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Erschienen in: Pediatric Nephrology 6/2010

01.06.2010 | Original Article

Orthostatic proteinuria and the spectrum of diurnal variability of urinary protein excretion in healthy children

verfasst von: John Robert Brandt, Aaron Jacobs, Hengameh H. Raissy, Franceska Marie Kelly, Amy Otten Staples, Ellen Kaufman, Craig Stephen Wong

Erschienen in: Pediatric Nephrology | Ausgabe 6/2010

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Abstract

The aim of this study was to characterize the 24-h and diurnal variability of urinary protein excretion and identify the prevalence of orthostatic proteinuria (OP) in healthy children. Upright, supine, and 24-h total urinary protein (UrTP) and creatinine clearance (CrCl) were measured in 91 healthy children ages 6–19 years. Urinary protein and creatinine excretions were calculated and examined by gender, age, Tanner stage, and body mass index (BMI). Orthostatic proteinuria (OP) was defined as a 24-h UrTP >100 mg/m2 with a normal supine UrTP (<4 mg/m2/h). There exists a marked diurnal variability in UrTP. The upright UrTP rate was three to four-times greater than the supine rate. UrTP, adjusted for body surface area, is higher in boys than girls and increases with age and BMI. There is a similar increase in upright CrCl compared with supine. Urinary protein to creatinine ratio (UPcr) is strongly correlated with UrTP. OP is common, being found in 20% of children in this cohort, and is more common in boys and associated with age >10 years and BMI >85%. In children with OP, a first morning UPcr shows a value in the normal range, whereas a random daytime UPcr is elevated. There exists a diurnal variability in urinary protein excretion that is exaggerated in participants with OP. UPcr reliably estimates 24-h UrTP. Using current pediatric criteria, OP is very common, particularly in boys. A normal first morning UPcr ratio indicates that a child with elevated random urinary protein has OP.
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Metadaten
Titel
Orthostatic proteinuria and the spectrum of diurnal variability of urinary protein excretion in healthy children
verfasst von
John Robert Brandt
Aaron Jacobs
Hengameh H. Raissy
Franceska Marie Kelly
Amy Otten Staples
Ellen Kaufman
Craig Stephen Wong
Publikationsdatum
01.06.2010
Verlag
Springer-Verlag
Erschienen in
Pediatric Nephrology / Ausgabe 6/2010
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-010-1451-z

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