Assessment of urinary protein excretion in the adolescent: effect of body position and exercise

We examined the effects of body position and exercise on the random urinary protein/creatinine ratio (Up/Ucr) in healthy adolescents, to provide reference data to be used in a simplified evaluation of proteinuria. Random urine samples were obtained during recumbency and after both ambulation and exercise in 116 subjects. The Up/Ucr was significantly (P less than 0.0001) higher with increasing levels of activity, and was widely variable, especially during the upright and postexercise periods. No sex-related differences in Up/Ucr were noted, except during recumbency, when values were significantly (P less than 0.001) higher in females. The urinary dipstick was found to be less sensitive as a tool to define abnormal degrees of recumbent proteinuria. We conclude that body position and exercise have significant effects on protein excretion, and suggest that the Up/Ucr in recumbent and upright urine samples will be useful in the evaluation of proteinuria.