The Teenager With Asymptomatic Proteinuria: Think Orthostatic First

Sebestyén, Judith; Alon, Uri

doi:10.1177/0009922810380904

Cited by 18 publications

(15 citation statements)

References 19 publications

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“…However, proteinuria is not always related to LN. Orthostatic proteinuria or postural proteinuria is the most common cause of proteinuria in teenagers, and should therefore be excluded as a cause of mild proteinuria in patients with (suspected) cSLE (19,20). If proteinuria is not orthostatic, confirmation and classification of renal involvement with consultation with paediatric nephrologist is recommended, proceeding to a percutaneous renal biopsy.…”

Section: Recommendations For Lupus Nephritis -Diagnosis (Table 1)mentioning

confidence: 99%

Європейські Доказові Рекомендації По Діагностиці Та Лікуванню Люпус-Нефриту У Дітей: Ініціатива SHARE

Groot¹,

Graeff²,

Marks³

2021

KIDNEYS

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Section: Recommendations For Lupus Nephritis -Diagnosis (Table 1)mentioning

confidence: 99%

Європейські Доказові Рекомендації По Діагностиці Та Лікуванню Люпус-Нефриту У Дітей: Ініціатива SHARE

Groot¹,

Graeff²,

Marks³

2021

KIDNEYS

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“…First, the vast majority (75–95%) of proteinuria in children and adolescents is due to benign causes such as transient and orthostatic proteinuria. [18–22] Transient proteinuria may be associated with exercise, fever, cold, stress, dehydration or seizure and is reported to occur in as many as 50–74% of cases of observed proteinuria in children and adolescents. [18, 20] Orthostatic proteinuria, another etiology of benign childhood proteinuria, is reported in 6–20% [23] of healthy children and adolescents and leads to no adverse outcomes after up to 50 years of follow-up.…”

Section: Natural Historymentioning

confidence: 99%

Diabetic kidney disease in children and adolescents

Afkarian

2014

Pediatr Nephrol

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Diabetes, more frequently type 1 but increasingly also type 2, commonly occurs in childhood. While more advanced diabetic kidney disease (DKD), e.g. loss of glomerular filtration rate (GFR), does not occur until adulthood, kidney biopsies show DKD structural changes as early as 1.5–5 years after the onset of type 1 diabetes. Earliest clinical sign of DKD, e.g. increased urine albumin excretion, commonly appears during childhood and adolescence and presents an important opportunity to detect and intervene on early DKD, perhaps more successfully than later in the disease course. Longitudinal studies of type 1 diabetes have enriched our understanding of the DKD natural history and modifiable risk factors for DKD progression. These studies have also shown that presence of DKD marks a subset of people with diabetes who are at the highest risk of early mortality, supporting an enhanced focus on DKD detection, prevention, and treatment. Early studies suggest that youth-onset type 2 diabetes is associated with a higher prevalence of comorbidities and risk factors and follows a more aggressive natural history. A deeper understanding of the natural history, risk factors, underlying mechanisms and therapeutic options for DKD in young-onset type 2 diabetes awaits further studies.

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“…Transient proteinuria is benign and non-pathologic and is usually after infantile febrile seizure, exposure to rigid cold, and strenuous exercise. [1617] These conditions require no specific therapy and need only health maintenance follow-up.…”

Section: Discussionmentioning

confidence: 99%

Simplified algorithm for evaluation of proteinuria in clinical practice: How should a clinician approach?

Mazaheri

Assadi

2019

Int J Prev Med

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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.

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The Teenager With Asymptomatic Proteinuria: Think Orthostatic First

Cited by 18 publications

References 19 publications

Європейські Доказові Рекомендації По Діагностиці Та Лікуванню Люпус-Нефриту У Дітей: Ініціатива SHARE

Європейські Доказові Рекомендації По Діагностиці Та Лікуванню Люпус-Нефриту У Дітей: Ініціатива SHARE

Diabetic kidney disease in children and adolescents

Simplified algorithm for evaluation of proteinuria in clinical practice: How should a clinician approach?

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