Adolescents with proteinuria and/or the nephrotic syndrome

Persistent proteinuria of various degrees of severity in adolescents should be regarded seriously, because recent evidence points to this abnormality's being associated with chronic kidney disease. However, it is also important for primary care physicians to be aware that most adolescents who are found to have proteinuria on a screening urinalysis do not have renal disease, and the proteinuria will usually resolve on repeat testing. Appropriate measures to determine whether the proteinuria is fixed and not orthostatic can and should be conducted expeditiously, because they will allay stress for most patients. For the minority of patients in whom more serious forms of proteinuria exist, timely consultation with a pediatric nephrologist is recommended.