is defined as urine PCR greater than 0.3 detected in a urine specimen during the daytime activity but less than 0.3 on the first morning void specimen. PCR above 3.0 signifies heavy proteinuria as seen in 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. Conclusions: We provide a simplified diagnostic algorithm for evaluation of proteinuria in primary care adolescents who appear well and in whom proteinuria is incidentally discovered during a routine examination. |
| first_indexed | 2024-12-10T12:51:19Z |
| format | Article |
| id | doaj.art-7240634158db4f469dc8dc8391234cd0 |
| institution | Directory Open Access Journal |
| issn | 2008-7802 2008-8213 |
| language | English |
| last_indexed | 2024-12-10T12:51:19Z |
| publishDate | 2019-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | International Journal of Preventive Medicine |
| spelling | doaj.art-7240634158db4f469dc8dc8391234cd02022-12-22T01:48:14ZengWolters Kluwer Medknow PublicationsInternational Journal of Preventive Medicine2008-78022008-82132019-01-01101353510.4103/ijpvm.IJPVM_557_18Simplified algorithm for evaluation of proteinuria in clinical practice: How should a clinician approach?Mojgan MazaheriFarahnak AssadiBackground: 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. Of the 64 reviewed articles, 24 studies were eligible for inclusion. Results: Random spot urine protein-to-creatinine (PCR) ratio is widely used to reliably detect proteinuria. The normal value for the spot PCR in children aged 2 years or older is less than 0.3. In children aged below 2 years, the PCR can be as high as 0.5. Orthostatic proteinuria is defined as urine PCR greater than 0.3 detected in a urine specimen during the daytime activity but less than 0.3 on the first morning void specimen. PCR above 3.0 signifies heavy proteinuria as seen in 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. Conclusions: We provide a simplified diagnostic algorithm for evaluation of proteinuria in primary care adolescents who appear well and in whom proteinuria is incidentally discovered during a routine examination.http://www.ijpvmjournal.net/article.asp?issn=2008-7802;year=2019;volume=10;issue=1;spage=35;epage=35;aulast=Mazaheriadolescentsalgorithmasymptomatic proteinuriachildren |
| spellingShingle | Mojgan Mazaheri Farahnak Assadi Simplified algorithm for evaluation of proteinuria in clinical practice: How should a clinician approach? International Journal of Preventive Medicine adolescents algorithm asymptomatic proteinuria children |
| title | Simplified algorithm for evaluation of proteinuria in clinical practice: How should a clinician approach? |
| title_full | Simplified algorithm for evaluation of proteinuria in clinical practice: How should a clinician approach? |
| title_fullStr | Simplified algorithm for evaluation of proteinuria in clinical practice: How should a clinician approach? |
| title_full_unstemmed | Simplified algorithm for evaluation of proteinuria in clinical practice: How should a clinician approach? |
| title_short | Simplified algorithm for evaluation of proteinuria in clinical practice: How should a clinician approach? |
| title_sort | simplified algorithm for evaluation of proteinuria in clinical practice how should a clinician approach |
| topic | adolescents algorithm asymptomatic proteinuria children |
| url | http://www.ijpvmjournal.net/article.asp?issn=2008-7802;year=2019;volume=10;issue=1;spage=35;epage=35;aulast=Mazaheri |
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