Proteinuria in Children

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Proteinuria is significant presence of protein in urine. Physiological proteinuria should not be higher than 100 mg/m2/24 hrs.[1]

Proteinuria can be:

  • glomerular proteinuria - usually albuminuria (selective),
  • tubular proteinuria - usually globulins and albumin (nonselective).
Glomerular proteinuria - based on proteins size.

Differential Diagnosis of Proteinuria in Children[✎ edit | edit source]

Mild Proteinuria[✎ edit | edit source]

As mild (or intermittent) proteinuria is classified every proteinuria < 0,5 g/m2/24 hrs. Typical causes of mild proteinuria in childhood are:

  • pyelonephritis,
  • renal cystic diseases,
  • obstructive uropathies,
  • mild glomerulonephritis.

Moderate Proteinuria[✎ edit | edit source]

As moderate proteinuria is clasified proteinurie 0,5 - 1,0 g/m2/24 hrs. Typical causes of moderate proteinuria in children are:

  • PSAGN - it is the most often cause of moderate proteinuria,
  • Henoch Schoenlein nephritis,
  • chronic glomerulonephritis,
  • HUS,
  • severe pyelonephritis.

Nephrotic Proteinuria[✎ edit | edit source]

Nephrotic proteinuria - typically more than 1 g/m2/24 hrs - is associated with nephrotic syndrome (proteinuria, hypoproteinaemia, hypercholesterolemia and edema). Diseases connected with nephrotic proteinuria are:


Management of child with proteinuria[✎ edit | edit source]

  • complete history and physical examination (previous pharyngitis → PSAGN, gastroenteritis → HUS, present edema, petechiae, hypertension ...)
  • confirmation of presence proteinuria (is necessary repeat urinalysis)
  • protein/creatinine ratio (from first morning urine sample), if P/C ratio is > 0,5, other evaluation is necessary:
    • serum electrolytes analysis, creatinine clearance, serum levels of cholesterol, total protein, albumin
    • streptozyme, C3, C4, ASLO analysis
    • renal ultrasonography

Links[✎ edit | edit source]

Related articles[✎ edit | edit source]

References[✎ edit | edit source]

  1. DOLEŽALOVÁ, Šárka. Nefrologie I [lecture for subject Peadiatrics, specialization Peadiatrics, 1 LF Charles University in Prague]. Prague. 2011-11-21. Avaliable from <http://kddl.lf1.cuni.cz/download/Nefrologie.I.pdf>. 

Bibliography[✎ edit | edit source]

  • KLIEGMAN, Robert M, et al. Nelson Essential of Pediatrics. 5th edition. Philadelphia : Elsevier, 2006. ISBN 1-4160-0159-X.