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Orthostatic proteinuria: an overestimated phenomenon?
Zümrüt Arslan1, Mustafa Koyun2, Hakan Erengin3
1School of Medicine, Department of Pediatrics, Akdeniz University, Antalya, Turkey.
Pediatric Nephrology (Berlin, Germany)
|May 13, 2020
Summary
Orthostatic proteinuria (OP) is common in children, but this study found a lower prevalence (0.65%) than previously reported. Most cases resolve spontaneously, indicating OP is a benign condition.
Area of Science:
- Pediatric Nephrology
- Clinical Epidemiology
Background:
- Orthostatic proteinuria (OP) is the most common cause of proteinuria in children.
- Limited data exist on OP prevalence and long-term prognosis in healthy schoolchildren.
Purpose of the Study:
- Determine the prevalence of OP in healthy children aged 6-15 years.
- Evaluate the relationship between OP, age, gender, and body mass index (BMI).
- Assess the long-term follow-up and prognosis of OP.
Main Methods:
- Population-based, stratified, cluster-sampling of 1701 healthy children.
- Multiple random urine samples (up to three) to exclude transient proteinuria.
- First morning urine samples for definitive OP diagnosis.
Main Results:
- Proteinuria detected in 3.7% initially, persisting in 0.94% after repeat testing.
- Orthostatic proteinuria (OP) diagnosed in 0.65% of participants.
- OP prevalence showed a non-significant trend towards decrease with increasing BMI.
- All 7 re-evaluated OP cases showed no proteinuria after 3 years.
Conclusions:
- The study identified a lower OP prevalence (0.65%) than previously reported.
- At least three urine samples are recommended to exclude transient proteinuria before diagnosing OP.
- Orthostatic proteinuria is a benign condition with spontaneous resolution in most cases.
- Underweight children showed a tendency towards OP, warranting further investigation.
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