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What is proteinuria in children?

Proteinuria is when protein is found in your child’s urine. All children have a little protein in their urine. But too much may signal a problem with your child’s kidneys. Kidneys are organs that filter out waste, extra fluid, and salt. These wastes leave the body through urine.

Sometimes older children can have orthostatic proteinuria. Orthostatic means “upright.” It’s called “orthostatic proteinuria” because protein goes into the urine only when the child is standing up. Children who have this condition have no kidney damage. But for some unknown reason, they lose protein into the urine during the day when they are active. At night, while they sleep, their kidneys don’t release protein into the urine.

SYMPTOMS

You can’t see protein in your child’s urine. However, it can be associated with swelling in his or her eyelids, ankles, and legs. High blood pressure is another sign of this condition. Proteinuria doesn’t cause pain.

CAUSES

What causes proteinuria in children?

Sometimes infection or chemicals damage the kidneys. This affects how well the kidneys work. If your child has an infection, their proteinuria will go away once the infection is treated.

Protein in the urine also can be associated with type 1 and type 2 diabetes. Tell your healthcare provider if your child has been excessively thirsty, hungry, unintentionally lost weight, or has fruity-smelling breath. These can be signs of type 1 diabetes.

DIAGNOSIS

How is proteinuria diagnosed?

Because you can’t see protein in your child’s urine, it must be diagnosed with a urine test. For this test, a sample of your child’s urine will be collected for diagnosis.

After the first test, your healthcare provider may want to recheck your child’s urine for protein. That’s because the protein will often go away on its own (transient proteinuria). If the protein is still high on the second test, your healthcare provider may ask you to collect a 24-hour urine sample from your child.

Your healthcare provider may test your child’s blood. They may also order an ultrasound or CT scan. These two procedures take pictures of your child’s kidneys and surrounding area to look for problems. These procedures aren’t painful.

To diagnose orthostatic proteinuria, your child’s healthcare provider will check 2 urine samples. The first is collected in the morning, right after your child gets up. The second sample is collected throughout the day. The samples are kept in separate containers. If your child has orthostatic proteinuria, the morning sample won’t have protein in it, but the urine collected during the day will have protein in it.

PREVENTION

Can proteinuria in children be prevented or avoided?

Proteinuria can’t be prevented or avoided. However, you can practice good kidney health by drinking lots of water every day. This will flush waste out of your kidneys.

TREATMENT

How is proteinuria treated?

If tests show your child has orthostatic proteinuria or only small amounts of protein in their urine, no treatment is needed.

If tests show a large amount of protein in your child’s urine, and they have swelling of the legs and eyelids, your healthcare provider may send your child to a kidney specialist (called a nephrologist). The nephrologist may perform a kidney biopsy. During this simple surgical procedure, a small piece of kidney tissue is removed. They will look at the piece under a microscope. This may help them find out what is causing the protein in your child’s urine When your healthcare provider finds out what causes the protein in your child’s urine, they can treat the problem.

Living with proteinuria in children

If your child has proteinuria in the urine, their activity level won’t need to change. They may feel uncomfortable because of swollen eyelids, ankles, or legs, but your healthcare provider can treat those issues.